title: Estimates of maternal mortality by the sisterhood method in rural nothern Tanzania: a household sample and an antenatal clinic sample.
abstract: OBJECTIVE
  To estimate maternal mortality in two samples of a population in northern Tanzania.
  
  
  METHODS
  Rural communities and antenatal clinics, Mbulu and Hanang districts, Arusha region, Tanzania.
  
  
  METHODS
  From a household survey 2,043 men and women aged 15-60, and from an antenatal clinic survey 4,172 women aged 15-59.
  
  
  METHODS
  The indirect sisterhood method.
  
  
  METHODS
  The risk of maternal deaths per 100,000 live births (maternal mortality ratio), and the lifetime risk of a maternal death.
  
  
  RESULTS
  The risk of a maternal death per 100,000 live births was 362 (95% CI 269-456) and 444 (95% CI 371-517) for the household and antenatal clinic surveys, respectively. The lifetime risk of maternal death was 1 in 38 and 1 in 31, respectively, for the two surveys. A significantly lower risk of maternal death was observed for the respondents attending antenatal clinics closer to the hospital than for those attending clinics further away: 325 (95% CI 237-413) compared with 561 (95% CI 446-677) per 100,000 live births. Lifetime risk of maternal death was 1 in 42 and 1 in 25, respectively.
  
  
  CONCLUSIONS
  The risk of maternal death per 100,000 live births in this area were comparatively high, but in our survey substantially lower than in previous surveys in Tanzania. Increasing distance from the antenatal clinics to the hospital was associated with higher maternal mortality. There was no significant difference between results based on household and antenatal clinic data, suggesting that accessible health facility data using the sisterhood method may provide a basis for local assessment of maternal mortality in developing countries.
authors.affiliation: Haydom Lutheran Hospital, Mbulu District, Tanzania.
authors.forename: B E
authors.initials: BE
authors.lastname: Olsen
authors.forename: S G
authors.initials: SG
authors.lastname: Hinderaker
authors.forename: M
authors.initials: M
authors.lastname: Kazaura
authors.forename: R T
authors.initials: RT
authors.lastname: Lie
authors.forename: P
authors.initials: P
authors.lastname: Bergsjø
authors.forename: P
authors.initials: P
authors.lastname: Gasheka
authors.forename: G
authors.initials: G
authors.lastname: Kvåle
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D005260:Female; D006801:Humans; D008297:Male; D008428:Maternal Mortality; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality*; D012111:Residence Characteristics; D012189:Retrospective Studies; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data; D013636:Tanzania / Q000453:epidemiology