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An option for measuring maternal mortality in developing countries: a survey using community informants
Siti Nurul Qomariyah1, David Braunholtz, Endang L Achadi
1Centre for Family Welfare, Faculty of Public Health, University of Indonesia, Depok, West Java, 16424, Indonesia. snqomariyah@gmail.com
BMC Pregnancy and Childbirth
|November 19, 2010
Summary
Estimating maternal mortality ratio (MMR) is challenging in developing countries. The MADE-IN/MADE-FOR approach effectively uses village informant networks to provide reliable, low-cost MMR estimates.
Area of Science:
- Public Health
- Epidemiology
- Demography
Background:
- High maternal mortality ratio (MMR) persists in developing nations.
- Accurate local MMR estimates are crucial for policy and intervention evaluation.
- Estimating MMR is difficult without robust vital registration systems.
Purpose of the Study:
- To describe and validate an efficient method for estimating MMR using village informant networks.
- To assess the validity and cost-effectiveness of the MADE-IN/MADE-FOR approach.
Main Methods:
- Developed the Maternal Deaths from Informants/Maternal Death Follow on Review (MADE-IN/MADE-FOR) method using two village informant networks (RTs and Kaders).
- Utilized capture-recapture (CRC) analysis to estimate network coverage and total pregnancy-related deaths (PRDs).
- Conducted home visits to confirm PRD status and gather cause of death information.
Main Results:
- The RT network identified a higher proportion of PRDs (0.85) than Kaders (0.71), but Kaders were more accessible and cost-effective.
- The Kader network provided more accurate PRD status assignment, especially for recent and rural deaths.
- The MADE-IN/MADE-FOR approach was highly cost-effective at $0.1 per women-year risk of exposure.
Conclusions:
- Reliable, local, and recent MMR estimates are achievable using two independent informant networks.
- Capture-recapture analysis enables self-calibration, accounting for incomplete case identification.
- Careful management of false positives and case matching via home visits are essential for accuracy.
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