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. 2014 Oct 29:7:25368.
doi: 10.3402/gha.v7.25368. eCollection 2014.

Pregnancy-related mortality in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System sites

P Kim Streatfield  1 , Nurul Alam  2 , Yacouba Compaoré  3 , Clementine Rossier  4 , Abdramane B Soura  3 , Bassirou Bonfoh  5 , Fabienne Jaeger  6 , Eliezer K Ngoran  7 , Juerg Utzinger  6 , Pierre Gomez  8 , Momodou Jasseh  8 , Akosua Ansah  9 , Cornelius Debpuur  9 , Abraham Oduro  9 , John Williams  9 , Sheila Addei  10 , Margaret Gyapong  10 , Vida A Kukula  11 , Evasius Bauni  12 , George Mochamah  12 , Carolyne Ndila  12 , Thomas N Williams  13 , Meghna Desai  14 , Hellen Moige  14 , Frank O Odhiambo  14 , Sheila Ogwang  14 , Donatien Beguy  15 , Alex Ezeh  15 , Samuel Oti  15 , Menard Chihana  16 , Amelia Crampin  17 , Alison Price  17 , Valérie Delaunay  18 , Aldiouma Diallo  18 , Laetitia Douillot  18 , Cheikh Sokhna  18 , Mark A Collinson  19 , Kathleen Kahn  20 , Stephen M Tollman  20 , Kobus Herbst  21 , Joël Mossong  22 , Jacques B O Emina  23 , Osman A Sankoh  24 , Peter Byass  25
Affiliations

Pregnancy-related mortality in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System sites

P Kim Streatfield et al. Glob Health Action. .

Abstract

Background: Women continue to die in unacceptably large numbers around the world as a result of pregnancy, particularly in sub-Saharan Africa and Asia. Part of the problem is a lack of accurate, population-based information characterising the issues and informing solutions. Population surveillance sites, such as those operated within the INDEPTH Network, have the potential to contribute to bridging the information gaps.

Objective: To describe patterns of pregnancy-related mortality at INDEPTH Network Health and Demographic Surveillance System sites in sub-Saharan Africa and southeast Asia in terms of maternal mortality ratio (MMR) and cause-specific mortality rates.

Design: Data on individual deaths among women of reproductive age (WRA) (15-49) resident in INDEPTH sites were collated into a standardised database using the INDEPTH 2013 population standard, the WHO 2012 verbal autopsy (VA) standard, and the InterVA model for assigning cause of death.

Results: These analyses are based on reports from 14 INDEPTH sites, covering 14,198 deaths among WRA over 2,595,605 person-years observed. MMRs varied between 128 and 461 per 100,000 live births, while maternal mortality rates ranged from 0.11 to 0.74 per 1,000 person-years. Detailed rates per cause are tabulated, including analyses of direct maternal, indirect maternal, and incidental pregnancy-related deaths across the 14 sites.

Conclusions: As expected, these findings confirmed unacceptably high continuing levels of maternal mortality. However, they also demonstrate the effectiveness of INDEPTH sites and of the VA methods applied to arrive at measurements of maternal mortality that are essential for planning effective solutions and monitoring programmatic impacts.

Keywords: Africa; Asia; INDEPTH Network; cause of death; maternal mortality; verbal autopsy.

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Figures

Fig. 1
Fig. 1
Estimated maternal mortality ratio (MMR) per 100,000 live births and maternal mortality rates per 1,000 person-years observed among women aged 15–49 at 14 INDEPTH sites.
Fig. 2
Fig. 2
Proportions of maternal and non-maternal mortality among women aged 15–49 by cause category for 14 INDEPTH sites.
Fig. 3
Fig. 3
Maternal mortality rates per 1,000 person-years by WHO 2012 VA cause categories for 14 INDEPTH sites.
See this image and copyright information in PMC

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