Afghanistan Mortality Survey 2010 - Measure DHS

MATERNAL MORTALITY 7Following the launch of the Safe Motherhood Initiative in 1987, attention to reproductive healthhas increased worldwide, as has the need for reliable countrywide estimates of maternal deaths.According to the World Health Organization (WHO), a maternal death is defined as “the death of awoman while pregnant or within 42 days of termination of pregnancy, regardless of the duration and siteof the pregnancy, from any cause related to or aggravated by the pregnancy or its management but notfrom accidental or incidental causes” (WHO, et al., 2010). However, accurate identification of theobstetrical causes of maternal deaths (excluding deaths due to accidental or incidental causes) is notalways possible, especially in a developing country where the majority of deliveries take place at home orin a noninstitutional setting, and where civil registration systems with accurate attribution of cause ofdeath are nonexistent or inadequate. As a result, the estimate of maternal mortality that is most commonlyused in developing countries (pregnancy-related mortality) is based only on the timing of death relative topregnancy. Pregnancy-related deaths are any deaths to women during pregnancy or within two monthsfollowing the termination of the pregnancy, including deaths from accidental or incidental causes. Thediscussion on pregnancy-related deaths generally includes four measures: The pregnancy-relatedmortality ratio, which is the most common measure, is defined as the number of pregnancy-related deathsduring a given time period per 100,000 live births during the same time period. The pregnancy-relatedmortality rate refers to the number of pregnancy-related deaths in a given time period per 1,000 womanyearsof exposure during the same period. The probability of dying from a pregnancy-related cause duringa woman’s reproductive life is the adult lifetime risk of pregnancy-related death. The final measure is theproportion of all deaths of women that are pregnancy related (proportion pregnancy related).The Maternal Mortality Estimation Inter-agency Group (WHO, et al., 2010) estimated that358,000 maternal deaths occurred worldwide in 2008. This is equivalent to one maternal death every oneand a half minutes. Almost all of these deaths (99 percent) occur in developing countries. In fact, maternalmortality statistics reflect one of the largest disparities between developing and developed countries ofany health indicator. One of every 120 women in developing countries dies from these complications,compared with 1 out of every 4,300 women in developed countries (WHO, et al., 2010). The risks ofdying during pregnancy and childbirth are increased by women’s lack of empowerment, education, andaccess to economic resources, as well as poor nutrition and a heavy physical workload during pregnancy.Most maternal deaths could be prevented by ensuring good quality maternal health services, such asantenatal and postnatal care, and skilled assistance during childbirth, including emergency obstetric care.Prevention of unwanted pregnancies and the provision of safe abortion services, as allowed by law, couldreduce maternal deaths and injuries caused by unsafe abortions. High quality family planning services,counseling, and information could further reduce maternal deaths and injuries.Maternal Mortality | 125