Maternal mortality in a rural district of southeastern Tanzania: an application of the sisterhood method

Abstract

The maternal mortality ratio (MMR) was 448 maternal deaths per 100,000 live births (95%CI : 363-534 deaths per 100,000 live births). Maternal causes accounted for 19% of total mortality in this age group. One in 39 women who survive until reproductive age will die before age 50 due to maternal causes. The main cause of death provided by hospital data was puerperal sepsis (35%) and postpartum haemorrhage (17%); this is compatible with the main causes reported for maternal death in settings with high levels of maternal mortality, and similar to data for other regions in Tanzania. The sisterhood method provides data comparable with others, together with a cost-effective and reliable estimate for the determination of the magnitude of maternal mortality in the rural Kilombero District.

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

“…It has been suggested that one third of all maternal deaths occur before delivery and so may well be missed (14), not only by the indirect methods but also possibly by the direct method since the rare event of a maternal death depends on linkage to registered births. Since abortion is illegal in Ethiopia, most probably MMRs by all three methods are underestimates in respect of abortion related deaths (15). The epidemiological situation of HIV in the area is unfortunately unknown, but the clinical impression is that the area is still outside the main HIV-epidemic in Ethiopia, and we do not consider that AIDS-related deaths have greatly influenced MMR estimates.…”

Analysis of maternal mortality in a small teaching hospital attached to tertiary care hospital (a 10 yr review)

“…More deaths occurring in this radius is attributed to the fact that more than half of the women lived within a 0–5 km range and sought admission for delivering in this hospital. In a rural district setting, Font, et al showed a lifetime risk between the age groups as relatively stable and declining with no higher risk of mortality with older age, although lower age group (15–19 years) values were higher than the rest(5) with a very wide confidence interval.…”

Seasonal Variation in the Risk and Causes of Maternal Death in the Gambia: Malaria Appears to Be an Important Factor

“…7 The sisterhood method is an indirect method of obtaining population-based estimates of MMRs by asking a sample of women 15−49 years old how many of their sisters reached the age of 15 and how many of them died while pregnant, during delivery, or up to six weeks after the end of pregnancy. 8 Anemia is the main maternal consequence of malaria among pregnant women in malarious areas. 9 Thus, the marked increase in the MMR due to anemia during the peak period of malaria transmission suggests that malaria is a significant factor in maternal deaths in The Gambia.…”