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The sisterhood method for estimating maternal
mortality
Guidance notes for potential users
SharePrint
Authors:
World Health Organization, Department of Reproductive Health and
Research
Publication details
Number of pages: 28
Publication date: 1997
Languages: English, French
WHO reference number: WHO/RHT/97.28
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overview
The sisterhood method is an indirect measurement technique of
the kind
frequently used for a variety of demographic parameters which
has been
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adapted to maternal mortality. It reduces sample size
requirements because it
obtains information by interviewing respondents about the
survival of all their
adult sisters. These guidance notes are intended for health
policy-makers and
planners who wish to estimate levels of maternal mortality, but
who may not befamiliar with the different approaches available and
the strengths and
weaknesses of each. They are not intended to provide detailed
technical
guidance on how to carry out sisterhood studies.
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Sisterhood methodFrom Wikipedia, the free encyclopedia
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This article may be written likean advertisement. If so,
please
helprewrite this articlefrom aneutral point of view.(February
2011)
Although maternal deaths are a major problem in developing
countries,high quality data are rare. Yet, numbers are needed for
planning in order to
reduce the problem ofmaternal death. Several methods have been
used
to estimate maternal deaths. One household survey to estimate
maternal
deaths is theSisterhood Method, which includes only 4 simple
questions.
The Sisterhood Method is one method recommended by theWHO. It
is
useful, because it is quick, cheap, and reduces sample size
requirements.[1][2]
Contents
[hide]
1 Background
2 Estimating maternal deaths
3 Sisterhood Method
4 How is the Sisterhood Method applied
5 When should the Sisterhood Method not be used
6 Variant of the original Sisterhood Method
7 References
[edit]Background
The death of a woman during or shortly after a pregnancyis
an
important medical problem in developing countries. 99% of
allmaternal
deathsoccur indeveloping countries.[3]In the poorest countries
in the
world, e.g. Sierra Leone, the lifetime risk for a woman dying
because of amaternal death is approx 1 in 6, whereas in developed
countries, e.g.
Sweden, the same lifetime risk is approx 1 in 30,000.[4]Half of
all maternal
deaths occur in six countries only: Afghanistan, Democratic
Republic of
Congo, Ethiopia, India, Nigeria, and Pakistan. Worldwide,
maternal deaths
decreased from approx 500,000 in 1980 to approx 350,000 in 2008.
This
decline in maternal deaths was associated mainly with better
maternal
education, maternal income, increased availability of trained
birth
attendants, and decreased pregnancy rates.
[5]
http://en.wikipedia.org/wiki/Wikipedia:NOT#SOAPBOXhttp://en.wikipedia.org/wiki/Wikipedia:NOT#SOAPBOXhttp://en.wikipedia.org/wiki/Wikipedia:NOT#SOAPBOXhttp://en.wikipedia.org/w/index.php?title=Sisterhood_method&action=edithttp://en.wikipedia.org/w/index.php?title=Sisterhood_method&action=edithttp://en.wikipedia.org/w/index.php?title=Sisterhood_method&action=edithttp://en.wikipedia.org/wiki/Wikipedia:Neutral_point_of_viewhttp://en.wikipedia.org/wiki/Wikipedia:Neutral_point_of_viewhttp://en.wikipedia.org/wiki/Maternal_deathhttp://en.wikipedia.org/wiki/Maternal_deathhttp://en.wikipedia.org/wiki/Maternal_deathhttp://en.wikipedia.org/wiki/WHOhttp://en.wikipedia.org/wiki/WHOhttp://en.wikipedia.org/wiki/WHOhttp://en.wikipedia.org/wiki/Sisterhood_method#cite_note-0http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-0http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-1http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-1http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-1http://en.wikipedia.org/wiki/Sisterhood_methodhttp://en.wikipedia.org/wiki/Sisterhood_methodhttp://en.wikipedia.org/wiki/Sisterhood_methodhttp://en.wikipedia.org/wiki/Sisterhood_method#Backgroundhttp://en.wikipedia.org/wiki/Sisterhood_method#Backgroundhttp://en.wikipedia.org/wiki/Sisterhood_method#Estimating_maternal_deathshttp://en.wikipedia.org/wiki/Sisterhood_method#Estimating_maternal_deathshttp://en.wikipedia.org/wiki/Sisterhood_method#Sisterhood_Methodhttp://en.wikipedia.org