scholarly journals A comparison of approaches to measuring maternal mortality in Bangladesh, Mozambique, and Bolivia

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Kavita Singh ◽  
Qingfeng Li ◽  
Karar Zunaid Ahsan ◽  
Sian Curtis ◽  
William Weiss
Keyword(s):  
Maternal Mortality ◽  
Household Survey ◽  
Data Sources ◽  
Sample Survey ◽  
Survey Method ◽  
Population Census ◽  
Registration System ◽  
Advantages And Disadvantages ◽  
Mortality Ratio ◽  
Mortality Survey

Abstract Background Many low- and middle-income countries cannot measure maternal mortality to monitor progress against global and country-specific targets. While the ultimate goal for these countries is to have complete civil registrations systems, other interim strategies are needed to provide timely estimates of maternal mortality. Objective The objective is to inform on potential options for measuring maternal mortality. Methods This paper uses a case study approach to compare methodologies and estimates of pregnancy-related mortality ratio (PRMR)/maternal mortality ratio (MMR) obtained from four different data sources from similar time periods in Bangladesh, Mozambique, and Bolivia—national population census; post-census mortality survey; household sample survey; and sample vital registration system (SVRS). Results For Bangladesh, PRMR from the 2011 census falls closely in line with the 2010 household survey and SVRS estimates, while SVRS’ MMR estimates are closer to the PRMR estimates obtained from the household survey. Mozambique's PRMR from household survey method is comparable and shows an upward trend between 1994 and 2011, whereas the post-census mortality survey estimated a higher MMR for 2007. Bolivia's DHS and post-census mortality survey also estimated comparable MMR during 1998–2003. Conclusions Overall all these data sources presented in this paper have provided valuable information on maternal mortality in Bangladesh, Mozambique, and Bolivia. It also outlines recommendations to estimate maternal mortality based on the advantages and disadvantages of several approaches. Contribution Recommendations in this paper can help health administrators and policy planners in prioritizing investment for collecting reliable and contemporaneous estimates of maternal mortality while progressing toward a complete civil registration system.

scholarly journals Estimates and Correlates of District-Level Maternal Mortality Ratio in India

2021 ◽  
Author(s):  
Srinivas Goli ◽  
Parul Puri ◽  
Pradeep Salve ◽  
Saseendran Pallikadavath ◽  
K.S. James
Keyword(s):  
Maternal Mortality ◽  
Tamil Nadu ◽  
Health Management ◽  
Spatial Clustering ◽  
Local Level ◽  
Maternal Mortality Ratio ◽  
Health Management Information System ◽  
Maternal Deaths ◽  
Registration System ◽  
Mortality Ratio

Despite the progress achieved, approximately one-quarter of all maternal deaths worldwide occur in India. Till now, India monitors maternal mortality in 18 out of its 36 provinces using information from the periodic sample registration system (SRS). The country does not have reliable routine information on maternal deaths for smaller states and districts. And, this has been a major hurdle in local-level health policy and planning to prevent avoidable maternal deaths. For the first time, using triangulation of routine records of maternal deaths under Health Management Information System (HMIS), Census of India, and SRS, we provide Maternal Mortality Ratio (MMR) for all states and districts of India. Also, we examined socio-demographic and health care correlates of MMR using large-sample and robust statistical tools. The findings suggest that 70% of districts (448 out of 640 districts) in India have reported MMR above 70 deaths-a target set under Sustainable Development Goal-3. According to SRS, only Assam shows MMR more than 200, while our assessment based on HMIS suggests that about 6-states (and two union territory) and 128-districts have MMR above 200. Thus, the findings highlight the presence of spatial heterogeneity in MMR across districts in the country, with spatial clustering of high MMR in North-eastern, Eastern, and Central regions and low MMR in the Southern and Western regions. Even the better-off states such as Kerala, Tamil Nadu, Andhra Pradesh, Karnataka, and Gujarat have districts of medium-to-high MMR. In order of their importance, fertility levels, the sex ratio at birth, health infrastructure, years of schooling, post-natal care, maternal age and nutrition, and poor economic status have emerged as the significant correlates of MMR. In conclusion, we show that HMIS is a reliable, cost-effective, and routine source of information for monitoring maternal mortality ratio in India and its states and districts.

