Every death counts: measurement of maternal mortality via a census
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Author(s): Stanton C, Hobcraft J, Hill K, Kodjogbe N, Mapeta WT, Munene F, Naghavi M, Rabeza V, Sisouphantong B, Campbell O
Methods for measuring maternal mortality at national and subnational levels in the developing world lag far behind the demand for estimates. Authors evaluated use of the national population census as a means of measuring maternal mortality by assessing data from Benin, Iran, Laos, Madagascar, and Zimbabwe, who identified maternal deaths in their censuses. Standard demographic methods were used to evaluate the completeness of reporting adult female deaths and births in the year prior to the census. Authors used the results from these exercises to adjust data. In four countries, the number of adult female deaths needed to be increased; three countries required upward adjustment for the numbers of recent births. The number of maternal deaths was increased by the same factor as that used for female adult deaths on the assumption that the proportion of adult female deaths due to maternal causes was correct. Age patterns of the various maternal mortality indicaotrs were plausible and consistent with external data sources for other populations. Data from this study suggest that, under favorable conditions, a national census is a feasible and promising approach for the measurement of maternal mortality. Moreover, use of the census circumvents several of the weaknesses of methods currently in use. Authors recommend that developing country governments learn from the experience of these five countries and place maternal mortality estimation in the hands of statistical agencies.
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