scholarly journals Estimating Maternal Mortality in Remote Rural Regions: an Application of the Sisterhood Method in Tajikistan

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Kylea Laina Liese ◽  
Heather Pauls ◽  
Sarah Robinson ◽  
Crystal Patil
Keyword(s):  
Soviet Union ◽  
Maternal Mortality ◽  
Time Lag ◽  
Maternal Mortality Ratio ◽  
Ethnographic Study ◽  
Reproductive Age ◽  
Mortality Data ◽  
Rural Regions ◽  
Demographic Transitions ◽  
Sisterhood Method

Introduction: The sisterhood method of maternal mortality data collection and analysis provides a validated framework for estimating maternal mortality ratios in situations of limited infrastructure. The aim of this study is to assess sub-national maternal mortality in the Badakhshan region of Tajikistan using the sisterhood method as part of a larger ethnographic study on maternal risk.Methods: In 2006-2007, 1004 married women of reproductive age in Gorno-Badakhshan Autonomous Oblast, Tajikistan were surveyed using the sisterhood method. Respondents were asked eleven questions about the sex, age and survivorship of all children born to the respondent’s mother.Results: Using a national total fertility rate (TFR) estimate of 4.88, the maternal mortality ratio (MMR) in Tajik Badakhshan was 141 maternal deaths per 100,000 live births (95% CI 49-235). The lifetime risk of maternal death was 1 in 141 (95% CI 34-103).Conclusion: Given the inherent time-lag of the sisterhood method, precise estimates of maternal mortality are dependent on accurate TFRs, which may vary based upon regional experiences of demographic transitions. Socio-political instability and the dismantling of Soviet welfare programs and civil war following Tajikistan’s independence from the Soviet Union in 1991 likely impacted TFR in Tajik Badakhshan. Socio-political trends influencing TFR in rural regions compared to urban, and the investigation of factors associated with maternal mortality, require additional investigation.

scholarly journals Estimating Maternal Mortality Level in Rural Northern Nigeria by the Sisterhood Method

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Henry V. Doctor ◽  
Sally E. Findley ◽  
Godwin Y. Afenyadu
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Maternal Mortality Ratio ◽  
Lifetime Risk ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Northern Nigeria ◽  
Maternal Deaths ◽  
Live Births ◽  
Sisterhood Method

Maternal mortality is one of the major challenges to health systems in sub Saharan Africa. This paper estimates the lifetime risk of maternal death and maternal mortality ratio (MMR) in four states of Northern Nigeria. Data from a household survey conducted in 2011 were utilized by applying the “sisterhood method” for estimating maternal mortality. Female respondents (15–49 years) were interviewed thereby creating a retrospective cohort of their sisters who reached the reproductive age of 15 years. A total of 3,080 respondents reported 7,731 maternal sisters of which 593 were reported dead and 298 of those dead were maternal-related deaths. This corresponded to a lifetime risk of maternal death of 9% (referring to a period about 10.5 years prior to the survey) and an MMR of 1,271 maternal deaths per 100,000 live births; 95% CI was 1,152–1,445 maternal deaths per 100,000 live births. The study calls for improvement of the health system focusing on strategies that will accelerate reduction in MMR such as availability of skilled birth attendants, access to emergency obstetrics care, promotion of facility delivery, availability of antenatal care, and family planning. An accelerated reduction in MMR in the region will contribute towards the attainment of the Millennium Development Goal of maternal mortality reduction in Nigeria.

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 of Maternal Mortality: 1980-2019

2021 ◽  
Vol 43 (09) ◽  
pp. 662-668
Author(s):  
Janete Vettorazzi ◽  
Edimárlei Gonsales Valério ◽  
Maria Alexandrina Zanatta ◽  
Mariana Hollmann Scheffler ◽  
Sergio Hofmeister de Almeida Martins Costa ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Medical Records ◽  
Causes Of Death ◽  
Maternal Mortality Ratio ◽  
Liver Steatosis ◽  
Reproductive Age ◽  
Porto Alegre ◽  
Maternal Deaths ◽  
Live Births ◽  
Mortality Ratio

