Issues in measuring maternal morbidity: lessons from the Philippines Safe Motherhood Survey Project
Stewart, M.K.; Stanton, C.K.; Festin, M.; Jacobson, N.
Studies in Family Planning 27(1): 29-35
1996
ISSN/ISBN: 0039-3665 PMID: 8677521 DOI: 10.2307/2138075Document Number: 286434
The major goal of the 1993 Philippines Safe Motherhood Survey (SMS) was to determine the prevalence of key obstetric complications and to describe related patterns of health service use. Validation and qualitative research helped in development of the final SMS questionnaire. The SMS was one of few studies that have tried to provide population-based data on specific issues of maternal health. There are no standard and accepted data collection techniques for maternal health as there are for the study of fertility and child health. Validation studies help quantify the sensitivity and specificity of interview questions about selected symptoms of obstetric complications, while qualitative research provides insight into women's own perceptions about their experiences as well as some of the sociocultural issues influencing their reports. The findings from these preliminary studies and the SMS suggest that interview-based diagnosis of obstetric complications is the only method of obtaining any indication of how prevalent maternal morbidity is among women within a population. Interviews do require considerable resources, however. For example, in the Philippines, 4-5 months of intensive activity took place before implementation of the standard pretest, interviewer training, and survey fieldwork. This intensive activity involved an epidemiologist and a social scientist with qualitative research skills, both of whom might not normally participate in a Demographic and Health Survey-type survey. Yet this information is needed to improve obstetric care and women's overall health status.