Applications for measuring maternal mortality: Three case studies using verbal autopsy methodology

An estimated 287,000 women die each year from complications in pregnancy or childbirth. Millennium Development Goal 5 includes a target to reduce the maternal mortality ratio by three quarters by 2015. Accurate measurement of maternal mortality is needed to develop a greater understanding of the problem, to increase effectiveness of program planning and targeting, and to track progress toward this goal. In the absence of good quality vital statistics, a number of interim methods are used to measure maternal mortality. The purpose of this study is to document three community-based interim methods that measure maternal mortality using verbal autopsy: a post-census mortality survey in Mozambique, a sample vital registration with verbal autopsy in Zambia, and a large-scale household survey in Bangladesh. This study will summarize the measures of maternal mortality obtained from these three platforms, compare and contrast the different methodologies employed, and evaluate strengths and weaknesses of each approach. This study will show that verbal autopsy is a feasible method for collecting maternal mortality data in the absence of reliable vital registration data and that choice of an interim method is dependent on balancing the trade-offs between statistical considerations and feasibility in the local context.