Aims, options and outcomes in measuring maternal mortality in developing societies

Berhane, Yemane; Andersson, Tobias; Wall, Stig; Byass, Peter; Högberg, Ulf

doi:10.1034/j.1600-0412.2000.079011968.x

Cited by 18 publications

(11 citation statements)

References 15 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As a result, we do not know whether our findings were under-reported or represent the reality of the area. The maternal mortality ratio of 425 per 100,000 live births was similar to the findings of community-based studies decades ago in other parts of Ethiopia: the MMR per 100,000 live births was 402 in Jimma in 1990 [23], and 440 in Butajira in 1996 [24]. However, our estimate is higher than the UN and World Bank's estimate for Ethiopia of 350 per 100,000 live births in 2010 [1].…”

Section: Discussionsupporting

confidence: 84%

Maternal and Neonatal Mortality in South-West Ethiopia: Estimates and Socio-Economic Inequality

et al. 2014

View full text Add to dashboard Cite

IntroductionEthiopia has achieved the fourth Millennium Development Goal by reducing under 5 mortality. Nevertheless, there are challenges in reducing maternal and neonatal mortality. The aim of this study was to estimate maternal and neonatal mortality and the socio-economic inequalities of these mortalities in rural south-west Ethiopia.MethodsWe visited and enumerated all households but collected data from those that reported pregnancy and birth outcomes in the last five years in 15 of the 30 rural kebeles in Bonke woreda, Gamo Gofa, south-west Ethiopia. The primary outcomes were maternal and neonatal mortality and a secondary outcome was the rate of institutional delivery.ResultsWe found 11,762 births in 6572 households; 11,536 live and 226 stillbirths. There were 49 maternal deaths; yielding a maternal mortality ratio of 425 per 100,000 live births (95% CI:318–556). The poorest households had greater MMR compared to richest (550 vs 239 per 100,000 live births). However, the socio-economic factors examined did not have statistically significant association with maternal mortality. There were 308 neonatal deaths; resulting in a neonatal mortality ratio of 27 per 1000 live births (95% CI: 24–30). Neonatal mortality was greater in households in the poorest quartile compared to the richest; adjusted OR (AOR): 2.62 (95% CI: 1.65–4.15), headed by illiterates compared to better educated; AOR: 3.54 (95% CI: 1.11–11.30), far from road (≥6 km) compared to within 5 km; AOR: 2.40 (95% CI: 1.56–3.69), that had three or more births in five years compared to two or less; AOR: 3.22 (95% CI: 2.45–4.22). Households with maternal mortality had an increased risk of stillbirths; OR: 11.6 (95% CI: 6.00–22.7), and neonatal deaths; OR: 7.2 (95% CI: 3.6–14.3). Institutional delivery was only 3.7%.ConclusionHigh mortality with socio-economic inequality and low institutional delivery highlight the importance of strengthening obstetric interventions in rural south-west Ethiopia.

show abstract

Section: Discussionsupporting

confidence: 84%

Maternal and Neonatal Mortality in South-West Ethiopia: Estimates and Socio-Economic Inequality

et al. 2014

View full text Add to dashboard Cite

show abstract

“…In Butajira, which is in south central Ethiopia, the MMR was estimated to be 665 per 100, 000 LB in 1996 using the sisterhood method [11]. The Butajira study might have been methodologically more robust than the current study as it was linked to demographic surveillance and probably had a more precise age estimation.…”

Section: Discussionmentioning

confidence: 93%

“…For example, the MMR was 590 (358–932) for 2008 according to the Institute for Health Metrics and Evaluation by Hogan et al [6], while the UN agencies and The World Bank estimated the MMR to be 470 (270–790) [8]. Estimates of the MMR from community-based studies also vary; specifically, for 1982/83 the MMR was 566 in Addis Ababa [9], 570 (420–720) for Illubabor in western Ethiopia in 1991 [10], and between 440 (314–598) and 665 (558–785) by surveillance and sisterhood method respectively for Butajira in south central Ethiopia in 1996 [11]. These surveys showed lower estimates than the mathematically-modelled estimates for the country.…”

