Interpretation
The true magnitude of perinatal deaths remains under-reported and under-investigated. Similar to many of its Pacific neighbours, The Solomon Islands currently does not formally register stillbirths. There is a need to optimise prospective documentation of all birth outcomes and to adopt classification of all perinatal deaths, in a similar to maternal deaths through the maternal death surveillance system. The WHO has recommended verbal autopsy as a tool to assist in determining cause of perinatal death in LMICs by gathering collateral data from mothers and clinicians. 19, 22 This may be utilised to reduce the number of “unclassified” deaths. Whilst many classification systems have been used in LMICs 23, we successfully utilised the ICD-PM classification system. There is a critical need for further research and formal classification into why mothers and babies are suffering in the Solomon Islands and more broadly, in the Asia-Pacific region. COVID-19 has significantly disrupted health systems and diverted funding from maternal and child health programs. This is likely to result in further adverse perinatal outcomes and maternal and infant death. 24