Alaska Maternal and Child Death Review (MCDR)
About MCDR
The Alaska Maternal and Child Death Review (MCDR) has been in place since 1989 and was established under Alaska State Statute 18.23.010 - 18.23.070. The program is federally funded by the HRSA Title V MCH Block grant, the CDC Sudden Unexpected Infant Death (SUID) Case Registry grant, the CDC Supporting Maternal Mortality Review Committees (MMRC) grant, the OASH Reducing Maternal Mortality due to Violence grant, and some state general funds.
The MCDR multi-disciplinary committee uses a systematic case review model. This evidence-based model specifically aims to identify causes and contributing factors to pregnancy-associated, infant, and child deaths and develop recommendations to prevent future deaths.
Goals and Objectives
The goal of MCDR is to reduce infant, child and pregnancy-associated mortality in Alaska by better understanding the factors associated with each death through a committee review process. MCDR program objectives are:
- Perform statewide epidemiological surveillance concerning infant, child and maternal deaths in Alaska and document patterns of mortality that may be preventable.
- Conduct annual comprehensive data analyses.
- Use MCDR committee findings to inform public policy and improve evaluation of established public health initiatives and programs.
- Educate stakeholders regarding diagnostic, therapeutic, and preventative strategies to reduce infant, child and maternal mortality in Alaska.
Ways to support MCDR
MCDR Listserv Recipient:
Anyone interested in MCDR related information should sign up to be a MCDR Listserv recipient. MCDR Listserv recipients receive quarterly reports that summarize the prevention recommendations generated from each case reviewed by the MCDR Expert Panelists, all MCDR data publications, MCDR program updates and announcements, and data publications related to Maternal and Child Health. Listserv recipients are encouraged to share the quarterly Report and Recommendations Summary and other publications as well as contact MCDR if the recommendations lead to any changes in policies or practices by agencies or individuals.
Annual Summit Attendee:
The MCDR program hosts an Annual Summit every year. The format for these meetings change every year based on identified needs and feedback from the prior year. Information on previous Summits and some of the presentations can be found on the Annual Summit page. The Summit is open to Core Committee members, Subject Matter Expert Panelists and other MCDR partners and supporters.
MCDR Subject Matter Expert Panelist:
To ensure that each death is reviewed by a culturally diverse, interdisciplinary team, MCDR maintains a list of volunteer Subject Matter Expert Panelists. Expert Panelists provide MCDR with information on their professional and personal background and are contacted when the MCDR Core Committee determines that their expertise is needed at an upcoming review meeting. During review meetings, Expert Panelists will individually review case files and participate in group discussions that generate prevention recommendations. Current Expert Panelists include medical providers such as pediatricians, neonatologists, obstetricians, and nurses as well as social workers, injury prevention experts, law enforcement officers, child protection workers, tribal representatives, and LGBTQ+ advocates.
The involvement of panelists who are Tribal Members, People of Color and who have experience working directly with populations experiencing health disparities is essential to MCDR’s efforts to promote health equity by identifying and making recommendations to address systemic factors underlying deaths. Please consider sharing your time if you fit the above description or are a behavioral health clinician, social service provider, or violence intervention professional as experts in these areas are needed.
To learn more about expert panelist requirements or to nominate a potential panelist, please contact us at hss.wcfh.MCDR@alaska.gov.
MCDR Core Committee Member:
MCDR Core Committee Members attend bi-monthly meetings to review and approve groupings and proposed panels of experts for upcoming review meetings. Core Committee members assist in identifying “gaps” in reviewer expertise and make recommendations for recruitment efforts by the Program Manager. Additionally, Core Committee members utilize personal and professional networks to recruit review experts as needed, provide strategic input to MCDR staff about dissemination of recommendations, identify priorities for data analysis and MCDR publications, review drafts of MCDR publications, and provide input to MCDR staff about processes and meeting facilitation as needed.
Data Collection Process
The Alaska Health Analytics and Vital Records Section (HAVRS) generates a monthly report of infant, child and pregnancy-associated deaths and provides birth and death certificate data elements to MCDR for each death. MCDR staff then request additional information from the Alaska State Troopers or municipal police departments, Department of Juvenile Justice, Office of Children Services, hospitals, health clinics, State Medical Examiner’s Office, and other data sources as appropriate.
Upon receipt of all documentation, the case files are abstracted for specific autopsy, medical, and social data and a summary is written. The Core Committee determines which areas of expertise are needed and the case files are then reviewed by the identified Subject Matter Expert Panelists. MCDR utilizes standardized data reporting forms, which are completed for all reviews. All information on infant and child deaths is entered and stored in the National Fatality Review Case Reporting System. Pregnancy-associated death information is entered into the Maternal Mortality Review Information Application. Confidentiality of records is maintained at all levels.
The population and age range of deaths reviewed by MCDR has evolved over time. Initially only pregnancy-associated, infant and occasionally fetal deaths were reviewed. In 2005, the program began reviewing child deaths; for 10 years only deaths among children through the age of 14 years were reviewed. In 2016, the age criterion was expanded to include children through the age of 17 years and the program’s name was changed from Maternal and Infant Mortality Review-Child Death Review (MIMR-CDR) to the Maternal and Child Death Review (MCDR). All reviews are conducted retrospectively (typically within 1 year of death).
Statutory Authority
MCDR operates under Alaska State Statute 18.23.70(C). Data collection is authorized under Alaska State Statute 18.15.360(b). The data MCDR collects is protected under Alaska State Statute 18.15.365.
Alaska’s Maternal and Child Death Review was originally established in 1988 and then re-established by the DHSS Commissioner in 1989 under changes made to Alaska Statute (AS) 18.23.070. These changes added subparagraph (5)(c) to specifically define a committee “established by the Commissioner of Health and Social Services and approved by the State Medical Board to review public health issues regarding morbidity or mortality.” The program operates under Alaska Statute Section 18.15.360b regarding acquisition of data for conditions of public health importance. Identifiable information provided to MCDR is protected under AS 18.15.355-18.15.395. The Committee does not act on individual cases or share data related to individuals, but makes public health recommendations based on aggregate data and trends.
