THE KERALA STORY

Kerala has been a pioneer in strengthening maternal health systems in India through the implementation of a confidential review mechanism for maternal deaths—an initiative that remains one of the first and most sustained efforts of its kind in the country.

The initative was launched on Oct 18th 2003 ,when a meeting was held at DHS office with great stalwarts fro WHO Dr Philpot and Gwyneth Lewis and stalwarts from KFOG Dr V P Paily,Dr Rajsekharan Nair,Dr P K Sekharan , Dr Presannakumari, Dr N Syamala Devi etc Under this initiative a government order was passed into Confidential Enquiry into the Maternal death on 19/12/2003 .

Launched in 2004 under the visionary leadership of Prof. Dr. V. P. Paily, the confidential review of maternal deaths in Kerala was designed to go beyond routine audits. The approach emphasizes a non-punitive, anonymous, and in-depth analysis of each maternal death to identify systemic gaps and preventable factors, rather than attributing individual blame.This initiative is carried forward by a dedicated, multidisciplinary team of doctors and healthcare professionals across the state.

Through regular and structured reviews, the program has enabled critical insights into delays in care, clinical decision-making, referral systems, and resource availability. The findings are then translated into actionable recommendations aimed at improving the quality of obstetric care at all levels.

Over the years, this sustained effort has contributed significantly to Kerala’s achievements in maternal health, including maintaining one of the lowest maternal mortality ratios in India. The model has also inspired similar review mechanisms in other parts of the country.

The confidential review system in Kerala stands as a benchmark for collaborative, evidence-based, and ethically grounded maternal death surveillance—demonstrating how continuous professional commitment and system-level introspection can drive meaningful change in public health.

GLIMPSIS OF MEETING HELD OVER THE YEARS

The analyses of maternal deaths of the first three years, which included a detailed account of causes of death and proposed remedial actions, were published in a groundbreaking work titled “Why Mothers Die.”

Four volumes of “Why Mothers Die” have been published to date. These publications have brought us national and international recognition and we are all proud of our achievements.

Since 2025,Prof Presanna Kumary is chairperson of Safe Motherhood committee and the secretary of CRMD is Prof Jyoti Ramesh Chandran.Under this leadership till now 4 CRMD programs have been conducted at Thiruvananthapuram on 11th May 2025,Kannur on 24th Aug 2025, Cochin on 13th Dec 2025 and Calicut on 15th March 2026