Abstract

This paper is aimed at improving our ability to assess the magnitude of maternal mortality in developing countries, where reliable data on maternal deaths are scarce. First, the upper and lower limits of maternal mortality in a population are determined based on the general levels of mortality and fertility in a population. The relative importance of maternal deaths as a proportion of death among women of reproductive ages may, therefore, vary from less than 1 percent in low-mortality countries to about 25-30 percent in high-mortality countries. Second, the analysis and interpretation of maternal mortality data from health facilities and vital registration systems can be improved if a variety of other data sources are used, such as coverage of deliveries in hospitals and at home, and all causes of death among women of reproductive age. It is estimated that approximately 515,000 women died annually due to pregnancy-related causes in developing countries between 1980 and 1985. Ninety percent of these deaths took place in Africa and South Asia, where births are frequent and maternal mortality levels are high.

PIP:

Ways of improving the ability to assess the magnitude of maternal mortality (MM) in developing countries, where reliable data on maternal deaths are scarce, are discussed. Measures of MM include the ratio, which indicates the obstetric risk in a population for the comparison of populations with different levels of fertility, and the MM rate, used to denote the relative importance of maternal as compared with other mortality affecting females. Using a scatter diagram and linear regression, an attempt is made to analyze the upper and lower limits of MM populations experiencing high MM. The relative importance of maternal deaths as a proportion of death among women of reproductive age may vary from 1% in low-mortality countries to 25%-30% in high-mortality countries. Except at the extremes of the regression line, specific ranges of MM rates are associated with ranges of ratios, e.g. between 20% and 30% of deaths are maternally-associated at ratio levels of 300-500/100,000 live births. 2nd, the analysis and interpretation of MM data from health facilities and vital registration systems can be improved if a variety of other data sources are used, such as coverage of deliveries in hospitals and at home, and all causes of death among women of reproductive age. It is estimated that approximately 515,000 women died annually due to pregnancy-related causes in developing countries between 1980 and 1985. 90% of these deaths took place in Africa and South Asia, even though these women constitute only 41% of the women in the world. Recommendations include attention to primary care and to the traditional health sector, as a response to the stagnation of development of health care facilities providing needed interventions such as transfusions.