Bangladesh initiated the implementation of the maternal and perinatal death review (MPDR) system in 2010 with the aim of achieving the Millennium Development Goal targets on maternal mortality reduction by 2015. The MPDR system was piloted between 2010 and 2015, initially covering 10 out of the country's 64 districts. Drawing on lessons learned from implementation and international guidelines, the program was subsequently updated and renamed as the Maternal and Perinatal Death Surveillance and Response (MPDSR) system in 2016. It became an integral part of the government's routine program and gradually expanded its geographic coverage, eventually encompassing all 64 districts by 2022.