An Assessment of DHS Estimates of Adult and Maternal Mortality

One of the Millenium Development Goals (MDG5) is to reduce the maternal mortality ratio in all developing countries by 75% between 1990 and 2015. Progress toward this goal has been documented by the World Health Organization (WHO) and the Institute for Health Metrics and Evaluation (IHME), using similar models to estimate levels and trends in virtually all countries. The Demographic and Health Surveys (DHS) are the principal source of data for the WHO and IHME models. Approximately 120 DHS surveys have included the maternal mortality module, using the direct sisterhood method; all of those surveys will be included. Estimates of adult mortality are also produced from these data, sometimes including information about brothers of the respondent. This will be the first such assessment since 1997, when only 14 surveys had included the module. Several strategies will be used, including comparisons of the reports from related members of the same household and comparisons across successive surveys in the same country. The paper will include recommendations for interpreting the estimates, will discuss potential adjustments (although DHS will continue to publish only unadjusted estimates) and will describe potential implications for the WHO and IHME models.