Abstract Objective To determine the profile of maternal deaths occurred in the period between 2000 and 2019 in the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym) and to compare it with maternal deaths between 1980 and 1999 in the same institution. Methods Retrospective study that analyzed 2,481 medical records of women between 10 and 49 years old who died between 2000 and 2018. The present study was approved by the Ethics Committee (CAAE 78021417600005327). Results After reviewing 2,481 medical records of women who died in reproductive age, 43 deaths had occurred during pregnancy or in the postpartum period. Of these, 28 were considered maternal deaths. The maternal mortality ratio was 37.6 per 100,000 live births. Regarding causes, 16 deaths (57.1%) were directly associated with pregnancy, 10 (35.1%) were indirectly associated, and 2 (7.1%) were unrelated. The main cause of death was hypertension during pregnancy (31.2%) followed by acute liver steatosis during pregnancy (25%). In the previous study, published in 2003 in the same institution4, the mortality rate was 129 per 100,000 live births, and most deaths were related to direct obstetric causes (62%). The main causes of death in this period were due to hypertensive complications (17.2%), followed by postcesarean infection (16%). Conclusion Compared with data before the decade of 2000, there was an important reduction in maternal deaths due to infectious causes.

Maternal mortality, as a largely avoidable cause of death and reduction in maternal mortality has been a top priority in Brazil, despite massive program efforts to avert maternal deaths, the maternal mortality ratio (MMR) in Brazil is still high especially in the poor area. Estimates of maternal mortality rates in Brazil are affected by underreporting of deaths, especially in less developed areas of the country where maternal mortality tends to be higher, and the absence of specific information indicating maternal death in reported deaths of women of reproductive age The objective of this study is to identify the true number of maternal deaths. We use data obtained from Ministry of Health information systems from the 2000 and 2012 Brazil Maternal Mortality Surveys to measure change in the maternal mortality ratio (MMR) and to measure changes in factors potentially related to such change. We estimate the changes in risk of maternal death between the two surveys using Poisson regression.

2016 ◽  
Vol 4 (2) ◽  
pp. 178-186
Author(s):  
Jose Campbell ◽  
Eliana Duarte Osis
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Maternal Mortality Ratio ◽  
Reproductive Age ◽  
Specific Information ◽  
Maternal Deaths ◽  
True Number ◽  
Mortality Ratio ◽  
Measure Change ◽  
Poor Area

Maternal mortality, as a largely avoidable cause of death and reduction in maternal mortality has been a top priority in Brazil, despite massive program efforts to avert maternal deaths, the maternal mortality ratio (MMR) in Brazil is still high especially in the poor area. Estimates of maternal mortality rates in Brazil are affected by underreporting of deaths, especially in less developed areas of the country where maternal mortality tends to be higher, and the absence of specific information indicating maternal death in reported deaths of women of reproductive age The objective of this study is to identify the true number of maternal deaths. We use data obtained from Ministry of Health information systems from the 2000 and 2012 Brazil Maternal Mortality Surveys to measure change in the maternal mortality ratio (MMR) and to measure changes in factors potentially related to such change. We estimate the changes in risk of maternal death between the two surveys using Poisson regression.

scholarly journals Improving the Metrics and Data Reporting for Maternal Mortality:A Challenge to Public Health Surveillance and Effective Prevention

2019 ◽  
Vol 11 (2) ◽  
Author(s):  
James Studnicki ◽  
David Reardon ◽  
Donna Harrison ◽  
John Fisher ◽  
Ingrid Skop
Keyword(s):  
Maternal Mortality ◽  
Pregnancy Outcome ◽  
Live Birth ◽  
Pregnancy Outcomes ◽  
Maternal Mortality Ratio ◽  
Mortality Data ◽  
Evidence Based ◽  
Maternal Deaths ◽  
Effective Prevention ◽  
Mortality Ratio

