Open Access Research article

From planning to practice: building the national network for the surveillance of severe maternal morbidity

Samira M Haddad1, José G Cecatti12*, Mary A Parpinelli1, João P Souza3, Maria L Costa1, Maria H Sousa2, Fernanda G Surita1, João L Pinto e Silva1, Rodolfo C Pacagnella1, Rodrigo S Camargo1, Maria V Bahamondes2, Vilma Zotareli2, Lúcio T Gurgel1, Lale Say3, Robert C Pattinson4 and National Network for the Surveillance of Severe Maternal Morbidity Group1

Author Affiliations

1 Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil

2 Campinas Center for Studies in Reproductive Health (CEMICAMP), Campinas, Brazil

3 UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland

4 MRC Maternal and Infant Health Care Strategies Research Unit, University of Pretoria, Gauteng, South Africa

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BMC Public Health 2011, 11:283  doi:10.1186/1471-2458-11-283

Published: 8 May 2011



Improving maternal health is one of the Millennium Development Goals for 2015. Recently some progress has been achieved in reducing mortality. On the other hand, in developed regions, maternal death is a relatively rare event compared to the number of cases of morbidity; hence studying maternal morbidity has become more relevant. Electronic surveillance systems may improve research by facilitating complete data reporting and reducing the time required for data collection and analysis. Therefore the purpose of this study was to describe the methods used in elaborating and implementing the National Network for the Surveillance of Severe Maternal Morbidity in Brazil.


The project consisted of a multicenter, cross-sectional study for the surveillance of severe maternal morbidity including near-miss, in Brazil.


Following the development of a conceptual framework, centers were selected for inclusion in the network, consensus meetings were held among the centers, an electronic data collection system was identified, specific software and hardware tools were developed, research material was prepared, and the implementation process was initiated and analyzed.


The conceptual framework developed for this network was based on the experience acquired in various studies carried out in the area over recent years and encompasses maternal and perinatal health. It is innovative especially in the context of a developing country. The implementation of the project represents the first step towards this planned management. The system online elaborated for this surveillance network may be used in further studies in reproductive and perinatal health.

surveillance network; severe maternal morbidity; near-miss; multicenter cross-sectional study