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    Jain, Anrudh K. Sathar, Zeba A. and Haque, Minhaj ul 2015. The Constraints of Distance and Poverty on Institutional Deliveries in Pakistan: Evidence from Georeference-Linked Data. Studies in Family Planning, Vol. 46, Issue. 1, p. 21.


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THE IMPORTANCE OF PUBLIC SECTOR HEALTH FACILITY-LEVEL DATA FOR MONITORING CHANGES IN MATERNAL MORTALITY RISKS AMONG COMMUNITIES: THE CASE OF PAKISTAN

  • ANRUDH K. JAIN (a1), ZEBA SATHAR (a2), MOMINA SALIM (a3) and ZAKIR HUSSAIN SHAH (a2)
  • DOI: http://dx.doi.org/10.1017/S0021932013000126
  • Published online: 26 March 2013
Abstract
Summary

This paper illustrates the importance of monitoring health facility-level information to monitor changes in maternal mortality risks. The annual facility-level maternal mortality ratios (MMRs), complications to live births ratios and case fatality ratios (CFRs) were computed from data recorded during 2007 and 2009 in 31 upgraded public sector health facilities across Pakistan. The facility-level MMR declined by about 18%; both the number of Caesarean sections and the episodes of complications as a percentage of live births increased; and CFR based on Caesarean sections and episodes of complications declined by 29% and 37%, respectively. The observed increases in the proportion of women with complications among those who come to these facilities point to a reduction in the delay in reaching facilities (first and second delays; Thaddeus & Maine, 1994); the decrease in CFRs points to improvements in treating obstetric complications and a reduction in the delay in receiving treatment once at facilities (the third delay). These findings point to a decline in maternal mortality risks among communities served by these facilities. A system of woman-level data collection instituted at health facilities with comprehensive emergency obstetric care is essential to monitor changes in the effects of any reduction in the three delays and any improvement in quality of care or the effectiveness of treating pregnancy-related complications among women reaching these facilities. Such a system of information gathering at these health facilities would also help policymakers and programme mangers to measure and improve the effectiveness of safe-motherhood initiatives and to monitor progress being made toward achieving the fifth Millennium Development Goal.

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Corresponding author
1Corresponding author. Email: ajain@popcouncil.org
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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

M. Islam & S. Yoshida (2009) Women are still deprived of access to lifesaving essential and emergency obstetric care. International Journal of Gynaecology and Obstetrics 106, 120124.

S. Lobis , D. Fry & A. Paxton (2005) Program note: applying the UN process indicators fro emergency obstetric care to the United States. International Journal of Gynaecology and Obstetrics 88, 203207.

C. Ronsmans , M. E. Chowdhury , M. Kobilinsky & A. Ahmed (2010) Care seeking at time of childbirth, and maternal and perinatal mortality in Matlab, Bangladesh. Bulletin of the World Health Organization 88, 289296.

S. Thaddeus & D. Maine (1994) Too far to walk: maternal mortality in context. Social Science & Medicine 38(8), 10911110.

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Journal of Biosocial Science
  • ISSN: 0021-9320
  • EISSN: 1469-7599
  • URL: /core/journals/journal-of-biosocial-science
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