title: Estimating maternal mortality in Monseñor Nouel Province, Dominican Republic.
abstract: OBJECTIVE
  Maternal deaths are estimated by the World Health Organization at over 500,000 annually. Various methods of calculating mortality ratios have been utilized throughout the world, but many are inaccurate. The purpose of this study was to measure maternal mortality by using a sibling survivorship survey and by recording and tracking death certificates.
  
  
  METHODS
  The data for the survey were collected within a specific province in the Dominican Republic that represents predominately rural communities. Interviews with 2,180 women and data from their 17,807 siblings were recorded, 9,723 of which were sisters. The Death Certificate data were obtained by tracking 3,430 records at the local government office in the same province.
  
  
  RESULTS
  The results from the rural sibling survey show a maternal mortality ratio significantly higher than other national estimates (348/100,000 live births versus 72-250/100,000). Data collection methods are discussed, including government record keeping and potential sources of inaccuracy.
  
  
  CONCLUSIONS
  Reported maternal mortality ratios may not portray the true magnitude of the poor health status of women in developing countries.
authors.affiliation: Department of Global Health, University of South Florida College of Public Health, Tampa, FL 33612, USA.
authors.forename: Wayne W
authors.initials: WW
authors.lastname: Westhoff
authors.forename: Ercilia R
authors.initials: ER
authors.lastname: Calcano
authors.forename: Robert J
authors.initials: RJ
authors.lastname: McDermott
authors.forename: Tara E
authors.initials: TE
authors.lastname: Trudnak
authors.forename: Guillermo E
authors.initials: GE
authors.lastname: Lopez
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001723:Birth Rate; D003625:Data Collection / Q000379:methods; D003644:Death Certificates; D004293:Dominican Republic / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008428:Maternal Mortality; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D012423:Rural Health; D012494:Sampling Studies; D035781:Siblings; D016019:Survival Analysis; D055815:Young Adult
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