/wiki/Sisterhood_method#Sisterhood_Methodhttp://en.wikipedia.org/wiki/Sisterhood_method#How_is_the_Sisterhood_Method_appliedhttp://en.wikipedia.org/wiki/Sisterhood_method#How_is_the_Sisterhood_Method_appliedhttp://en.wikipedia.org/wiki/Sisterhood_method#When_should_the_Sisterhood_Method_not_be_usedhttp://en.wikipedia.org/wiki/Sisterhood_method#When_should_the_Sisterhood_Method_not_be_usedhttp://en.wikipedia.org/wiki/Sisterhood_method#Variant_of_the_original_Sisterhood_Methodhttp://en.wikipedia.org/wiki/Sisterhood_method#Variant_of_the_original_Sisterhood_Methodhttp://en.wikipedia.org/wiki/Sisterhood_method#Referenceshttp://en.wikipedia.org/wiki/Sisterhood_method#Referenceshttp://en.wikipedia.org/w/index.php?title=Sisterhood_method&action=edit§ion=1http://en.wikipedia.org/w/index.php?title=Sisterhood_method&action=edit§ion=1http://en.wikipedia.org/w/index.php?title=Sisterhood_method&action=edit§ion=1http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-2http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-2http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-2http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-3http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-3http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-3http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-4http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-4http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-4http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-4http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-3http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-2http://en.wikipedia.org/w/index.php?title=Sisterhood_method&action=edit§ion=1http://en.wikipedia.org/wiki/Sisterhood_method#Referenceshttp://en.wikipedia.org/wiki/Sisterhood_method#Variant_of_the_original_Sisterhood_Methodhttp://en.wikipedia.org/wiki/Sisterhood_method#When_should_the_Sisterhood_Method_not_be_usedhttp://en.wikipedia.org/wiki/Sisterhood_method#How_is_the_Sisterhood_Method_appliedhttp://en.wikipedia.org/wiki/Sisterhood_method#Sisterhood_Methodhttp://en.wikipedia.org/wiki/Sisterhood_method#Estimating_maternal_deathshttp://en.wikipedia.org/wiki/Sisterhood_method#Backgroundhttp://en.wikipedia.org/wiki/Sisterhood_methodhttp://en.wikipedia.org/wiki/Sisterhood_method#cite_note-1http://en.wikipedia.org/wiki/Sisterhood_method#cite_note-0http://en.wikipedia.org/wiki/WHOhttp://en.wikipedia.org/wiki/Maternal_deathhttp://en.wikipedia.org/wiki/Wikipedia:Neutral_point_of_viewhttp://en.wikipedia.org/w/index.php?title=Sisterhood_method&action=edithttp://en.wikipedia.org/wiki/Wikipedia:NOT#SOAPBOX
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[edit]Estimating maternal deaths
Although maternal deaths are a major problem in developing
countries,
seen globally, the numbers are not very large, and there is an
absence of
high quality data. Yet, numbers are needed for planning in order
to reducematernal deaths. Several methods have been used to
estimate maternal
deaths. They include analysing census records and
medical/death
certificates[6], andReproductive Age Mortality
Studies(RAMOS).[7]Also,household surveysare used. All of
these
methods are not totally precise, but they can provide some
useful
information to decrease maternal mortality.
In contrast, fullsurveillance programmeswould be too costly and
too
unrealistic for many developing countries.[8]
[edit]Sisterhood Method
TheSisterhood Methodis the commonest household survey for
estimating maternal deaths. It is quick, cheap, and reduces
sample size
requirements; in countries or areas with high levels of maternal
deaths, i.e.
over 500 maternal deaths per 100,000 live births, a sample size
of only
4000 households or less is acceptable for this method[9]. But
the method
still provides a useful means of assessing maternal
mortality.
This method includes only 4 simple questions about the sisters
of the
woman in question:
Question 1:How many sisters have you ever had, born to the
same
mother, who ever reached the age 15 (or who were ever married),
including
those who are now dead?
Question 2:How many of your sisters who reached the age of 15
are alive
now?
Question 3:How many of these sisters are dead?
Question 4:How many of your sisters who are dead died during
a
pregnancy or during childbirth, or during the six weeks after
the end of a
pregnancy?
[edit]How is the Sisterhood Method applied
Deaths occurring over a large interval of time are documented.
