Measuring Maternal Mortality with Dual Method: A New Method for Maternal Mortality Estimation in Developing Countries

Saifuddin Ahmed, Johns Hopkins University

The Millennium Development Goal-5 (MDG-5) targets to reduce maternal mortality ratio by three-quarters between 1990 and 2015, but it remains a major challenge to evaluate its success because the estimation of maternal mortality ratio (MMR) is notoriously difficult without a functional vital registration system. We present a method of unbiased MMR estimation by combining data from two independent sources, medical records and community deaths audits, with correction for under-reporting. Using the proposed “dual method,” we estimate maternal mortality in Bangladesh, and compare to the nationally representative Bangladesh Maternal Health Services and Maternal Mortality Survey (BMMS 2001). The estimated maternal mortality ratio (MMR) by the dual method was 375 (95% CI: 369-380) per 100000 live births, and the pregnancy related mortality ratio (PRMR) was 419 (413-425). The BMMS based direct estimation of MMR was 322 (253-391), and PRMR was 382(305-460). Our empirical application shows that the proposed method is feasible.