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Reporting Maternal Mortality Rate per day and seconds

This question was posted the Assessment and Surveillance forum area and has 2 replies.

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Anonymous 31865

Research Assistant

Normal user

11 Feb 2019, 09:00

WHO says that the global maternal mortality rate is 303,000/100,000 livebirths. WHO further reported that this figure represents 830 maternal deaths per day.
Question: How did WHO convert from 303,000/100,000 to 830 maternal deaths per day? Please help me understand this calculation.

Bradley A. Woodruff

Self-employed

Technical expert

11 Feb 2019, 19:59

Dear Anonymous 31865:

I think your statements are not entirely accurate. The WHO fact sheet (see: https://www.who.int/news-room/fact-sheets/detail/maternal-mortality) says that in 2015, there were an estimated 303,000 maternal deaths worldwide. This fact sheet further states that the maternal mortality ratio is about 239 maternal deaths per 100,000 live births in developing countries and about 12 maternal deaths per 100,000 live births in developed countries. Note that this is a ratio, not a rate, because in a rate, persons in the denominator must be eligible to be included in the numerator. Newborn children (denominator of maternal mortality ratio) cannot suffer a maternal death (numerator of ratio). Moreover, there is no time element in the maternal mortality ratio. I suspect that WHO multiplied the maternal mortality ratio by the number of live births per day to get an estimate of the crude number of maternal deaths per day. I have no idea if they did this by country or by region, then summed the total maternal deaths, or used overall worldwide estimates of maternal mortality ratio and the number of live births. Perhaps someone from WHO could clarify.

However, the maternal mortality ratio is notoriously difficult to measure given the rather basic level of vital statistics systems in many countries in which many deaths may go entirely unreported to public health authorities. Even reported deaths may not have an accurate cause of death ascribed. In addition, data on the temporal relationship between a woman's death and any recent pregnancy may be unknown; this is crucial because the definition of a maternal death requires that it occur within 42 days of the end of a pregnancy. Moreover, in many countries even the number of live births may be uncertain. Alternative data collection systems have been used, but these are often expensive and imprecise. So most estimates of the maternal mortality ratio should be taken with a certain degree of skepticism.

Marie McGrath

Mrs

Forum moderator

12 Feb 2019, 13:44

Dear Anon,
I checked with WHO regarding the calculation and they helpfully shared this:
Maternal mortality ratio (MMR): number of maternal deaths during a given time period per 100 000 live births during the same time period.
The maternal mortality ratio (MMR) for 2015 is estimated to be 216.
The annual number of maternal deaths in 2015: 303 000
So the annual number of maternal deaths in 2015/365 days = deaths per day
303 000 maternal deaths/365 days = 830 maternal deaths per day.

Please refer to: https://www.who.int/reproductivehealth/publications/monitoring/maternal-mortality-2015/en/

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