The overallestimate of maternal mortality is determined for 10-12
years before the
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survey. The Sisterhood Method is useful because usually
maternal
mortality changes slowly. It provides some meaningful data in
countries or
areas where there are no alternative means of generating
estimates.
[edit]When should the Sisterhood Method not beused
The Sisterhood Method is not appropriate in countries or areas
where the
total fertility rate is less than 4 children per family, in
areas of significant
migration, as well as during civil war, civil unrest or other
significant social
disruption.
[edit]Variant of the original Sisterhood Method
The original Sisterhood Method is an indirect method. The
newerDirect
Sisterhood Methodtargets a more limited reference period for
sister
deaths and uses more in depth questions (e.g., deaths among all
siblings,
all deaths that are pregnancy related, and when these deaths
occurred).
This variant relies on fewer assumptions than the original
Sisterhood
Method. However, it requires a larger sample size, data
gathering and
analysis are more complex, and has large confidence intervals.
Despite
these limitations, the Direct Sisterhood Method can result in
greater
specificity of information. A retrospective maternal mortality
ratio (MMR)
can be calculated. This variant is used byDemographic and
Health
Surveys(DHS).[10]
[11]
[edit]References
1.^The sisterhood method for estimating maternal mortality:
Guidance
notes for potential users. WHO. Geneva, Switzerland. 1997.
2.^Indirect estimation of maternal mortality: The sisterhood
method.Graham W, Brass W, Snow RW. Stud Fam Planning.
1989:20(3):125-
35.
3.^Maternal mortality in 2000: Estimates developed by WHO,
UNICEF
and UNFPA. AbouZahar C, Wardlaw T (Eds). WHO. Geneva,
Switzerland. 2003.
4.^Maternal mortality: Who, when, where, and why. Ronsmans
C,
Graham WJ; Lancet Maternal Survival Series Steering Group.
Lancet.
2006;368(9542):1189-200.
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5.^Maternal mortality for 181 countries, 1980-2008: A
systematic
analysis of progress towards Millennium Development Goal 5.
Hogan
MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, Lopez
AD, Lozano R, Murray CJ. Lancet. 2010;375(9726):1609-23.
6.^Underreporting of maternal deaths on death certificates and
the
magnitude of the problem of maternal mortality. Horon IL. Am J
Public
Health. 2005;95(3):478-82.
7.^National maternal mortality study, 2005. Carried out by:
Haceteppe
University Medical School, Institute of Population Studies. For
the
Turkish Ministry of Health, the General Directorate of Mother
and Child
Health and Family Planning, and the Delegation of European
Commission to Turkey. Ankara, Turkey. 2006.
8.^Measuring maternal mortality: An overview of opportunities
and
options for developing countries. Graham WJ, Ahmed S, Stanton
C,
Abou-Zahr C, Campbell OM. BMC Med. 2008;6:12.
9.^http://www.who.org/reproductive-
health/publications/rht_97_28/RHT_97_28_chapter2.en.html
10. ^Direct and indirect estimates of maternal mortality from
the
Sisterhood Method. Rutenberg N, Sullivan JM (Eds). Washington
DC,
USA. 1991.
11. ^An assessment of DHS maternal mortality indicators. Stud
Fam
Planning. 2000:31(2):111-23.
