Heidi Moseson1, Moses Massaquoi2, Luke Bawo3, Linda Birch4, Bernice Dahn3, Yah Zolia3, Maria Barreix2, Caitlin Gerdts5. 1. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA. Electronic address: heidi.moseson@ucsf.edu. 2. Clinton Health Access Initiative, Monrovia, Liberia. 3. Ministry of Health and Social Welfare, Monrovia, Liberia. 4. Ministry of Health and Social Welfare, Monrovia, Liberia; Bomi County Health Team/Ministry of Health and Social Welfare, Tubmanburg, Liberia. 5. Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA, USA.
Abstract
OBJECTIVE: To establish representative local-area baseline estimates of maternal and neonatal mortality using a novel adjusted sisterhood method. METHODS: The status of maternal and neonatal health in Bomi County, Liberia, was investigated in June 2013 using a population-based survey (n=1985). The standard direct sisterhood method was modified to account for place and time of maternal death to enable calculation of subnational estimates. RESULTS: The modified method of measuring maternal mortality successfully enabled the calculation of area-specific estimates. Of 71 reported deaths of sisters, 18 (25.4%) were due to pregnancy-related causes and had occurred in the past 3 years in Bomi County. The estimated maternal mortality ratio was 890 maternal deaths for every 100 000 live births (95% CI, 497-1301]. The neonatal mortality rate was estimated to be 47 deaths for every 1000 live births (95% CI, 42-52). In total, 322 (16.9%) of 1900 women with accurate age data reported having had a stillbirth. CONCLUSION: The modified direct sisterhood method may be useful to other countries seeking a more regionally nuanced understanding of areas in which neonatal and maternal mortality levels still need to be reduced to meet Millennium Development Goals.
OBJECTIVE: To establish representative local-area baseline estimates of maternal and neonatal mortality using a novel adjusted sisterhood method. METHODS: The status of maternal and neonatal health in Bomi County, Liberia, was investigated in June 2013 using a population-based survey (n=1985). The standard direct sisterhood method was modified to account for place and time of maternal death to enable calculation of subnational estimates. RESULTS: The modified method of measuring maternal mortality successfully enabled the calculation of area-specific estimates. Of 71 reported deaths of sisters, 18 (25.4%) were due to pregnancy-related causes and had occurred in the past 3 years in Bomi County. The estimated maternal mortality ratio was 890 maternal deaths for every 100 000 live births (95% CI, 497-1301]. The neonatal mortality rate was estimated to be 47 deaths for every 1000 live births (95% CI, 42-52). In total, 322 (16.9%) of 1900 women with accurate age data reported having had a stillbirth. CONCLUSION: The modified direct sisterhood method may be useful to other countries seeking a more regionally nuanced understanding of areas in which neonatal and maternal mortality levels still need to be reduced to meet Millennium Development Goals.
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