Maternal Mortality Data and Measures 101
We only have ESTIMATES—yes, that’s what they are—because we don’t have the actual maternal death data from vital registration systems in most countries. Because many developing countries lack the capacity to accurately gather, analyze, disseminate and report data on a regular basis, we can’t express maternal mortality accurately either as absolute numbers or as rates (i.e. the number of maternal deaths in a specific time interval /total number of women of reproductive age in a specific time interval). So, the next best option is estimating the number of maternal deaths from different data sources—vital registration, household surveys, census, health service records and specific studies on reproductive-age mortality (RAMOS). These estimated numbers of maternal deaths are also expressed as a ratio of 100,000 live births to calculate a different measure of mortality: Maternal Mortality Ratio (MMR). MMR is the MDG Goal 5 indicator, and measures the risk associated with each pregnancy (i.e. obstetric risk). While monitoring MMRs is particularly useful for policy making and decisions regarding the accessibility to and the quality of prenatal and obstetric care, it does not allow us to determine whether these deaths are due to direct or indirect causes (see below).
Making thereby a case for better data – and this sits in well with a vision for a technology project (possibly mobile phone based) that gathers data simultaneously – with giving care. This infact is a vision for a Episurveyor/Datadyne like technology (though now based upon smart phones) to be deployed in clusters.