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Alaska Maternal and Child Death Review (MCDR)


About MCDR

The Alaska Maternal and Child Death Review (MCDR) is a program based on a national evidence based model to systematically and comprehensively review deaths using a multi-disciplinary consensus decision making approach. This model specifically aims to identify causes and contributing factors to maternal, infant, and child deaths in Alaska and develop recommendations to prevent future deaths. This goal is accomplished through expert committee reviews of medical records, autopsy reports, death scene investigation reports, and other relevant information that is compiled for every death. MCDR has been in place since 1989. This program is federally funded by the Title V, MCH Block Grant and the Sudden Unexplained Infant Death (SUID) Grant, and is housed in the Alaska Division of Public Health, Section of Women’s, Children’s, and Family Health.

Goals and Objectives

The goal of MCDR is to reduce infant, child and maternal 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.
  • Conduct annual comprehensive data analyses.
  • Use MCDR committee findings to inform public policy and improve evaluation of established public health initiatives and programs.
  • Document patterns of infant, child and maternal mortality that may be preventable.
  • Educate health care providers regarding diagnostic, therapeutic, and preventative strategies to reduce infant, child and maternal mortality in Alaska.

The MCDR Committee

MCDR committee members serve on a voluntary basis and are approved by the DHSS Commissioner and State of Alaska Medical Board.  Committee membership includes medical providers such as pediatricians, neonatologists, obstetricians, and nurses, as well as social workers, epidemiologists, tribal representatives, and children’s justice advocates. Efforts to expand membership are ongoing to ensure a broad spectrum of professionals and perspectives are represented at each review.

To learn more about membership requirements or nominate a potential committee member, please contact the MCDR Program Associate:

Monthly reviews typically cover 10-12 cases with a subset of committee members present.  The goal of monthly reviews are to be timely in order to allow for 'real time' prevention recommendations.

Data Collection Process

The Alaska Health Analytics and Vital Records Section (HAVRS) generates a monthly report of infant, child and maternal 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. The records are then brought before the MCDR monthly or annual meeting to be reviewed by the presiding committee members. 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 Child Death Review Reporting System. Maternal deaths are entered into an internal database. Confidentiality of records is maintained at all levels.

Initially, the program only reviewed maternal, infant and occasionally fetal deaths. In 2005, the program began reviewing child deaths as well, although for several years only deaths among children through the age of 14 years were reviewed. In 2016, the age criterion was expanded to include children up to 18 years of age. All reviews are conducted retrospectively (typically within 1 year of death).​

Statutory Authority

Alaska’s Maternal and Infant Mortality Review Committee 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.