scholarly journals Meta-analysis on maternal deaths and assessing significant factors for heterogeneity between states of India during 2016

2021 ◽  
Vol 10 (8) ◽  
pp. 3192
Author(s):  
Vanamail Perumal
Keyword(s):  
Maternal Mortality ◽  
Meta Analysis ◽  
Random Effect ◽  
Maternal Mortality Ratio ◽  
Random Effect Model ◽  
Registration System ◽  
Mortality Ratio ◽  
Meta Regression ◽  
Meta Regression Analysis ◽  
Significant Factors

Objective of the study was to provide a more precise estimate of maternal mortality (MM), maternal mortality ratio (MMR) and to identify significant factors contributing for heterogeneity between the states in India. “Metaprop” procedure in STATA software, which are specific to binomial data was applied on state wise MM data published by sample registration system (SRS) during 2014-16. An overall MM estimate and potential sources of heterogeneity could be identified using meta-regression. Corrected estimates of MMR by states were compared. SRS published the MM data by 17 Major states. Overall reported MM was 8.8 per 100, 000 women. Estimate obtained by random effect model was 8.3 (95% CI: 5.9-11.1) per 100,000 women. Heterogeneity between states was very high (I2-statistics =91.9%), and egger regression revealed no reporting bias (p=0.672). Meta-regression analysis indicated that the percent women attending full antenatal care (ANC) visits found to be highly significant (p<0.001) for MM with inverse relationship implying that the states with a higher percentage of women with full ANC visits are likely to have lesser MM. While the estimate of MMR by SRS was 130 per 100,000 live births, corrected MMR was 123 (95% CI: 87-164) accounting for 26% reduction from previous estimate 167 obtained in 2013. This paper provided a precious estimate of both MM and MMR adjusted for sampling weight. Further, the importance of either full ANC visits or four ANC visits could be demonstrated for reduction in MMR on achieving the Millennium development goal (MDG) in the country. 

scholarly journals Studi Kematian Ibu dan Kematian Bayi di Provinsi Sumatera Barat: Faktor Determinan dan Masalahnya

2011 ◽  
Vol 5 (6) ◽  
pp. 243
Author(s):  
Ulvi Mariati ◽  
Z Agus ◽  
D Sulin ◽  
Masrul Masrul ◽  
Z Amri ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Maternal Mortality ◽  
Household Survey ◽  
Infant Mortality Rate ◽  
World Health ◽  
Survey Method ◽  
Maternal Mortality Rate ◽  
Exact Number ◽  
Year 2000