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Applying the Sisterhood Method forEstimating Maternal Mortality
to aHealth Facility-Based Sample: AComparison with Results from
a
Household-Based Sample1. ISABELLA DANEL*,
http://en.wikipedia.org/wiki/Category:Deaths_in_childbirthhttp://en.wikipedia.org/wiki/Category:Deaths_in_childbirthhttp://en.wikipedia.org/wiki/Category:Deathhttp://en.wikipedia.org/wiki/Category:Deathhttp://en.wikipedia.org/wiki/Category:Obstetricshttp://en.wikipedia.org/wiki/Category:Obstetricshttp://en.wikipedia.org/wiki/Category:Demographyhttp://en.wikipedia.org/wiki/Category:Demographyhttp://en.wikipedia.org/w/index.php?title=Special:UserLogin&returnto=Sisterhood_method&campaign=ACP3http://en.wikipedia.org/w/index.php?title=Special:UserLogin&returnto=Sisterhood_method&campaign=ACP3http://en.wikipedia.org/wiki/Sisterhood_methodhttp://en.wikipedia.org/wiki/Sisterhood_methodhttp://en.wikipedia.org/wiki/Talk:Sisterhood_methodhttp://en.wikipedia.org/wiki/Talk:Sisterhood_methodhttp://en.wikipedia.org/wiki/Sisterhood_methodhttp://en.wikipedia.org/wiki/Sisterhood_methodhttp://en.wikipedia.org/w/index.php?title=Sisterhood_method&action=edithttp://en.wikipedia.org/w/index.php?title=Sisterhood_method&action=edithttp://en.wikipedia.org/w/index.php?title=Sisterhood_method&action=historyhttp://en.wikipedia.org/w/index.php?title=Sisterhood_method&action=historyhttp://en.wikipedia.org/wiki/Main_Pagehttp://en.wikipedia.org/wiki/Main_Pagehttp://en.wikipedia.org/wiki/Portal:Contentshttp://en.wikipedia.org/wiki/Portal:Contentshttp://en.wikipedia.org/wiki/Portal:Featured_contenthttp://en.wikipedia.org/wiki/Portal:Featured_contenthttp://en.wikipedia.org/wiki/Portal:Current_eventshttp://en.wikipedia.org/wiki/Portal:Current_eventshttp://en.wikipedia.org/wiki/Special:Randomhttp://en.wikipedia.org/wiki/Special:Randomhttp://wikimediafoundation.org/wiki/Special:Landingcheck?landing_page=WMFJA085&language=en&utm_source=donate&utm_medium=sidebar&utm_campaign=20101204SB002http://wikimediafoundation.org/wiki/Special:Landingcheck?landing_page=WMFJA085&language=en&utm_source=donate&utm_medium=sidebar&utm_campaign=20101204SB002http://en.wikipedia.org/wiki/Help:Contentshttp://en.wikipedia.org/wiki/Help:Contentshttp://en.wikipedia.org/wiki/Wikipedia:Abouthttp://en.wikipedia.org/wiki/Wikipedia:Abouthttp://en.wikipedia.org/wiki/Wikipedia:Community_portalhttp://en.wikipedia.org/wiki/Wikipedia:Community_portalhttp://en.wikipedia.org/wiki/Special:RecentChangeshttp://en.wikipedia.org/wiki/Special:RecentChangeshttp://en.wikipedia.org/wiki/Wikipedia:Contact_ushttp://en.wikipedia.org/wiki/Wikipedia:Contact_ushttp://en.wikipedia.org/wiki/Wikipedia:Text_of_Creative_Commons_Attribution-ShareAlike_3.0_Unported_Licensehttp://en.wikipedia.org/wiki/Wikipedia:Text_of_Creative_Commons_Attribution-ShareAlike_3.0_Unported_Licensehttp://en.wikipedia.org/wiki/Wikipedia:Text_of_Creative_Commons_Attribution-ShareAlike_3.0_Unported_Licensehttp://wikimediafoundation.org/wiki/Terms_of_usehttp://wikimediafoundation.org/wiki/Terms_of_usehttp://wikimediafoundation.org/wiki/Terms_of_usehttp://www.wikimediafoundation.org/http://www.wikimediafoundation.org/http://www.wikimediafoundation.org/http://en.wikipedia.org/wiki/Wikipedia:Contact_ushttp://en.wikipedia.org/wiki/Wikipedia:Contact_ushttp://ije.oxfordjournals.org/search?author1=ISABELLA+DANEL&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=ISABELLA+DANEL&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=ISABELLA+DANEL&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=ISABELLA+DANEL&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=ISABELLA+DANEL&sortspec=date&submit=Submithttp://en.wikipedia.org/wiki/Wikipedia:Contact_ushttp://www.wikimediafoundation.org/http://wikimediafoundation.org/wiki/Terms_of_usehttp://en.wikipedia.org/wiki/Wikipedia:Text_of_Creative_Commons_Attribution-ShareAlike_3.0_Unported_Licensehttp://en.wikipedia.org/wiki/Wikipedia:Contact_ushttp://en.wikipedia.org/wiki/Special:RecentChangeshttp://en.wikipedia.org/wiki/Wikipedia:Community_portalhttp://en.wikipedia.org/wiki/Wikipedia:Abouthttp://en.wikipedia.org/wiki/Help:Contentshttp://wikimediafoundation.org/wiki/Special:Landingcheck?landing_page=WMFJA085&language=en&utm_source=donate&utm_medium=sidebar&utm_campaign=20101204SB002http://en.wikipedia.org/wiki/Special:Randomhttp://en.wikipedia.org/wiki/Portal:Current_eventshttp://en.wikipedia.org/wiki/Portal:Featured_contenthttp://en.wikipedia.org/wiki/Portal:Contentshttp://en.wikipedia.org/wiki/Main_Pagehttp://en.wikipedia.org/w/index.php?title=Sisterhood_method&action=historyhttp://en.wikipedia.org/w/index.php?title=Sisterhood_method&action=edithttp://en.wikipedia.org/wiki/Sisterhood_methodhttp://en.wikipedia.org/wiki/Talk:Sisterhood_methodhttp://en.wikipedia.org/wiki/Sisterhood_methodhttp://en.wikipedia.org/w/index.php?title=Special:UserLogin&returnto=Sisterhood_method&campaign=ACP3http://en.wikipedia.org/wiki/Category:Demographyhttp://en.wikipedia.org/wiki/Category:Obstetricshttp://en.wikipedia.org/wiki/Category:Death
