When a mother or newborn dies in hospital, the tragedy affects not just the family, it also impacts the health workers who cared for them.

Doctors, nurses and midwives are left asking the same question: what can we learn from this case to prevent another family from experiencing the same loss?

Through the Maternal and Newborn Death Surveillance and Response (MNDSR) system, health teams across Afghanistan come together to review each case, identify gaps in care and agree on practical changes.

For Farzana, a midwife at Nangarhar provincial hospital, reviewing the death of a mother or newborn is never easy. “We remember each case,” she says. “But when we sit together and look carefully at what happened, we can at least assess what needs to be improved.”

With financial support from the Asian Development Bank (ADB), technical support from WHO, and in collaboration with national health authorities, this approach has been strengthened across hospitals and provincial public health directorates.

Since World Health Organization (WHO)-supported MNDSR work in Afghanistan began in 2003 more than 900 health workers and managers have been trained and teams in 50 supported hospitals have reviewed maternal and newborn deaths to better understand why they happened and what improvements need to be implemented.

The reviews highlight challenges such as haemorrhage, eclampsia and sepsis among mothers, and prematurity, birth asphyxia and neonatal sepsis among newborns. MNDSR findings are shared with health workers and hospital managers, helping them reflect on each case and identify practical ways to improve care. As a result, hospitals have strengthened referral systems, improved clinical practices and enhanced support for mothers and newborns most at risk.