Estimating maternal mortality in rural areas of Mexico: the application of an indirect demographic method.
OBJECTIVE
To measure maternal mortality levels in rural areas of Mexico.


METHODS
In a cross-sectional study, a census of 13,378 households was carried out in the municipalities of Yecapixtla and Tlaltizapan, Morelos, Mexico. Information on 10,443 subjects from 12 to 49 years old was included in the analysis. An indirect method of measuring maternal mortality--the sisterhood method--was used to estimate maternal mortality. Information about the number of sisters of the interviewees who died due to maternal causes was collected in the census. With this information, estimates of maternal mortality related to a period of 10-12 years before the application of the census were obtained. An innovation to the original method was the calculation of a confidence interval for the estimated maternal mortality rate (MMR).


RESULTS
The MMR in this region was 18.68/10,000 live births (95% CI 15.79-21.58/10,000 live births). The average risk of dying due to maternal causes was 1 in 87 for women between 12 and 49 years of age.


CONCLUSIONS
The sisterhood method was effective for estimating maternal mortality in a small region, with no previous information about this indicator. The method proved to be useful for identifying a priority region for the implementation of maternal mortality reduction programs. Furthermore, the method was particularly convenient since it was applied as part of a multipurpose survey.
Hernández
B
B
Center for Public Health Research, National Institute of Public Health, Cuernavaca, Mexico.
Chirinos
J
J
Romero
M
M
Langer
A
A
D000293:Adolescent; D000328:Adult; D001723:Birth Rate; D002423:Cause of Death; D002648:Child; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D006292:Health Priorities; D006306:Health Surveys; D006801:Humans; D008423:Maternal Age; D008428:Maternal Mortality; D008429:Maternal Welfare; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009679:Nuclear Family; D011159:Population Surveillance / Q000379:methods*; D015203:Reproducibility of Results; D012307:Risk Factors; D012424:Rural Population