Maternal Mortality in South Africa: Lessons from a Case Study in the Use of Deaths Reported by Households in Censuses and Surveys
Rob Dorrington, University of Cape Town
Debbie Bradshaw, Medical Research Council of South Africa
South Africa is a developing country which has asked questions on pregnancy-related deaths in its census and monitors maternal and pregnancy-related mortality via vital registration and a confidential enquiry into maternal deaths. This paper examines estimates from a range of sources to assess to what extent differences between them are due to data, methodological or definitional deficiencies. The results show that since maternal deaths are relatively rare, it is fairly difficult to establish the maternal mortality rate (MMR) with much accuracy in a setting where data are less than perfect, and that the differences are due to differences in the processing of data, but that the pregnancy-related mortality rate (PRMR) from vital registration was double the MMR, and the PRMR from census data was double that from vital registration. Nonetheless, all the data indicate an upward trend in maternal mortality that is consistent with the increase in HIV prevalence.