Background
The national Maternal and Perinatal Death Surveillance and Response (MPDSR) committee serves as the formal coordination mechanism within the Ministry of Health for reviewing maternal and perinatal deaths across referral hospitals and provincial health offices. MPDSR review sessions in Cambodia promote a no-blame culture combined with defined accountability measures to convert findings into follow-up actions.
Case investigations routinely apply the three delays framework to identify delays in deciding to seek care, reaching care, and receiving timely, appropriate treatment. The MPDSR process links clinical case review to operational recommendations aimed at improving antenatal risk identification, referral coordination, and facility-level service capacity.
Key Developments
On 10 July 2026, the national MPDSR committee convened a joint review with the National Pediatric Hospital and Ratanakiri provincial health authorities to examine maternal and perinatal death cases around birth and response arrangements. The meeting was chaired by the Secretary of State at the Ministry of Health, who leads the national MPDSR committee, and included representatives from national and provincial MPDSR committees, hospital-level committees, district health offices and health centres, totaling 78 participants.
The group reviewed findings using the three delays approach and highlighted areas of good practice alongside specific gaps. The meeting produced four operational recommendations: prioritize active risk assessment and follow-up for high-risk pregnant women during antenatal care; ensure district and facility teams discuss and coordinate support for identified at-risk pregnancies; increase resources and staff capacity to deliver quality maternal and newborn services; and strengthen inter-hospital collaboration to build staff skills and investigate risk factors using standardized colour-coded risk stratification.
Operational Implications
Implementing the committee’s recommendations requires routine ANC-based risk screening with documented follow-up contact, formal case discussion mechanisms across district and referral facilities, and targeted capacity-strengthening of clinical and referral pathways. Standardising risk stratification (for example, by agreed colour codes) is intended to improve triage and referral decisions between community-level providers and referral hospitals.
These measures are governance tools that translate case-review findings into practical changes in service delivery and inter-facility coordination without altering formal regulatory instruments.
Official Source
Ministry of Health announcement via social media: https://www.facebook.com/MinistryofHealthofCambodia/posts/pfbid02ZkRAyZZat7tAmdhKEJSARyuaUqsMB6tJKGmkzqqKmvW6G9Lu1Lh1FE6fHPpRNpF6l
