Estimating Maternal Mortality in Remote Rural Regions: an Application of the Sisterhood Method in Tajikistan.

Central Asian Journal of Global Health Pub Date : 2019-01-23 eCollection Date: 2019-01-01 DOI:10.5195/cajgh.2019.341
Kylea Laina Liese, Heather Pauls, Sarah Robinson, Crystal Patil
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引用次数: 3

Abstract

Introduction: The sisterhood method of maternal mortality data collection and analysis provides a validated framework for estimating maternal mortality ratios in situations of limited infrastructure. The aim of this study is to assess sub-national maternal mortality in the Badakhshan region of Tajikistan using the sisterhood method as part of a larger ethnographic study on maternal risk.

Methods: In 2006-2007, 1004 married women of reproductive age in Gorno-Badakhshan Autonomous Oblast, Tajikistan were surveyed using the sisterhood method. Respondents were asked eleven questions about the sex, age and survivorship of all children born to the respondent's mother.

Results: Using a national total fertility rate (TFR) estimate of 4.88, the maternal mortality ratio (MMR) in Tajik Badakhshan was 141 maternal deaths per 100,000 live births (95% CI 49-235). The lifetime risk of maternal death was 1 in 141 (95% CI 34-103).

Conclusion: Given the inherent time-lag of the sisterhood method, precise estimates of maternal mortality are dependent on accurate TFRs, which may vary based upon regional experiences of demographic transitions. Socio-political instability and the dismantling of Soviet welfare programs and civil war following Tajikistan's independence from the Soviet Union in 1991 likely impacted TFR in Tajik Badakhshan. Socio-political trends influencing TFR in rural regions compared to urban, and the investigation of factors associated with maternal mortality, require additional investigation.

Abstract Image

估计偏远农村地区的孕产妇死亡率:姐妹法在塔吉克斯坦的应用。
导言:孕产妇死亡率数据收集和分析的姐妹方法为在基础设施有限的情况下估计孕产妇死亡率提供了一个有效的框架。本研究的目的是评估塔吉克斯坦巴达赫尚地区的次国家级产妇死亡率,使用姐妹方法作为更大的产妇风险人种学研究的一部分。方法:2006-2007年,采用姐妹法对塔吉克斯坦戈尔诺-巴达赫尚自治州1004名已婚育龄妇女进行调查。受访者被问及11个问题,涉及其母亲所生所有孩子的性别、年龄和生存状况。结果:使用全国总生育率(TFR)估计值4.88,塔吉克巴达赫尚省的孕产妇死亡率(MMR)为每10万活产141例孕产妇死亡(95% CI 49-235)。孕产妇死亡的终生风险为1 / 141 (95% CI 34-103)。结论:鉴于姐妹法固有的时滞,对孕产妇死亡率的精确估计取决于准确的总生育率,而总生育率可能因人口转型的区域经验而异。1991年塔吉克斯坦从苏联独立后,社会政治不稳定和苏联福利计划的瓦解以及内战可能影响了塔吉克巴达赫尚的总生育率。与城市相比,影响农村地区总生育率的社会政治趋势,以及与孕产妇死亡率相关因素的调查,都需要进一步调查。
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来源期刊
Central Asian Journal of Global Health
Central Asian Journal of Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
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