Community inquiry on maternal mortality was conducted in a rural area of North India. Maternal deaths were identified by multiple informants and investigated by doctors. Amongst 257 deaths registered in women in the 15-44 year age group, 55(21.4%) were maternal deaths. Maternal mortality ratio was 230 per 100,000 live births. Major causes were antepartum and postpartum hemorrhage (18.2%), puerperal sepsis (16.4%), severe anemia (16.4%), abortion (9.1%) and obstructed labor (7.3%). This rapid, simple and low cost method is recommended for application in areas where vital registration system is unsatisfactory.
PIP: A community inquiry on maternal mortality was conducted in a rural area of North India. Maternal deaths were identified by multiple informants and investigated by doctors. Among 257 deaths registered in women aged 15-44 years, 55 (21.4%) were maternal deaths. Maternal mortality ratio (MMR) was 230/100,000 live births. Major causes were antepartum and postpartum hemorrhage (18.2%), puerperal sepsis (16.4%), severe anemia (16.4%, abortion (9.1%) and obstructed labor (7.3%). The largest number of deaths were in poor socioeconomic class. The majority of the deaths occurred in the 20-29 age group. Cases were predominantly with low parity (0-2). 1/3 of cases had availed of prenatal care from qualified personnel. Untrained traditional birth attendants (TBAs) conducted delivery in 24 cases out of a total of 41 who died after delivery. There are wide variations in mortality not only between the Indian states, but also within; infant mortality ratio varies from 32-152/1000 live births. Crude death rate varies from 6-17/1000 population. MMR ranges from 280-1360/100,000 live births. In this study information of the signs and symptoms preceding death was collected by professionals, such as family members, TBAs and doctors. In 51 of 55 cases cause of death assigned by an independent panel of experts was the same as assigned by the investigating team. However, this investigation does not provide data on births and therefore an exact MMR cannot be computed. To overcome this limitation, a sample survey in the area on birth rate and population estimate on the basis of the census were used to estimate the MMR. This rapid, simple low cost (approximately US$1150) method is recommended for application in areas where vital registration system is unsatisfactory.