Levels and causes of maternal mortality in southern India
Bhatia, J.C.
Studies in Family Planning 24(5): 310-318
1993
ISSN/ISBN: 0039-3665 PMID: 8296332 DOI: 10.2307/2939224Document Number: 330507
Most studies of maternal mortality are hospital based. However, in developing countries where many such deaths take place in the home, hospital statistics do not reflect the true extent of maternal mortality. Furthermore, the socioeconomic and demographic factors and health behaviour affecting mortality are rarely known. A study conducted in 1986 in southern India demonstrates a new approach to investigating maternal mortality that combines the collection of information from hospital and health facility records, field surveys and case control studies. Carried out in Anantapur district, Andhra Pradesh, the study specifically investigated: levels of maternal mortality in the area, based on the occurrence of such deaths in the whole community over a period of one year; the causes of deaths in clinical terms; and the socioeconomic, cultural and behavioural factors that might be altered to prevent maternal deaths. During the first phase of the study, interviewers visited 16 hospitals and municipal offices serving an urban population of 569500, and 22 villages with primary health centres, 181 villages with subcentres, and 1192 other villages spread over the district, comprising a total rural population of 1 090 640. During the second phase, the interviewers again visited all the towns and 10 villages, 65 subcentre villages and 135 other villages. The findings from the study indicate that there were a total of 1073 maternal deaths (867 and 206 in the rural and urban areas, respectively) over the period, which represented 7.98 deaths per 1000 live births. Around half of these deaths occurred in the home or on the way to the hospital. Maternal deaths accounted for 36% of mortality for women of reproductive age. No rural-urban differentials in the age pattern of these deaths were discernible. Analysis reveals that many of these deaths were preventable and that significant differentials existed with regard to demographic, social and behavioural factors between the cases of maternal deaths and the controls.