USAPI Maternal Health Summit Unites Pacific Delegates to Strengthen Local Maternal Mortality Review Committees

Honolulu, HI - Public health professionals, clinicians, and partners from across the U.S.-Affiliated Pacific Islands (USAPIs) gathered in Honolulu from October 8–10, 2025, for the USAPI Maternal Health Summit, a first-of-its-kind regional meeting aimed at advancing local Maternal Mortality Review Committees (MMRCs) supported by the U.S. Centers for Disease Control and Prevention’s (CDC) Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (ERASE MM) program. Co-sponsored by the Pacific Island Health Officers’ Association (PIHOA) and the Pacific Islands Primary Care Association (PIPCA), the summit brought together delegations from American Samoa, Guam, the Commonwealth of the Northern Mariana Islands (CNMI), Palau, the Federated States of Micronesia (FSM), the Republic of the Marshall Islands (RMI), and key partners from CDC, United Nations Population Fund (UNFPA), Fiji Ministry of Health and Medical Services, and the Hawaiʻi Department of Health.

Participants recognized the urgent need to improve maternal mortality surveillance in the region, where maternal deaths are often underreported due to limited data systems, incomplete death certification, and challenges with vital statistics coding and reporting. Discussions highlighted wide variability in the availability of electronic health records, the need for cross-agency data-sharing agreements, and the importance of culturally sensitive family interviews in areas where documentation is limited. Participants emphasized that developing consistent and thorough processes for identifying pregnancy-associated deaths is essential for building effective MMRCs and preventing future avoidable deaths.

During the summit, each jurisdiction developed a tailored action plan to work towards building their local MMRC. Shared regional priorities include finalizing MMRC Terms of Reference and confidentiality agreements, improving birth and death certification processes, developing data sharing agreements for data abstraction, and training clinicians on medical certification of cause of death. While jurisdictions are at different stages of readiness, all expressed strong commitment to advancing maternal health through improved surveillance and review structures.

Technical assistance needs identified during the meeting included abstractor training, legislation and data sharing agreement drafting, and support for strengthening vital statistics systems including strengthening of certification, coding, and data reporting. PIHOA and partners will continue supporting these efforts through targeted technical assistance, resource sharing, and regional collaborations.

The summit closed with a shared commitment to ensure that every pregnancy-associated death in the USAPIs is recognized, reviewed, and used to strengthen health systems in order to prevent future avoidable deaths. Participants expressed optimism that the momentum generated in Honolulu will translate into long-term, sustainable improvements in maternal health across the region.

This work was primarily supported by funds made available from the U.S. Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) through PIHOA’s Partnership Cooperative Agreement OT21-2101: Strengthening the Public Health Systems in the US-Affiliated Pacific Islands, with additional funds provided by the Pacific Islands Primary Care Association. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.