title: Strategy for the selection and investigation of deaths of women of reproductive age.
abstract: BACKGROUND
  Different approaches have been developed in order to deal with maternal mortality. In 2008 the Brazilian Ministry of Health made mandatory the investigation of all deaths of women of reproductive age. So far, completeness of investigation has not been thoroughly accomplished in the State of Rio de Janeiro (RJ) due to the constrained capacity of public health services to investigate the large number of eligible deaths. Our aim was to develop a strategy to improve the selection of deaths of women of reproductive age for investigation under maternal death surveillance.
  
  
  METHODS
  The study population comprised all deaths of women of reproductive age that occurred in the counties of Belford Roxo and Niterói, RJ, between May and September of 2008. Deaths were classified according to priority for investigation, based on data regarding its underlying cause and relation to either pregnancy, delivery or puerperium, as registered in deaths certificate's fields 43 and 44 (related to maternal deaths).
  
  
  RESULTS
  Data related to fields 43 and 44 was missing in around 47% of death certificates; following investigation it was recovered for approximately 74% of such deaths. Of the 132 deaths investigated, four occurred either during pregnancy, delivery or puerperium and were classified as priority for investigation, among which three were classified as maternal deaths. The strategy developed to improve the selection of deaths of women of reproductive age for investigation under maternal death surveillance was considered appropriate.
authors.affiliation: Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Brazil. carolmadalena@yahoo.com.br
authors.forename: Caroline Madalena
authors.initials: CM
authors.lastname: Ribeiro
authors.forename: Antônio José Leal
authors.initials: AJ
authors.lastname: Costa
authors.forename: Angela Maria
authors.initials: AM
authors.lastname: Cascão
authors.forename: Maria de Lourdes Tavares
authors.initials: Mde L
authors.lastname: Cavalcanti
authors.forename: Pauline Lorena
authors.initials: PL
authors.lastname: Kale
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002423:Cause of Death; D016021:Epidemiologic Studies; D005260:Female; D005298:Fertility; D006801:Humans; D008428:Maternal Mortality / Q000639:trends*