AbstractBackgroundThe current measuring metric and reporting methods for assessing maternal mortality are seriously flawed. Evidence-based prevention strategies require consistently reported surveillance data and validated measurement metrics.Main BodyThe denominator of live births used in the maternal mortality ratio reinforces the mistaken notion that all maternal deaths are consequent to a live birth and, at the same time, inappropriately inflates the value of the ratio for subpopulations of women with the highest percentage of pregnancies ending in outcomes other than a live birth. Inadequate methods for identifying induced or spontaneous abortion complications assure that most maternal deaths associated with those pregnancy outcomes are unlikely to be attributed. Absent the ability to identify all maternal deaths, and without the ability to differentiate those deaths by specific pregnancy outcomes, existing variations in pregnancy outcome-specific maternal deaths are masked by the use of an aggregated (all outcome) numerator. Under these circumstances, clear and accurate data is not available to inform evidence-based preventive strategies. As the result, algorithms applied for analyzing maternal mortality data may return distorted results.ConclusionImprovement in the effectiveness of maternal mortality surveillance will require: mandatory certification of all fetal losses; linkage of death, birth and all fetal loss (induced and natural) certificates; modification of the structure of the overall maternal mortality ratio to enable pregnancy outcome-specific ratio calculations; development of the appropriate ICD codes which are specific to induced and spontaneous abortions; education for providers on identifying and reporting early pregnancy losses; and, flexible information systems and methods which integrate these capabilities and inform users. 

scholarly journals Knowledge and practices on maternal health care among mothers: A case study from Sewar Bansbot village of Dang district

2020 ◽  
pp. 13-27
Author(s):  
Ganga KC
Keyword(s):  
Health Care ◽  
Health Status ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Maternal Mortality Ratio ◽  
Maternal Health Care ◽  
Reproductive Age ◽  
Safe Motherhood ◽  
Early Marriage ◽  
Significant Shift

Knowledge and practices regarding maternal health care among women has had a significant shift in Nepali culture. Understanding this ship can help to improve women's overall status. Nepal implemented a safe motherhood program, which slightly improved maternal health. Data, showed the maternal mortality ratio decreased during the period between 1996 and 2016 but still there is high ratio in maternal mortality. Conservative practices of maternal health are prevalent to this date. Health education is one of the crucial factors empowering women to be attentive of their rights and health status to get appropriate health services. Maternal health is a major burning issue in Nepal, which has been affected mainly due to early marriage, teenage pregnancy, superstition, low women literacy rate, and unhygienic behavioural practices. Women go through a rather depressing situation due to workload ignorance, lack of health facilities, economic, and social conditions. Despite the efforts from various types of private, government, and voluntary health agencies, there has not been a satisfactory improvement in maternal health status and safe motherhood. This study focuses on the knowledge and practices of maternal Health care. It also describes antenatal care, delivery care, and postnatal care. The study was conducted in Sewar Basbot village of ward no. 13, Ghorahi Sub-metropolitan city of Dang district that is situated near by district headquarters, Ghorahi. In total, 45 women of reproductive age (15-49 years) who were pregnant and having children below five years of age were purposively interviewed and completed the self-administered interview schedule.

Maternal Mortality - A Public Health Problem

2013 ◽  
Vol 6 (2) ◽  
pp. 64-69 ◽  
Author(s):  
Sonia Shirin ◽  
Shamsun Nahar
Keyword(s):  
Maternal Mortality ◽  
Maternal Mortality Ratio ◽  
Adult Life ◽  
Public Health Problem ◽  
Developed Countries ◽  
Reproductive Age ◽  
Hypertensive Disorder ◽  
Skilled Attendant ◽  
Important Indicator ◽  
Mortality Ratio

