Confidential Enquiry Into Maternal Deaths (CEMD)

Confidential Enquiry into Maternal Deaths (CEMD) is a systematic, multidisciplinary, anonymous investigation of all pregnancy-related deaths which identifies the numbers, causes and avoidable or remediable factors associated with them. It was introduced in Malaysia in 1991 under the purview of Family Health Development Division through the National Technical CEMD Committee.

The commitee uses a systematic work-flow of identifying and investigating pregnancy-related deaths at multiple levels using the “road to death” model allows for a timely report submission to be made. Recommendations made by the CEMD committee are followed through for implementation at various levels including policy changes, resource allocation, work process improvement, capacity building, upgrading facilities and equipment.

Since the introduction of CEMD, maternal mortality ratio (MMR) has decreased from 44 per 100,000 live births in 1991 to a steady decline in early 2000 with the lowest MMR so far was 21.1 in 2019. The enquiry has enabled Malaysia to consolidate the database for pregnancy-related deaths, identify gaps for appropriate channeling of resources and ultimately improve the quality of maternal health services.