Salah satu tujuan yang hendak dicapai oleh World Health Organization pada tahun 2000 adalah health for all by year 2000. Beberapa indikator digunakan untuk mengukur pencapaian tersebut, diantaranya angka kematian bayi (AKB) dan angka kematian ibu (AKI). Dinas Kesehatan Sumatera Barat telah berhasil menurunkan AKB dan AKI selama 5 tahun terakhir, akan tetapi angka-angka tersebut tidak menggambarkan angka yang sebenarnya karena hanya diperoleh berdasarkan prediksi perhitungan statistik kependudukan. Angka tersebut juga tidak dapat memperlihatkan disparitas antarwilayah dan kelompok sosial ekonomi di Sumatera Barat. Penelitian ini dilakukan untuk mendapatkan AKB dan AKI yang tepat serta mengetahuifaktor determinan dan permasalahannya di Sumatera Barat pada tahun 2007. Desain penelitian adalah Direct Household Survey Method dengan pendekatan prospektif. Penelitian dilakukan di 19 kabupaten/kota di Provinsi Sumatera Barat dari tanggal 1 Januari sampai 31 Desember 2007. Hasil penelitian menunjukkan AKB dan AKI Sumatera Barat tahun 2007 berkisar 28,4 per 1.000 kelahiran hidup dan 211,9 per 100.000 kelahiran hidup. Asfiksia dan perdarahan postpartum merupakan penyebab kematian utama ibu dan bayi. Dinas Kesehatan Sumatera Barat dan pemerintahannya harus mempunyai komitmen yang kuat untuk membangun jaringan kerja yang efektif untuk menurunkan AKB dan AKI di Sumatera Barat.Kata kunci: Angka kematian bayi, angka kematian ibu, asfiksia, postpartumAbstractOne of the main goals that WHO wants to reach in 2000 is Health for All Year 2000. Some of indicators have been using to measure the goals, such as infant mortality rate (IMR) and maternal mortality rate (MMR). West Sumatera Health Office had been successed reducing IMR and MMR for over 5 years, but the score was not mentioned the exact number becausethis measurement just using national statistic measurement. It also could not describe the disparity between the area and sosial group in West Sumatera. This research aim is to get the exact number of IMR and MMR, determinat factors and its problems in West Sumatera in 2007. The study desain was Direct Household Survey Method with prospective approach. The research was done in 19 different government district in West Sumatera from January 1st until December 31st 2007. Result of this research found IMR and MMR of West Sumatera in 2007 is 28,4 per 1.000 birth life and 211,9 per 100.000 birth life. Asphyxia and postpartum bleeding is the main cause of infant and maternal death. West Sumatera Health Office and its government should have a strong commitment to build effective networking to reduce IMR and MMR in West Sumatera.Key words: Infant mortality rate, maternal mortality rate, asphyxia, postpartum

scholarly journals Sdg 3 monitoring at sub-national level with data from the civil registration system in rajasthan state, india : 2001-14

2017 ◽  
Vol 7 (3) ◽  
pp. 410-425
Author(s):  
Manoj Kumar Rau ◽  
Ananta Basudev Sahub
Keyword(s):  
Maternal Mortality ◽  
National Level ◽  
Maternal Mortality Ratio ◽  
Well Being ◽  
Civil Registration System ◽  
Registration System ◽  
Live Births ◽  
Civil Registration ◽  
Registration Data ◽  
Mortality Ratio

In India, Civil registration was initiated under the registration of births and deaths act,1969 to give reliable estimates of fertility and mortality situation for the nation up to the lowest administrative levels, but due to its inadequate and underreporting, still the Sample Registration System is used to generate reliable indicators of fertility and mortality. In this paper, an attempt is made to compute certain indicators from the civil registration system for the period of 2001-14 in the State of Rajasthan, India. The major SDG indicators of goal 3 of ensuring healthy lives and promoting well-being for all at all ages; targets 3.1 (By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births) and 3.2 (By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births) with indicators of Under-five Mortality Rate (indicator 3.2.1) and Maternal Mortality Ratio (indicator 3.1.1) and other fertility and mortality indicators can be computed, if certain denominator bases are available every year. As the civil registration data has not been classified by the place of residence, it is not strictly comparable to SRS figures. But it has been presented here so as to serve as an indication and for the improvement of the system for generation of reliable vital rates at subnational levels using civil registration data, which is the need of the day for planning purposes for programme managers and policy makers.

IDENTIFICATION OF PROBLEM SOLVING STRATEGIES IN MATHEATICS AMONG HIGH SCHOOL STUDENTS

2017 ◽  
Vol 4 (36) ◽  
Author(s):  
J. Navaneetha Krishnan ◽  
P. Paul Devanesan
Keyword(s):  
High School ◽  
High School Students ◽  
Problem Solving ◽  
Sample Survey ◽  
Survey Method ◽  
Teaching Mathematics ◽  
School Students ◽  
Problem Solving Strategies ◽  
Achievement In Mathematics

The major aim of teaching Mathematics is to develop problem solving skill among the students. This article aims to find out the problem solving strategies and to test the students’ ability in using these strategies to solve problems. Using sample survey method, four hundred students were taken for this investigation. Students’ achievement in solving problems was tested for their Identification and Application of Problem Solving Strategies as a major finding, thirty one percent of the students’ achievement in mathematics is contributed by Identification and Application of Problem Solving Strategies.

scholarly journals Maternal mortality during the COVID-19 pandemic in Mexico: a preliminary analysis during the first year

