Strategic Informatics for Maternal Mortality Tracking in Africa

Abstract

Maternal mortality remains a critical public health crisis, particularly in Sub-Saharan Africa, where the burden is disproportionately high. Accurate and timely data are fundamental to understanding the causes of maternal deaths, identifying at-risk populations, and implementing effective interventions. However, existing tracking systems often suffer from fragmentation, data quality issues, and limited analytical capacity. This white paper argues for the strategic integration of health informatics to revolutionize maternal mortality tracking. It presents a conceptual framework and highlights key informatics solutions, including robust data collection platforms, advanced analytics, and digital health tools. By leveraging these innovations, African nations can significantly improve the precision of maternal death surveillance, enhance response mechanisms, and accelerate progress towards the Sustainable Development Goal (SDG) targets for maternal health, ultimately saving countless lives.

Introduction

The death of a mother during pregnancy, childbirth, or the postpartum period is a profound tragedy with devastating consequences for families, communities, and national development. Despite global efforts, maternal mortality remains unacceptably high, with Sub-Saharan Africa accounting for approximately 70% of all maternal deaths worldwide (Africanews, 2025). The Sustainable Development Goal (SDG) 3.1 aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030; however, at the current rate, Africa is projected to fall significantly short of this target (WHO Regional Office for Africa, 2025).

A fundamental barrier to addressing this crisis is the inadequacy of current maternal mortality tracking and surveillance systems. Without precise, real-time data on who is dying, where, and why, public health interventions cannot be effectively targeted or evaluated. Health informatics, the interdisciplinary field that uses information technology to organize and analyze health data, offers a powerful solution to these challenges. By transforming fragmented data into actionable insights, informatics can empower healthcare providers, policymakers, and communities to make informed decisions that directly impact maternal survival. This white paper delves into the critical role of informatics in improving maternal mortality tracking, focusing on its particular relevance and potential impact across the African continent.

Background: The Complexities of Maternal Mortality Tracking in Africa

Tracking maternal deaths in Africa is fraught with complexities stemming from a confluence of systemic, infrastructural, and socio-cultural factors:

• Underreporting and Misclassification: Many maternal deaths occur outside formal health facilities, particularly in rural or remote areas, making their capture challenging. When deaths are recorded, the precise cause may be misclassified due to limited diagnostic capabilities or inadequate training of healthcare personnel. This leads to a significant underestimation of the true burden and obscures the underlying causes (Number Analytics, 2025a).

• Fragmented and Inconsistent Data Systems: Data related to pregnancy, childbirth, and postpartum care are often collected through a patchwork of paper-based records, disparate facility-level electronic systems, and community health worker reports. These systems frequently lack interoperability, leading to data silos, duplication, and inconsistencies. The absence of a unified data architecture makes it difficult to link information across the continuum of care, from antenatal visits to delivery outcomes and postnatal follow-up (Henao et al., 2025).

• Limited Data Quality and Timeliness: Manual data entry, lack of standardized reporting protocols, and insufficient data validation processes contribute to poor data quality. Delays in data aggregation and analysis mean that insights are often outdated by the time they reach decision-makers, hindering rapid response to emerging issues or localized crises (Number Analytics, 2025b).

• Inadequate Human and Technical Capacity: Many African health systems face critical shortages of trained personnel in data management, biostatistics, and health informatics. Even where digital systems exist, the capacity to effectively utilize, analyze, and interpret complex datasets for programmatic action is often limited (PubMed Central, 2025).

• Resource Constraints: Implementing and sustaining robust informatics solutions requires significant financial investment in infrastructure, software, and human resources—a challenge for many low-income countries (Africanews, 2025).

Despite these challenges, there is a growing momentum for digital transformation in health across Africa. Tanzania's success in significantly reducing maternal mortality through initiatives like Maternal and Perinatal Death Reviews and Surveillance (MPDSR), which involve systematic recording and discussion of every death, highlights the potential of data-driven approaches even with existing limitations (Africa CDC, 2025). This demonstrates that with strategic application, informatics can provide the necessary tools to overcome these barriers and drive tangible improvements in maternal health outcomes.

Strategic Imperative: Leveraging Informatics for Improved Tracking

Health informatics offers a multi-faceted approach to addressing the challenges in maternal mortality tracking, moving beyond simple data collection to sophisticated analysis and actionable intelligence.

1. Robust Data Collection and Integration Platforms

The foundation of improved tracking lies in establishing integrated, standardized data collection systems.

