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Measuring Maternal Mortality: Three Case Studies Using Verbal Autopsy with Different Platforms.

Siân L Curtis1, Robert G Mswia2, Emily H Weaver3

  • 1Department of Maternal & Child Health, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America; Carolina Population Center at The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.

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Verbal autopsy is a feasible method for collecting maternal mortality data. However, interim methods require large sample sizes, making continuous civil registration systems essential for tracking changes in maternal mortality.

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Area of Science:

  • Public Health
  • Demography
  • Epidemiology

Background:

  • Accurate maternal mortality measurement is crucial for program planning and progress tracking.
  • Good quality vital statistics are often unavailable, necessitating interim measurement methods.
  • Verbal autopsy is an established interim method for assessing causes of death.

Purpose of the Study:

  • To document experiences with three community-based interim methods for measuring maternal mortality using verbal autopsy.
  • To compare and contrast methodologies, evaluating strengths and weaknesses.
  • To discuss challenges in data collection and estimation.

Main Methods:

  • Utilized a post-census mortality survey, sample vital registration with verbal autopsy, and a large-scale household survey.
  • Summarized maternal mortality measures from three data platforms.
  • Evaluated issues including death identification, classification, sample size, data quality, and cost.

Main Results:

  • Sample sizes varied, yielding small numbers of identified maternal deaths.
  • The proportion of maternal deaths among women of reproductive age ranged from 8.8% to 17.3%.
  • Maternal mortality rate was estimable using two platforms; maternal mortality ratio was estimable using only one.

Conclusions:

  • Verbal autopsy is a feasible method for collecting maternal mortality data.
  • Interim methods are unsuitable for detecting short-term mortality changes due to sample size limitations.
  • Comprehensive civil registration systems are essential for long-term, high-quality vital statistics.