title: Verbal autopsy of maternal deaths in two districts of Pakistan--filling information gaps.
abstract: In Pakistan, the vital registration system is weak, and population-based data on the maternal mortality ratio are limited. This study was carried out to collect information on maternal deaths from different existing sources during the current year-2007 (prospective) and the past two years--2005 and 2006-(retrospective), identify gaps in information, and critically analyze maternal deaths at the community and health-facility levels in two districts in Pakistan. The verbal autopsy questionnaire was administered to households where a maternal death had occurred. No single source had complete data on maternal deaths. Risk factors identified among 128 deceased women were low socioeconomic status, illiteracy, low-earning jobs, parity, and bad obstetric history. These were similar to the findings of earlier studies. Half of the women did seek antenatal care, 34% having made more than four visits. Of the 104 women who died during or after delivery, 38% had delivered in a private facility and 18% in a government facility. The quality of services in both private and public sectors was inadequate. Sixty-nine percent of deaths occurred in the postpartum period, and 51% took place within 24 hours of delivery. The study identified gaps in reporting of maternal deaths and also provided profile of the dead women and the causes of death.
authors.affiliation: National Committee for Maternal and Neonatal Health, 36C, 14th Street, Khayaban-Shamsheer, Phase 5, DHA, Karachi, Pakistan. ncmnh@cyber.net.pk
authors.forename: Sadiqua N
authors.initials: SN
authors.lastname: Jafarey
authors.forename: Talat
authors.initials: T
authors.lastname: Rizvi
authors.forename: Marge
authors.initials: M
authors.lastname: Koblinsky
authors.forename: Nazo
authors.initials: N
authors.lastname: Kureshy
mesh_terms: D000293:Adolescent; D000328:Adult; D001344:Autopsy / Q000379:methods*; D002423:Cause of Death; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000592:standards*; D008428:Maternal Mortality; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult