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Maternal mortality for 181 countries

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Institute for Health Metrics and Evaluation - University of Washington
Institute for Health Metrics and Evaluation - University of Washington
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Maternal mortality for 181 countries, 1980-2008 ,[object Object]
Opportunities for a Robust Reassessment of Maternal Mortality ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clarifying the Definition of the MMR ,[object Object],[object Object],[object Object],  Direct Indirect HIV Incidental Early maternal (<42 days) A B C D Late maternal (> 42 days & < 1 year) E F    
Systematic Identification of Data ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Final Database by Source ,[object Object],[object Object]
Sibling History Data Needs to be Corrected for Survivor Bias Obermeyer et al 2010, PLoS Medicine
Analytical Approach ,[object Object],[object Object],[object Object],[object Object],[object Object]
Model Validation: An Essential Test ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sources of Uncertainty ,[object Object],[object Object],[object Object],[object Object]
India: Available Studies and Predicted MMR With Uncertainty
Mali: Available Studies and Predicted MMR With Uncertainty
Trend in Global Maternal Deaths
MMR in 2008
Top 21 Countries: 80% of Maternal Deaths Order Country Deaths in 1000s (UI) % Cumulative % Births (%) Cumulative % 1 India 68.3 (41.6-106.2) 19.9 19.9 19.7 19.7 2 Nigeria 36.7 (22.4-57.0) 10.7 30.6 4.4 24.1 3 Pakistan 20.1 (12.3-31.3) 5.9 36.5 3.9 28.0 4 Afghanistan 20.0 (7.5-43.1) 5.8 42.3 0.9 28.9 5 Ethiopia 18.2 (11.1-28.8) 5.3 47.6 2.3 31.2 6 Congo, the Democratic Republic of the 15.4 (9.0-24.7) 4.5 52.1 2.1 33.3 7 Bangladesh 11.6 (6.7-18.7) 3.4 55.5 2.5 35.8 8 Indonesia 9.6 (5.6-16.0) 2.8 58.3 3.1 38.9 9 Tanzania, United Republic of 8.0 (4.8-12.8) 2.3 60.6 1.3 40.2 10 China 7.3 (6.4-8.3) 2.1 62.7 13.3 53.5 11 Malawi 6.8 (4.0-10.9) 2.0 64.7 0.4 53.9 12 Côte d'Ivoire 6.8 (4.1-10.8) 2.0 66.7 0.5 54.4 13 Kenya 6.2 (3.6-10.2) 1.8 68.5 1.1 55.5 14 Chad 5.3 (3.3-8.2) 1.5 70.0 0.4 55.9 15 Mozambique 5.2 (3.1-8.4) 1.5 71.5 0.6 56.5 16 Uganda 5.2 (3.1-8.2) 1.5 73.0 1.1 57.6 17 Cameroon 5.0 (2.8-8.1) 1.4 74.4 0.5 58.1 18 Niger 4.7 (3.0-7.3) 1.4 75.8 0.6 58.7 19 Angola 4.6 (1.8-9.9) 1.3 77.1 0.6 59.3 20 Sudan 4.0 (2.5-6.0) 1.2 78.3 0.9 60.2 21 Mali 3.6 (2.3-5.5) 1.1 79.4 0.4 60.6 All other countries (160) 70.3 (43.0-112.2) 20.5 100.0 39.3 100.0 Total   342.9 100.0 100.0 100.0 100.0
Annualized Rate of Decline in MMR, 1990 to 2008
Progress Undocumented But Not Unexpected ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Improving Maternal Mortality Measurement in the Future ,[object Object],[object Object],[object Object],[object Object],[object Object]
Progress on MDG4 and MDG5 Can be Different Equivalence Line
Global Progress Toward Reducing Maternal and Child Mortality

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Maternal mortality for 181 countries

  • 1.
  • 2.
  • 3.
  • 4.
  • 5.
  • 6. Sibling History Data Needs to be Corrected for Survivor Bias Obermeyer et al 2010, PLoS Medicine
  • 7.
  • 8.
  • 9.
  • 10. India: Available Studies and Predicted MMR With Uncertainty
  • 11. Mali: Available Studies and Predicted MMR With Uncertainty
  • 12. Trend in Global Maternal Deaths
  • 14. Top 21 Countries: 80% of Maternal Deaths Order Country Deaths in 1000s (UI) % Cumulative % Births (%) Cumulative % 1 India 68.3 (41.6-106.2) 19.9 19.9 19.7 19.7 2 Nigeria 36.7 (22.4-57.0) 10.7 30.6 4.4 24.1 3 Pakistan 20.1 (12.3-31.3) 5.9 36.5 3.9 28.0 4 Afghanistan 20.0 (7.5-43.1) 5.8 42.3 0.9 28.9 5 Ethiopia 18.2 (11.1-28.8) 5.3 47.6 2.3 31.2 6 Congo, the Democratic Republic of the 15.4 (9.0-24.7) 4.5 52.1 2.1 33.3 7 Bangladesh 11.6 (6.7-18.7) 3.4 55.5 2.5 35.8 8 Indonesia 9.6 (5.6-16.0) 2.8 58.3 3.1 38.9 9 Tanzania, United Republic of 8.0 (4.8-12.8) 2.3 60.6 1.3 40.2 10 China 7.3 (6.4-8.3) 2.1 62.7 13.3 53.5 11 Malawi 6.8 (4.0-10.9) 2.0 64.7 0.4 53.9 12 Côte d'Ivoire 6.8 (4.1-10.8) 2.0 66.7 0.5 54.4 13 Kenya 6.2 (3.6-10.2) 1.8 68.5 1.1 55.5 14 Chad 5.3 (3.3-8.2) 1.5 70.0 0.4 55.9 15 Mozambique 5.2 (3.1-8.4) 1.5 71.5 0.6 56.5 16 Uganda 5.2 (3.1-8.2) 1.5 73.0 1.1 57.6 17 Cameroon 5.0 (2.8-8.1) 1.4 74.4 0.5 58.1 18 Niger 4.7 (3.0-7.3) 1.4 75.8 0.6 58.7 19 Angola 4.6 (1.8-9.9) 1.3 77.1 0.6 59.3 20 Sudan 4.0 (2.5-6.0) 1.2 78.3 0.9 60.2 21 Mali 3.6 (2.3-5.5) 1.1 79.4 0.4 60.6 All other countries (160) 70.3 (43.0-112.2) 20.5 100.0 39.3 100.0 Total   342.9 100.0 100.0 100.0 100.0
  • 15. Annualized Rate of Decline in MMR, 1990 to 2008
  • 16.
  • 17.
  • 18. Progress on MDG4 and MDG5 Can be Different Equivalence Line
  • 19. Global Progress Toward Reducing Maternal and Child Mortality