Centre for International Health, University of Bergen, Bergen, Norway.
BMC Pregnancy Childbirth. 2012 Nov 23;12:136. doi: 10.1186/1471-2393-12-136.
Estimation of maternal mortality is difficult in developing countries without complete vital registration. The indirect sisterhood method represents an alternative in places where there is high fertility and mortality rates. The objective of the current study was to estimate maternal mortality indices using the sisterhood method in a rural district in south-west Ethiopia.
We interviewed 8,870 adults, 15-49 years age, in 15 randomly selected rural villages of Bonke in Gamo Gofa. By constructing a retrospective cohort of women of reproductive age, we obtained sister units of risk exposure to maternal mortality, and calculated the lifetime risk of maternal mortality. Based on the total fertility for the rural Ethiopian population, the maternal mortality ratio was approximated.
We analyzed 8503 of 8870 (96%) respondents (5262 [62%] men and 3241 ([38%] women). The 8503 respondents reported 22,473 sisters (average = 2.6 sisters for each respondent) who survived to reproductive age. Of the 2552 (11.4%) sisters who had died, 819 (32%) occurred during pregnancy and childbirth. This provided a lifetime risk of 10.2% from pregnancy and childbirth with a corresponding maternal mortality ratio of 1667 (95% CI: 1564-1769) per 100,000 live births. The time period for this estimate was in 1998. Separate analysis for male and female respondents provided similar estimates.
The impoverished rural area of Gamo Gofa had very high maternal mortality in 1998. This highlights the need for strengthening emergency obstetric care for the Bonke population and similar rural populations in Ethiopia.
在没有完整生命登记的发展中国家，估算孕产妇死亡率较为困难。间接姐妹法是一种替代方法，适用于生育率和死亡率较高的地区。本研究旨在使用姐妹法在埃塞俄比亚西南部的一个农村地区估算孕产妇死亡率指数。
我们在甘莫戈法的邦克区 15 个随机选择的农村村庄中，对 8870 名 15-49 岁的成年人进行了访谈。通过构建育龄妇女的回顾性队列，我们获得了具有母婴死亡率风险暴露的姐妹单位，并计算了母婴死亡率的终生风险。根据农村埃塞俄比亚人口的总生育率，近似估计了孕产妇死亡率比。
我们分析了 8870 名受访者中的 8503 名（96%）（5262 名[62%]男性和 3241 名[38%]女性）。这 8503 名受访者报告了 22473 名姐妹（平均每位受访者有 2.6 名姐妹），她们存活到了育龄期。在 2552 名（11.4%）死亡的姐妹中，有 819 名（32%）发生在妊娠和分娩期间。这提供了 10.2%的妊娠和分娩期间终生风险，相应的孕产妇死亡率比为 1667（95%CI：1564-1769）每 100000 例活产。该估计的时间范围是 1998 年。对男性和女性受访者进行单独分析得出了类似的估计。
甘莫戈法的贫困农村地区在 1998 年的孕产妇死亡率非常高。这突显了为邦克人口和埃塞俄比亚类似农村人口加强紧急产科护理的必要性。