• Electronic Health Records (EHRs): Implementing comprehensive EHR systems in health facilities allows for standardized, real-time capture of patient-level data, including antenatal care visits, delivery details, complications, and postnatal follow-up. This moves away from fragmented paper records and enables longitudinal tracking of individual women (Number Analytics, 2025b).

• Mobile Health (mHealth) Solutions: For community-level data collection, mHealth applications on smartphones or tablets can empower community health workers (CHWs) to record vital information, identify pregnant women, track their progress, and report births and deaths in real-time, even in remote areas. These tools can also facilitate two-way communication between CHWs and health facilities, ensuring timely referrals for high-risk pregnancies or complications (Deloitte, 2024; ResearchGate, 2024). Examples like South Africa's MomConnect and NurseConnect demonstrate the power of SMS-based solutions in linking pregnant women to care (ResearchGate, 2024).

• Interoperability Standards: Crucially, data from EHRs, mHealth apps, laboratory systems, and civil registration vital statistics (CRVS) systems must be able to communicate seamlessly. Adopting international interoperability standards (e.g., HL7 FHIR) and developing robust APIs are essential for creating a unified view of maternal health data (Henao et al., 2025).

• Maternal Death Surveillance and Response (MDSR) Systems: Strengthening MDSR systems is paramount. Informatics can digitize the entire MDSR cycle: from immediate notification of suspected maternal deaths, to systematic review by local committees, aggregation and analysis of findings, development of recommendations, and monitoring of implementation. This ensures that every maternal death is not just counted, but thoroughly investigated to identify preventable factors and inform targeted responses (Number Analytics, 2025a; PubMed Central, 2024).

2. Advanced Analytical Techniques and Tools

Beyond data collection, the power of informatics lies in transforming raw data into meaningful insights.

• Descriptive Analytics and Dashboards: Interactive dashboards and visualization tools (e.g., Power BI, Tableau, or custom web interfaces) can provide real-time snapshots of key maternal health indicators. These include maternal mortality ratios, causes of death, antenatal care coverage, skilled birth attendance rates, and geographical distribution of deaths. Such visualizations make complex data accessible to a wide range of stakeholders, from frontline health workers to national policymakers (Number Analytics, 2025b).

• Spatial Analytics (GIS): Integrating Geographic Information Systems (GIS) with maternal health data allows for the mapping of maternal deaths, healthcare facility locations, and population density. This can reveal geographical hotspots, identify areas with limited access to emergency obstetric care, and inform the strategic placement of resources or outreach programs (Number Analytics, 2025b).

• Predictive Analytics and Machine Learning (ML): Leveraging historical data, ML algorithms can identify patterns and predict women at higher risk of adverse maternal outcomes based on demographic factors, medical history, and real-time physiological data (e.g., from wearable devices). This enables proactive interventions, such as closer monitoring or timely referrals (PubMed Central, 2025a).

• Text Analytics (NLP): Applying Natural Language Processing (NLP) to unstructured clinical notes or verbal autopsy reports can extract critical information on contributing factors to maternal deaths that might otherwise be missed. This provides richer qualitative insights to complement quantitative data.

3. Capacity Building and Data Governance

Technological solutions are only as effective as the human capacity to utilize them and the governance structures that ensure their ethical use.

• Training and Education: Comprehensive training programs are essential for all levels of the health workforce—from CHWs on mobile data entry to clinicians on EHR use, and public health professionals on data analysis and interpretation. This builds local expertise and fosters a data-use culture.

• Data Quality Assurance: Implementing automated data validation rules within systems, coupled with regular data audits and feedback mechanisms, is crucial for maintaining high data quality.

• Data Governance and Ethics: Establishing clear policies and protocols for data collection, storage, access, sharing, and security is paramount, especially given the sensitive nature of health information. Adhering to ethical guidelines and ensuring data privacy and confidentiality are non-negotiable (CDC, 2024).

Case Study: MatriCare's Informatics Transformation

Setting: MatriCare, a hypothetical low-income country in West Africa, grappling with persistently high maternal mortality rates, particularly in its rural and hard-to-reach regions. Its health system was characterized by a mix of public and private facilities, with largely paper-based record-keeping and delayed, incomplete reporting.

Problem Statement: MatriCare's Ministry of Health recognized that its inability to accurately track maternal deaths and understand their root causes was severely hampering efforts to improve maternal health outcomes. There was a critical need for a system that could provide timely, granular, and actionable data.

The Informatics Initiative: In partnership with international development organizations and local technology firms, MatriCare launched a national informatics initiative for maternal health, focusing on a phased approach:

1. Phase 1: Digitizing Data Collection at Point-of-Care:

   • Piloted a robust mHealth application for community health workers (CHWs) to register all pregnancies, track antenatal care attendance, and report births and any adverse maternal events in real-time, even offline.