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2. WENDY GRAHAM**,3. PAUL STUPP*and4. PEDRO CASTILLO
+Author Affiliations1. *Centers for Disease Control and
Prevention, Division of Reproductive
Health MS K-35, 1600 Clifton Road, Atlanta, GA30333, USA.2.
**Dugald Baird Centre for Research on Women's Health, Aberdeen
University UK.
3. Alejandro Davila Bolanos Hospital Esteli, Nicaragua. Revision
received March 1, 1996.
Abstract
Danel I (Centers for Disease Control and Prevention, Division
of
Reproductive Health, MS K-35, 1600 Clifton Road, Atlanta, GA
30333,
USA), Graham W, Stupp P and Castillo P. Applying the
sisterhoodmethod for estimating maternal mortality to a health
facility-basedsample: A comparison with results from a
household-based sample.
International Journal of Epidemiology 1996; 25:
10171022.BackgroundThe sisterhood method Is an Indirect technique
used to
estimate maternal mortality In developing countries, where
maternal
deaths are often poorly registered in official statistics. It
has been usedsuccessfully in many community-based household
surveys. Because such
surveys can be costly, this study investigated the suitability
of using data
collected in outpatient hearth facilities.MethodsAdults visiting
any one of 91 health centres or posts in a rural
region of Nicaragua were randomly sampled and interviewed by
health
personnel A sample size, proportional to the population served,
wasassigned to each facility and 9232 adults were interviewed.
Characteristics of heath facility users were compared with the
general
population to identify factors that would allow generalization
of results to
other settings.Results Based on these data, the lifetime risk of
maternal death was
0.0144 (1 in 69). This estimate is essentially identical to that
from a
household-based survey in the same region 8 months earlier,
whichobtained a lifetime nsk of 0.0145 (1 in 69). These findings
correspond to
a maternal mortality ratio of 241 and 243/100 000 livebirths,
respectively.ConclusionsThis is the first report comparing results
of the sisterhood
method from household and health facility-based samples. The
sisterhood
method provided a robust estimate of the magnitude of
maternal
mortality. Results from the opportunistic health facility-based
sample
were virtually identical to results from the household-based
study.
Guidelines need to be developed for applying this low-cost and
efficient
aproach to estimating maternal mortality in suitable
opportunistic settingsat subnational levels.
http://ije.oxfordjournals.org/search?author1=WENDY+GRAHAM&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=WENDY+GRAHAM&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=WENDY+GRAHAM&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=PAUL+STUPP&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=PAUL+STUPP&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=PAUL+STUPP&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=PEDRO+CASTILLO&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=PEDRO+CASTILLO&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=PEDRO+CASTILLO&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/content/25/5/1017.abstracthttp://ije.oxfordjournals.org/content/25/5/1017.abstracthttp://ije.oxfordjournals.org/search?author1=PEDRO+CASTILLO&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=PEDRO+CASTILLO&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=PAUL+STUPP&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=PAUL+STUPP&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=WENDY+GRAHAM&sortspec=date&submit=Submithttp://ije.oxfordjournals.org/search?author1=WENDY+GRAHAM&sortspec=date&submit=Submit
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Key words
maternal mortality
sisterhood method
health surveys
Nicaragua
International Epidemiological Association
Articles citing this article Adult mortality: time for a
reappraisalInt J Epidemiol (2004) 33(4): 710-717
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Online ISSN 1464-3685 -
Print ISSN 0300-5771
Stud Fam Plann.1989 May-Jun;20(3):125-35.
