Improving the measurement of maternal mortality in Thailand using multiple data sourcesReport as inadecuate




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Population Health Metrics

, 14:16

First Online: 04 May 2016Received: 21 November 2015Accepted: 26 April 2016DOI: 10.1186-s12963-016-0087-z

Cite this article as: Chandoevwit, W., Phatchana, P., Sirigomon, K. et al. Popul Health Metrics 2016 14: 16. doi:10.1186-s12963-016-0087-z

Abstract

BackgroundThailand uses cause of death records in civil registration to summarize maternal mortality statistics. A report by the Department of Health using the Reproductive Age Mortality Studies RAMOS reported that the maternal mortality ratio MMR in 1997 was approximately three to four times higher than MMR based on the civil registration cause of death records. Here, we used multiple data sources to systematically measure maternal mortality in Thailand and showed a disparity between age groups and regions.

MethodsWe calculated the number of maternal deaths using a two-stage method. In the first stage, we counted the number of deceased mothers who successfully gave live births. In the second stage, we counted the number of women who died during the pregnancy, delivery, or the postpartum period without a live birth.

ResultsThe number of maternal deaths dropped from 268 in 2007 to 226 in 2014. Nearly 50 % of the deaths occurred in Stage 1. The maternal mortality ratio in 2007 was 33.6 per 100,000 live births; the rate fell to 31.8 in 2014. The age ranges of women observed were 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, and 45-49, and the MMR averages were 21.5, 23.8, 27.0, 42.1, 67.7, 115.4, and 423.4 per 100,000 live births, respectively. The Southern region consistently exhibited the highest MMR compared to other regions for every year analyzed, except 2012. Women in Bangkok had a lower risk of dying during pregnancy, delivery, and the postpartum period than women from other regions.

ConclusionsWe demonstrated that using multiple administrative data sources in the two-stage method was an efficient method that provided systematic measurement and timely reporting on the maternal mortality ratio. An additional benefit of the method was that information provided from the combined data sources, e.g., the number of maternal deaths by age group and region was relevant to the safe motherhood policy.

KeywordsMaternal mortality ratio Maternal death Pregnancy Civil registration Thailand AbbreviationsBHPBureau of Health Promotion

BPSBureau of Policy and Strategy

CHICentral Office for Healthcare Information

CIconfidence interval

CScivil servant medical benefit scheme

ICD-10International Statistical Classification of Diseases and Related Health Problems 10 edition

LBslive births

MDmaternal deaths

MMRmaternal mortality ratio

NESDBNational Economic and Social Development Board

NHSONational Health Security Office

PIDPersonal Identification Number

RAMOSReproductive Age Mortality Studies

SSsocial security scheme

SSOSocial Security Office

UCSuniversal coverage scheme

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Author: Worawan Chandoevwit - Phasith Phatchana - Kanjana Sirigomon - Kunakorn Ieawsuwan - Jutatip Thungthong - Saray Ruangdej

Source: https://link.springer.com/







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