Challenges in the epidemiological surveillance of maternal mortality in Bolivia: a retrospective analysis

Abstract

Objective: To address the challenges in epidemiological surveillance of maternal mortality in Bolivia, highlighting the importance of improving this process and highlighting the lack of updated data. Methods: This is a descriptive, retrospective study using data from the National Health Information and Epidemiological Surveillance System (SNIS-VE) of the Bolivian Ministry of Health and Sports. Two periods were examined: 2001-2014 and 2015-2022, with an emphasis on changes introduced in the SNIS-VE, such as the categorisation of reported and confirmed maternal deaths. Results: A deterioration in epidemiological surveillance was observed in 2020 and 2021 due to the COVID-19 pandemic. The situation varied between departments and levels of care, highlighting regional differences and differences in the quality of registration systems. These findings underline the complexity of epidemiological surveillance of maternal mortality in Bolivia. Conclusions: This study highlights the urgent need to improve the epidemiological surveillance of maternal mortality in Bolivia, improve the registration by the statistics department to avoid under-registration and strengthen the organization and operation of the Technical Committees for Maternal Mortality Surveillance, to in order to improve the Epidemiological Surveillance process in its different stages. These efforts are essential to move towards safer and more effective maternal care in Bolivia.