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nina Mendez-Dominguez ◽  
Karen Santos-Zaldívar ◽  
Salvador Gomez-Carro ◽  
Sudip Datta-Banik ◽  
Genny Carrillo
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Maternal Mortality ◽  
Respiratory Distress ◽  
Pregnant Women ◽  
Distress Syndrome ◽  
Maternal Mortality Ratio ◽  
Maternal Deaths ◽  
Immune Impairment ◽  
Mortality Ratio

Abstract Background In Mexico, the COVID-19 pandemic led to preventative measures such as confinement and social interaction limitations that paradoxically may have aggravated healthcare access disparities for pregnant women and accentuated health system weaknesses addressing high-risk patients’ pregnancies. Our objective is to estimate the maternal mortality ratio in 1 year and analyze the clinical course of pregnant women hospitalized due to acute respiratory distress syndrome and COVID-19. Methods A retrospective surveillance study of the national maternal mortality was performed from February 2020–February 2021 in Mexico related to COVID-19 cases in pregnant women, including their outcomes. Comparisons were made between patients who died and those who survived to identify prognostic factors and underlying health conditions distribution. Results Maternal Mortality Ratio increased by 56.8% in the studied period, confirmed COVID-19 was the cause of 22.93% of cases. Additionally, unconfirmed cases represented 4.5% of all maternal deaths. Among hospitalized pregnant women with Acute Respiratory Distress Syndrome consistent with COVID-19, smoking and cardiovascular diseases were more common among patients who faced a fatal outcome. They were also more common in the age group of < 19 or > 38. In addition, pneumonia was associated with asthma and immune impairment, while diabetes and increased BMI increased the odds for death (Odds Ratio 2.30 and 1.70, respectively). Conclusions Maternal Mortality Ratio in Mexico increased over 60% in 1 year during the pandemic; COVID-19 was linked to 25.4% of maternal deaths in the studied period. Lethality among pregnant women with a diagnosis of COVID-19 was 2.8%, and while asthma and immune impairment increased propensity for developing pneumonia, obesity and diabetes increased the odds for in-hospital death. Measures are needed to improve access to coordinated well-organized healthcare to reduce maternal deaths related to COVID-19 and pandemic collateral effects.

scholarly journals The origins of cultural divergence: evidence from Vietnam

2021 ◽  
Author(s):  
Hoang-Anh Ho ◽  
Peter Martinsson ◽  
Ola Olsson
Keyword(s):  
Cultural Differences ◽  
Current Distribution ◽  
Household Survey ◽  
Mekong River ◽  
Cultural Norms ◽  
Population Census ◽  
Territorial Expansion ◽  
And Migration ◽  
Historical Accounts ◽  
North Vietnam

AbstractCultural norms diverge substantially across societies, often within the same country. We propose and investigate a self-domestication/selective migration hypothesis, proposing that cultural differences along the individualism–collectivism dimension are driven by the out-migration of individualistic people from collectivist core regions of states to peripheral frontier areas, and that such patterns of historical migration are reflected even in the current distribution of cultural norms. Gaining independence in 939 CE after about a thousand years of Chinese colonization, historical Vietnam emerged in the region that is now north Vietnam with a collectivist social organization. From the eleventh to the eighteenth centuries, historical Vietnam gradually expanded its territory southward to the Mekong River Delta through repeated waves of conquest and migration. Using a nationwide household survey, a population census, and a lab-in-the-field experiment, we demonstrate that areas annexed earlier to historical Vietnam are currently more prone to collectivist norms, and that these cultural norms are embodied in individual beliefs. Relying on many historical accounts, together with various robustness checks, we argue that the southward out-migration of individualistic people during the eight centuries of the territorial expansion is an important driver, among many others, of these cultural differences.

scholarly journals Two year review of maternal mortality at a tertiary care hospital of GMERS, Valsad, Gujarat, India

2018 ◽  
Vol 7 (6) ◽  
pp. 2283
Author(s):  
Darshna M. Patel ◽  
Mahesh M. Patel ◽  
Vandita K. Salat
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Rural Areas ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Live Births ◽  
Mortality Ratio

