Methods for measuring maternal mortality at national and subnational
levels in the developing world lag far behind the demand for estimates.
The study evaluated use of the national population census as a means of
measuring maternal mortality by assessing data from five countries
(Benin, Islamic Republic of Iran, Lao People’s Democratic Republic,
Madagascar, and Zimbabwe) which identified maternal deaths in their
Standard demographic methods were used to evaluate the completeness of
reporting of adult female deaths and births in the year prior to the
census. The results from these exercises were used to adjust the data.
In four countries, the numbers of adult female deaths needed to be
increased and three countries required upward adjustment of the numbers
of recent births. The number of maternal deaths was increased by the
same factor as that used for adult female deaths on the assumption that
the proportion of adult female deaths due to maternal causes was
correct. Age patterns of the various maternal mortality indicators were
plausible and consistent with external sources of data for other
Data suggest that under favourable 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. However, it should also be noted
that careful evaluation of the data and adjustment, if necessary, are
essential. The public health community is urged to encourage governments
to learn from the experience of these five countries and to place
maternal mortality estimation in the hands of statistical agencies.
Stanton, C.; Hobcraft, J.; Hill, K.; Kodjogbe, N.; Mapeta, W.T.; Munene, F.; Naghavi, M.; Rabeza, V.; Sisouphanthong, B.; Campbell, O. Every death counts: measurement of maternal mortality via a census. Bulletin of the World Health Organization (2001) 79 (7) 657-664.
Every death counts: measurement of maternal mortality via a census