Estimate of maternal mortality in a rural area of Niger: use of the indirect sisterhood method

Abstract:  Maternal mortality remains one of the major public health problems nowadays. Each year, all over the world, half a million women die of pregnancy-related complications most of which could be avoided. In spite of enormous efforts at handling this problem, the results have been small. In many countries, the extent of the problem is virtually unknown for lack of reliable birth and mortality data. Where vital statistics are incomplete or non-existent, one should have recourse to other sources of information. In reaction to the classic, yet inadequate methods of collecting information, indirect techniques for estimating maternal mortality have been developed. One of these procedures is the sisterhood method: using this technique, researchers are able to deduce indicators of maternal mortality based on the proportion of sisters, who, once reached childbearing age, survived or died during pregnancy, childbirth or postpartum. The authors tested this method in Niger in a rural area with difficult access to primary health care. They noted a maternal mortality rate of 1,050 every 100,000 live births. This practical and simple method of estimating maternal mortality in a given area, at a relatively low cost, could readily be incorporated into routine medical activities.