Field Test Results of the Motherhood Method to Measure Maternal Mortality (Report)
The current estimate of global maternal deaths is 3429001. Almost all of these occur in developing countries. Among the six countries accounting for more than 50 per cent of all maternal deaths, two South Asian countries, India and Pakistan occupy 1st and 3rd position (1). Over the past decade, reduction in maternal deaths has attained a high priority in global health movements. The fifth Millennium Development Goal (MDG5) of improving maternal health has set a target of reducing the maternal mortality ratio by 75 per cent between 1990 and 2015 (2). The most widely used measure of maternal mortality is the maternal mortality ratio, which is the ratio of the number of maternal deaths to the number of live births. It reflects (but is not identical to) the risk of maternal death once a woman has become pregnant. The 10th Revision of the International Classification of Diseases (ICD-10) defined a maternal death as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes” (3). Maternal deaths are divided into direct and indirect obstetrical deaths. In practice the distinction between an accidental and incidental death or a direct and indirect death is problematic, and a precise cause of death may not be known despite knowledge of pregnancy. ICD-10 has, therefore, introduced an alternative definition of maternal death, the pregnancy related death, which emphasizes timing of death rather than the cause to which the death is attributed (3). Many maternal mortality surveys, such as the sisterhood method (4) typically measure pregnancy-related deaths as maternal deaths, since the cause of death is not elicited in such surveys.