Maternal mortality is an important indicator which reflects the health status of a community. It can be calculated by maternal mortality ratio (MMR), maternal mortality rate (MMRate), and adult life time risk of maternal death. MMR estimates are based on varieties of methods that include household surveys, sisterhood methods, reproductive-age mortality studies (RAMOS), verbal autopsies and censuses. Main causes of maternal mortality are hemorrhage, infection, unsafe abortion, hypertensive disorder of pregnancy and obstructed labour. Factors of maternal mortality have been conceptualized by three delays model. Estimates of maternal mortality ratio (MMR) trend between 1990 and 2010 (over 20 years period) suggest a global reduction (47%), with a greater reduction in developing countries (47%) including Bangladesh than in developed countries (39%). However, to meet the challenge of Fifth Millennium Development Goal (MDG5 i.e. to ensure 75% reduction of MMR by the year 2015), the annual rate of MMR decline and increase of skilled attendant at birth need to be still faster. DOI: http://dx.doi.org/10.3329/imcj.v6i2.14735 Ibrahim Med. Coll. J. 2012; 6(2): 64-69

scholarly journals Why Are So Many Nepali Women Killing Themselves? A Review Of Key Issues

2015 ◽  
Vol 1 (4) ◽  
pp. 43-49 ◽  
Author(s):  
P Simkhada ◽  
E Van Teijlingen ◽  
R C Winter ◽  
C Fanning ◽  
A Dhungel ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Partner Violence ◽  
Grey Literature ◽  
Maternal Mortality Ratio ◽  
Reproductive Age ◽  
High Rate ◽  
Unpublished Studies ◽  
Mortality Ratio ◽  
Culture Of Silence ◽  
Nepali Women

For decades the maternal mortality in Nepal was the lead cause of death among women, with serious improvements in the maternal mortality ratio in the twentieth century the second most common cause has become more prominent. Suicide is now one of the leading causes of death for women of a reproductive age in Nepal. This scoping review brings together the key available literature to identify the causes of suicide among women in Nepal. Published and unpublished studies and the grey literature published on women and suicide related to Nepal between 2000 and 2014 were searched and included in this review. This review suggested a number of explanations for high rate of suicide among women including: partner violence, alcoholism and polygamy, the culture of silence, early age marriage and prolonged child bearing and dependency on men for financial security. This paper highlights some challenges and suggests ways forward in the improvement of mental health in Nepal.DOI: http://dx.doi.org/10.3126/jmmihs.v1i4.12001Journal of Manmohan Memorial Institute of Health Sciences Vol. 1, Issue 4, 2015Page: 43-49

Maternal mortality in the city of Berlin: consequences for perinatal healthcare

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Lars Hellmeyer ◽  
Zahavah Zinn-Kirchner ◽  
Josefine T. Königbauer
Keyword(s):  
Maternal Mortality ◽  
Maternal Mortality Ratio ◽  
Healthcare Sector ◽  
Mortality Data ◽  
Hypertensive Disorder ◽  
Healthcare Provision ◽  
Maternal Deaths ◽  
Accurate Picture ◽  
Mortality Ratio ◽  
Development Goals

Abstract Objectives The fifth of the United Nations’ Millennium Development Goals proposed for 2000–2015 was to improve maternal health, which has only partially been achieved. Worldwide, the maternal mortality ratio is currently estimated at 216/100.000 livebirths, compared to 380/100,000 in 1990. As yet, there has been no published comprehensive analysis of maternal mortality data as it pertains to Berlin and by extension Germany. Aim of the study was to evaluate and analyze the maternal mortality rate of Berlin as a result of shortcomings in healthcare provision and identify possible solutions. Methods The Institute for Quality and Transparency in the Healthcare Sector sourced external quality control from the Qualitätsbüro Berlin to provide maternal mortality data from Berlin hospitals from 2007 to 2020. Results Nineteen maternal deaths were registered between 2007 and 2020 in total. Case analysis shows that two main events occur: thrombosis and hemorrhage at 31.6%, respectively, followed by hypertensive disorder (15.8%), and sepsis (15.8%). After detailed analysis of each case report, we determined 8/19 (42.1%) maternal deaths as being potentially preventable given slightly altered circumstances. Consequences The system of registration of perinatal data in Germany does not allow for a comprehensive recording of maternal death and requires alteration to provide a more accurate picture of the phenomenon of maternal mortality; presumably, there exist twice as many unreported cases. Conclusions Symptoms, risks, and primary prevention tactics of thromboembolism during pregnancy and birth should be imparted to every licensed professional in individual hospital settings, along with evidence-based simulation training for the event of obstetric or prepartum hemorrhage.

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