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MATERNAL MORTALITY STUDY Presented by Dr. Henrietta Odoi-Agyarko

MATERNAL MORTALITY STUDY Presented by Dr. Henrietta Odoi-Agyarko Deputy Director Public Health (FH) Ghana Health Service Health Summit, 14/12/2004. OUTLINE OF PRESENTATION. Goal of the study Objectives Highlights Timeline/Workplan

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MATERNAL MORTALITY STUDY Presented by Dr. Henrietta Odoi-Agyarko

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  1. MATERNAL MORTALITY STUDY Presented by Dr. Henrietta Odoi-Agyarko Deputy Director Public Health (FH) Ghana Health Service Health Summit, 14/12/2004

  2. OUTLINE OF PRESENTATION • Goal of the study • Objectives • Highlights • Timeline/Workplan • Budget

  3. GOAL OF THE STUDY • To develop reliable tools for monitoring the progress of national intervention programmes aimed at reducing maternal morbidity and mortality

  4. OBJECTIVES • To estimate national and regional burden of maternal mortality • To estimate the burden of obstetric fistulae • To estimate national and regional abortion rates • To estimate the national and regional rates of infertility • To assess existing methods and systems for reporting maternal mortality

  5. OBJECTIVES CONT’D · To ascertain socio-economic factors that influence maternal mortality, infertility, obstetric fistulae and abortions at the national and regional levels • To assess the coverage of essential obstetric care (EOC) in both public and private health facilities • To estimate proportion of maternal deaths in selected health facilities in the country • To make recommendations towards reducing maternal mortality and improving the health of women

  6. METHODOLOGY • The study proposes a multi-faceted approach • Data from births and deaths registration system • Hospital and mortuary records from the major hospitals • Data from the World Health Survey 2002 • Primary data collection based on information from selected districts

  7. VITAL REGISTRATION SYSTEM • Accounts for less than 25% of the deaths and about 30% of the births • Analysis will provide useful insight into the burden of maternal deaths • Collation of existing data of all female deaths aged 15-49 years from all vital registration centres • Examine ways of strengthening the system

  8. VITAL REGISTRATION SYSTEM CONT’D • Data collection: • Demographic characteristics • Date and place of death • Cause of death, and • Whether or not the death was certified by a medical doctor • Analysis: • Development of adjustment factors to compensate for the level of under-registration and coverage

  9. HOSPITAL AND MORTUARY RECORDS • To obtain trends in the level of maternal mortality • To assess the coverage of essential obstetric care Focus will be on the major health centres and hospitals in all regions including public and private sectors

  10. HOSPITAL AND MORTUARY RECORDS CONT’D • Data to be collected will include: • Total monthly outpatient attendance (all ages) • Monthly antenatal registrants • Total monthly deliveries • All females aged 15-49 years who died in the facility • Total monthly maternal deaths by cause • Availability of essential obstetric services • Review all audited maternal deaths in 2004

  11. WORLD HEALTH SURVEY 2002 • Analysis to be done on the maternal mortality component • To provide insight into the burden of maternal mortality in the country

  12. IMMPACT • Findings from the IMMPACT’s study in the measurement of maternal mortality will be reviewed • To provide further insight into the burden of maternal mortality

  13. SURVEY ON MATERNAL MORTALITY • A nationwide sample survey using the “direct” sisterhood method • Information will be obtained by interviewing women aged 15-49 years • Two main questionnaires will be used for the survey • Household questionnaire • Identifies eligible individuals for interview

  14. SURVEY ON MATERNAL MORTALITY CONT’D • Individual questionnaire • Socio-demographic characteristics of the respondents • Questions on the sisterhood method • Socio-economic characteristics of the victims of maternal deaths • Questions to ascertain the cause of the maternal death through verbal autopsy

  15. SURVEY ON MATERNAL MORTALITY CONT’D • Individual questionnaire • Questions on infertility (primary and secondary) • Questions on obstetric fistulae • Questions on the practices and prevalence of abortion

  16. SAMPLING • Multistage sampling technique will be used • List of enumerated areas (AE’s) from the 2000 population and housing census will be the frame • Each AE will serve as a cluster • The frame will first be stratified into regions and then into urban and rural

  17. SAMPLE SIZE • With a maternal mortality level of 214-540 • Thirteen thousand (13,000) respondents needed for the direct sisterhood method per region (+/-10% margin of error) • 130,000 respondents needed nationwide • The number of households will approximately be 144,000 (female adults /household is 0.95, DHS 2003)

  18. WORKPLAN

  19. BUDGET ESTIMATES (US$) • Selection and printing of EA maps- 5,738 • Collection and analysis of data- 120,000 • Household listing • Training and fieldwork - 441,447 • Procurement • Computers, vehicles,etc - 923,147

  20. BUDGET ESTIMATES CONT’D (US$) • Publicity/Communication - 18,550 • Fieldwork - 1,123,898 • Data processing - 315,291 • Secretarial staff - 7,200 • Consultants • And project personnel - 327,000

  21. BUDGET ESTIMATES CONT’D (US$) • Total - 3,282,271 • 10% Contingency - 328,227.1 • GRAND TOTAL 3,610,498

  22. THANK YOU!!

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