Maternal Mortality Decline in the Kassena-Nankana District of Northern Ghana
Maternal Mortality Decline in the Kassena-Nankana District of Northern Ghana
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DOI：
10.1007/s10995-007-0289-x
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发表时间：
2008-09-01
影响因子：
2.3
通讯作者：
Hodgson, Abraham
中科院分区：
文献类型：
--
作者：
Mills, Samuel;Williams, John E.;Hodgson, Abraham
在加纳缺乏适当的生命登记系统的情况下，1993年建立的Navrongo人口监测系统（NDSS）为监测贫困农村地区实现联合国千年发展目标（MDG）孕产妇健康（MDG）提供了一种可行的替代方案，即在1990年至2015年期间将孕产妇死亡率降低75%。方法在NDSS数据库中确定的518名妇女年龄在12 - 49岁，在2002年1月至2004年12月期间在卡塞纳-南卡纳区死亡，配偶或家庭成员完成了口头尸检采访516名女性死亡。结果在516例女性死亡中，45例被确定为孕产妇死亡。71%的孕产妇死亡是由于直接的孕产妇原因，29%是由于间接的孕产妇原因。与堕胎有关的死亡是产妇死亡的最常见原因。2002-2004年期间的产妇死亡率为每100 000例活产373例产妇死亡，表明产妇死亡率比1995-1996年每100 000例活产637例产妇死亡的水平下降了40%。然而，2002-2004年期间，该地区基于保健设施的产妇死亡率（不包括保健设施外的产妇死亡）为每100 000例活产141例产妇死亡。结论该地区有望实现孕产妇健康千年发展目标。最后，加强人口动态登记系统以向决策者提供及时信息应取代衡量孕产妇死亡率的其他方法。
Objective In the absence of an adequate vital registration system in Ghana, the Navrongo demographic surveillance system (NDSS) established in 1993 presents a viable alternative to monitor, in a poor rural district, the UN Millennium Development Goal on maternal health (MDG) of reducing maternal mortality by 75% between 1990 and 2015. Methods Of the 518 women aged 12 49 years identified in the NDSS database to have died in the Kassena-Nankana district in the period January 2002 December 2004, spouses or family members completed verbal autopsy interviews for 516 female deaths. Results Of the 516 female deaths, 45 were identified as maternal deaths. 71% of the maternal deaths were attributed to direct maternal causes while 29% were due to indirect maternal causes. Abortion-related deaths were the most frequent cause of maternal deaths. The maternal mortality ratio for the period 2002-2004 was 373 maternal deaths per 100,000 live births indicating a 40% reduction of maternal mortality from the 1995-1996 level of 637 maternal deaths per 100,000 live births. However, the health-facility based maternal mortality ratio in the district (which excludes maternal deaths outside health facilities) was 141 maternal deaths per 100,000 live births for the period 2002-2004. Conclusion This district may be on track to achieve the MDG on maternal health. Ultimately, strengthening vital registration systems to provide timely information to policymakers should supersede the other methods of measuring maternal mortality.