Introduction Reducing maternal mortality and guaranteeing universal access to reproductive health are related to the fifth Millennium Development goal; however, the identification of maternal deaths and the trustworthiness and comparability of the data are a challenge for epidemiological surveillance and the Maternal Mortality Committee (MMC), in assessing this information.

Methods All reproductive-aged women's deaths in the city of João Pessoa, Brazil, in 2005–2010, were investigated using multiple data sources (RAMOS). The MMC analysed this information for the correction of the Maternal Mortality Rate (MMR).

Results Investigation and data analysis showed that 44.4% of deaths (24 360) of residents in João Pessoa during 2005–2010 were feminine. Of these, 1417 (13.1%) involved women aged 10 to 49 years. Of the deaths investigated, 25 (1.8%) occurred during pregnancy, childbirth or puerperium (PCP). The MMR found was 36.73/100 000 live-births, with no correction factor. The principal causes of maternal death were: puerperal infection (24%) and eclampsia (12%). The times when fields 43 (ie, death during pregnancy, labour or miscarriage) and 44 (during the puerperium) of the death certificate showed potential reasons for sub-registration, beyond not contributing to the selection of the deaths investigated.

Conclusion The analysis of the deaths investigated enabled us to clarify all the cases of maternal morbi-mortality. This study showed how joint surveillance action together with that of the Committee enhances the quality of the information and contributes to the advance of maternal health.