Background: According to the WHO, 80 of maternal deaths in developing countries are due to direct maternal causes such as haemorrhage, hypertensive disorders and sepsis. These deaths are largely preventable. Maternal mortality ratio (MMR) in India is 167/100,000 live births.Methods: This retrospective observational study was conducted at GMERS, Valsad. Data regarding maternal deaths from January 2016 to December 2017 were collected and analyzed with respect to epidemiological parameters. The number of live births in the same period was obtained from the labour ward ragister. Maternal mortality rate and Mean maternal mortality ratio for the study period was calculated.Results: The mean Maternal mortality rate in the study period was 413.3/100,000 births. The maternal mortality ratio (MMR) in India is 167/100,000 live births. More than half of maternal deaths were reported in multiparous patients. More maternal deaths were observed in women from rural areas (67.3%), unbooked patients (73.3%) and illiterate women (65.3%). Thirty six (69.3%) maternal death occurred during postpartum period. Most common delay was first delay (60.0%) followed by second delay (40.0%). Postpartum haemorrhage (28.8%), preeclampsia (17.3%), sepsis (13.46%) were the major direct causes of maternal deaths. Indirect causes accounted for one third of maternal deaths in our study. Anemia, hepatitis and heart disease were responsible for 13.4%, 5.7%, and 1.9% of maternal deaths, respectively.Conclusions: Majority of maternal deaths are observed in patients from rural areas, unbooked, and illiterate patients. Hemorrhage, eclampsia and sepsis are leading causes of maternal deaths. Most of these maternal deaths are preventable if patients are given appropriate treatment at periphery and timely referred to higher centers.

The use of the sisterhood method for estimating maternal mortality ratio in Lagos state, Nigeria

2011 ◽  
Vol 31 (4) ◽  
pp. 315-319 ◽  
Author(s):  
B. A. Oye-Adeniran ◽  
K. A. Odeyemi ◽  
A. Gbadegesin ◽  
E. E. Ekanem ◽  
O. K. Osilaja ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Maternal Mortality Ratio ◽  
Sisterhood Method ◽  
Lagos State ◽  
Mortality Ratio

scholarly journals Temporal evolution and spatial distribution of maternal death

2014 ◽  
Vol 48 (4) ◽  
pp. 662-670 ◽  
Author(s):  
Ioná Carreno ◽  
Ana Lúcia de Lourenzi Bonilha ◽  
Juvenal Soares Dias da Costa
Keyword(s):  
Spatial Distribution ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Temporal Evolution ◽  
Maternal Mortality Ratio ◽  
Rio Grande ◽  
The State ◽  
Rio Grande Do Sul ◽  
Maternal Risk ◽  
Mortality Ratio

OBJECTIVE To analyze the temporal evolution of maternal mortality and its spatial distribution.METHODS Ecological study with a sample made up of 845 maternal deaths in women between 10 and 49 years, registered from 1999 to 2008 in the state of Rio Grande do Sul, Southern Brazil. Data were obtained from Information System on Mortality of Ministry of Health. The maternal mortality ratio and the specific maternal mortality ratio were calculated from records, and analyzed by the Poisson regression model. In the spatial distribution, three maps of the state were built with the rates in the geographical macro-regions, in 1999, 2003, and 2008.RESULTS There was an increase of 2.0% in the period of ten years (95%CI 1.00;1.04; p = 0.01), with no significant change in the magnitude of the maternal mortality ratio. The Serra macro-region presented the highest maternal mortality ratio (1.15, 95%CI 1.08;1.21; p < 0.001). Most deaths in Rio Grande do Sul were of white women over 40 years, with a lower level of education. The time of delivery/abortion and postpartum are times of increased maternal risk, with a greater negative impact of direct causes such as hypertension and bleeding.CONCLUSIONS The lack of improvement in maternal mortality ratio indicates that public policies had no impact on women’s reproductive and maternal health. It is needed to qualify the attention to women’s health, especially in the prenatal period, seeking to identify and prevent risk factors, as a strategy of reducing maternal death.

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