Estimating maternal mortality: the sisterhood method.
Graham W,Brass W,Snow RW.
Source
Maternal and Child Epidemiology Unit, London School of Hygiene
and TropicalMedicine, United Kingdom.
Abstract
http://ije.oxfordjournals.org/cgi/content/short/39/3/675?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/39/3/675?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/39/3/675?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/39/3/675?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/39/3/675?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/39/3/675?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/39/3/675?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/30/3/427?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/30/3/427?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/30/4/668?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/30/4/668?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/30/4/668?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/30/4/668?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/30/4/668?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/31/2/285?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/31/2/285?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/31/2/285?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/31/2/285?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/31/2/285?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/31/2/285?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/31/2/285?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/reports/mfr1.dtlhttp://ije.oxfordjournals.org/reports/mfr1.dtlhttp://www.oxfordjournals.org/contact_us.html#custservhttp://www.oxfordjournals.org/contact_us.html#custservhttp://www.oxfordjournals.org/contact_us.html#custservhttp://www.oxfordjournals.org/contact_us.html#custservhttp://www.ncbi.nlm.nih.gov/pubmed/2734809http://www.ncbi.nlm.nih.gov/pubmed/2734809http://www.ncbi.nlm.nih.gov/pubmed?term=%22Graham%20W%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Graham%20W%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Brass%20W%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Brass%20W%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Brass%20W%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Snow%20RW%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Snow%20RW%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Snow%20RW%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Snow%20RW%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Brass%20W%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Graham%20W%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/2734809http://www.oxfordjournals.org/contact_us.html#custservhttp://www.oxfordjournals.org/contact_us.html#custservhttp://ije.oxfordjournals.org/reports/mfr1.dtlhttp://ije.oxfordjournals.org/cgi/content/short/31/2/285?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/31/2/285?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/31/2/285?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/31/2/285?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/30/4/668?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/30/4/668?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/30/3/427?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/39/3/675?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/39/3/675?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/39/3/675?rss=1&ssource=mfrhttp://ije.oxfordjournals.org/cgi/content/short/39/3/675?rss=1&ssource=mfr
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This paper describes a new indirect technique for deriving
population-based
estimates of maternal mortality. The technique, called the
"sisterhood
method," is relevant to developing countries where the
alternative data
sources and approaches to estimation are often inadequate and
inappropriate.The sisterhood method uses the proportions of adult
sisters dying during
pregnancy, childbirth, or the puerperium reported by adults
during a census or
survey, to derive a variety of indicators of maternal mortality.
The first field trial
of the method was carried out in the North Bank Division of The
Gambia, West
Africa, in 1987. The results indicate a lifetime risk of
maternal mortality of
0.0584, or 1 in 17, approximating a maternal mortality ratio of
1,005 per
100,000 live births, which is consistent with previous estimates
for this region.
PMID:
2734809
[PubMed - indexed for MEDLINE]
Publication Types, MeSH Terms
Estimating Maternal Mortality: The Sisterhood MethodWendy
Graham, William Brass and Robert W. SnowStudies in Family
PlanningVol. 20, No. 3 (May - Jun., 1989), pp. 125-135(article
consists of 11 pages)Published by:Population CouncilStable URL:
http://www.jstor.org/stable/1966567
http://www.ncbi.nlm.nih.gov/pubmed/2734809http://www.ncbi.nlm.nih.gov/pubmed/2734809http://www.jstor.org/action/showPublisher?publisherCode=popcouncilhttp://www.jstor.org/action/showPublisher?publisherCode=popcouncilhttp://www.jstor.org/action/showPublisher?publisherCode=popcouncilhttp://www.jstor.org/action/showPublisher?publisherCode=popcouncilhttp://www.ncbi.nlm.nih.gov/pubmed/2734809
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Studies in Family Planning 1989Population Council
http://www.jstor.org/action/showPublisher?publisherCode=popcouncilhttp://www.jstor.org/action/showPublisher?publisherCode=popcouncilhttp://www.jstor.org/action/showPublisher?publisherCode=popcouncilhttp://www.jstor.org/action/showPublisher?publisherCode=popcouncil