   • Introduced simplified EHR modules in primary health centers and district hospitals for capturing delivery details, complications, and immediate postnatal care.

   • Implemented unique patient identifiers to enable linkage of data across different points of care.

2. Phase 2: Centralized Data Platform and Analytics:

   • Established a centralized data warehouse, leveraging an enhanced national DHIS2 instance, to integrate data from mHealth apps, EHRs, and vital registration offices.

   • Developed interactive dashboards for district, regional, and national health managers, visualizing maternal mortality ratios, causes of death, and geographical distribution. These dashboards allowed for disaggregation by age, parity, and HIV status, providing granular insights.

   • Integrated GIS capabilities to create "maternal mortality maps," highlighting hotspots and areas with limited access to emergency obstetric care.

3. Phase 3: Enhanced Surveillance and Response:

   • Digitized the MDSR process, enabling immediate electronic notification of suspected maternal deaths. Review committees could access relevant patient data directly from the integrated platform, streamlining investigations.

   • Implemented automated alerts for high-risk pregnancies or delayed follow-up, prompting CHWs or facility staff to intervene proactively.

   • Conducted regular data review meetings at all levels, fostering a culture of data-driven decision-making.

Results and Impact:

Within three years, MatriCare witnessed significant improvements:

• Increased Reporting and Accuracy: The proportion of maternal deaths officially reported increased by 30%, and the completeness of data on causes of death improved by 25%, providing a more accurate picture of the maternal mortality burden.

• Targeted Interventions: Spatial analysis identified specific sub-districts with high maternal mortality rates linked to long distances to health facilities. This led to the strategic deployment of mobile clinics and the establishment of new maternity waiting homes, resulting in a 12% reduction in facility-based maternal deaths in these areas.

• Improved Quality of Care: Data from MDSR reviews highlighted common preventable factors, such as delays in referral or inadequate management of postpartum hemorrhage. These insights informed targeted training for healthcare providers and improvements in emergency obstetric care protocols, leading to a 15% reduction in case fatality rates for major obstetric complications.

• Proactive Risk Management: The automated alert system led to a 20% increase in timely referrals for high-risk pregnancies, preventing potential complications.

• Evidence-Based Policy: Policymakers used the real-time data to advocate for increased funding for maternal health services and to revise national guidelines on antenatal care and emergency obstetric care, aligning them with identified needs.

Discussion

The MatriCare case study exemplifies how a comprehensive informatics approach can fundamentally transform maternal mortality tracking and response in African contexts. The success hinged on several critical factors:

• Holistic Approach: Integrating data from community, facility, and civil registration levels provided a complete picture, addressing the issue of underreporting.

• User-Centric Design: The mHealth tools were designed with input from CHWs, ensuring usability and relevance to their daily tasks, fostering high adoption rates.

• Actionable Insights: The focus was not just on collecting data, but on generating clear, digestible, and actionable insights that directly informed decision-making at all levels of the health system.

• Sustainability through Capacity Building: Investing in local human capacity for data management, analysis, and system maintenance ensured the long-term viability of the initiative.

• Strong Partnerships: Collaboration between the Ministry of Health, technology partners, and funding organizations provided the necessary resources and technical expertise.

Despite these successes, challenges remain. Ensuring the long-term sustainability of digital infrastructure, managing data security and privacy in increasingly interconnected systems, and adapting to evolving technological landscapes will require continuous investment and strategic planning. Furthermore, addressing the digital divide to ensure equitable access to digital health tools, particularly for the most vulnerable populations, is an ongoing imperative. The experience underscores that while technology provides powerful tools, it is the strategic application, human capacity, and robust governance that truly drive improved public health outcomes.

Conclusion

Improving maternal mortality tracking through informatics is not merely an option but a strategic imperative for African nations committed to safeguarding the lives of mothers. By embracing integrated data platforms, leveraging advanced analytical techniques, and investing in human capacity and robust data governance, countries can move beyond fragmented reporting to real-time, actionable intelligence. The hypothetical case study of MatriCare demonstrates the profound impact of such a transformation: leading to more accurate data, targeted interventions, improved quality of care, and ultimately, a significant reduction in preventable maternal deaths. As the global community strives to achieve the SDG targets for maternal health, the strategic adoption of health informatics will be the cornerstone of building resilient, responsive health systems that ensure every mother has the chance to give life safely and thrive.

References

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