Section: Introductionmentioning

confidence: 99%

High maternal mortality in rural south-west Ethiopia: estimate by using the sisterhood method

Yaya

Lindtjørn

2012

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

BackgroundEstimation of maternal mortality is difficult in developing countries without complete vital registration. The indirect sisterhood method represents an alternative in places where there is high fertility and mortality rates. The objective of the current study was to estimate maternal mortality indices using the sisterhood method in a rural district in south-west Ethiopia.MethodWe interviewed 8,870 adults, 15–49 years age, in 15 randomly selected rural villages of Bonke in Gamo Gofa. By constructing a retrospective cohort of women of reproductive age, we obtained sister units of risk exposure to maternal mortality, and calculated the lifetime risk of maternal mortality. Based on the total fertility for the rural Ethiopian population, the maternal mortality ratio was approximated.ResultsWe analyzed 8503 of 8870 (96%) respondents (5262 [62%] men and 3241 ([38%] women). The 8503 respondents reported 22,473 sisters (average = 2.6 sisters for each respondent) who survived to reproductive age. Of the 2552 (11.4%) sisters who had died, 819 (32%) occurred during pregnancy and childbirth. This provided a lifetime risk of 10.2% from pregnancy and childbirth with a corresponding maternal mortality ratio of 1667 (95% CI: 1564–1769) per 100,000 live births. The time period for this estimate was in 1998. Separate analysis for male and female respondents provided similar estimates.ConclusionThe impoverished rural area of Gamo Gofa had very high maternal mortality in 1998. This highlights the need for strengthening emergency obstetric care for the Bonke population and similar rural populations in Ethiopia.

show abstract

“…A governmental hospital, which opened in 2001, has expanded access to obstetric care, but few women choose to deliver in this setting in keeping with other rural Ethiopian areas. In Butajira, maternal mortality rates are estimated at 400–850/100,000 births (Berhane et al 2000). Nationally, only an estimated 28% of women attend for antenatal care and fewer than 10% of women deliver in a health facility (CSA 2006).…”

Section: Methodsmentioning

confidence: 99%

Between life and death: exploring the sociocultural context of antenatal mental distress in rural Ethiopia

Hanlon

Whitley

Wondimagegn

et al. 2010

Arch Womens Ment Health

View full text Add to dashboard Cite

The high prevalence of antenatal common mental disorders in sub-Saharan Africa compared to high-income countries is poorly understood. This qualitative study explored the sociocultural context of antenatal mental distress in a rural Ethiopian community. Five focus group discussions and 25 in-depth interviews were conducted with purposively sampled community stakeholders. Inductive analysis was used to develop final themes. Worry about forthcoming delivery and fears for the woman’s survival were prominent concerns of all participants, but only rarely perceived to be pathological in intensity. Sociocultural practices such as continuing physical labour, dietary restriction, prayer and rituals to protect against supernatural attack were geared towards safe delivery and managing vulnerability. Despite strong cultural norms to celebrate pregnancy, participants emphasised that many pregnancies were unwanted and an additional burden on top of pre-existing economic and marital difficulties. Short birth interval and pregnancy out of wedlock were both seen as shameful and potent sources of mental distress. The notion that pregnancy in traditional societies is uniformly a time of joy and happiness is misplaced. Although antenatal mental distress may be self-limiting for many women, in those with enduring life difficulties, including poverty and abusive relationships, poor maternal mental health may persist.

show abstract

Aims, options and outcomes in measuring maternal mortality in developing societies

Abstract: The advantages and disadvantages of the different approaches are compared, both for operational feasibility and outcome.

Cited by 18 publications

References 15 publications

Maternal and Neonatal Mortality in South-West Ethiopia: Estimates and Socio-Economic Inequality

Maternal and Neonatal Mortality in South-West Ethiopia: Estimates and Socio-Economic Inequality

High maternal mortality in rural south-west Ethiopia: estimate by using the sisterhood method

Between life and death: exploring the sociocultural context of antenatal mental distress in rural Ethiopia

Contact Info

Product

Resources

About