#ConversandoSobreSIS #ZeroMaternalDeaths #EveryMaternalDeathMatters
Series of Webinars – Study on the failure to record the causes of maternal deaths in Argentina (EORMM)
Thursday - 11 October
Presenters: Dr. Mariana Duhau / Elida Marconi
Simultaneous interpretation into English will be available.
Maternal mortality constitutes an important public health problem that affects the right of women and girls to life, health, equity, nondiscrimination, and access to scientific knowledge to achieve the highest possible level of health, as recognized by the United Nations. In the majority of countries, moreover, the vital statistics system tends to omit maternal mortality.
To find out the magnitude of this omission, Argentina conducted its first nationwide study, comparing information in the vital statistics system’s Statistical Report on Deaths with clinical histories and other documents available in the health centers where these deaths occurred, based on a 2014 sample of deaths of women of childbearing age due to causes suspected of concealing maternal deaths.
The study was carried out by Argentina’s National Ministry of Health, with the participation of the National Directorate of Maternity, Childhood, and Adolescence; the Bureau of Statistics and Health Information; and the Argentine Disease Classification Center, together with international cooperation agencies, international research centers, and scientific associations.
Objective: Determine the magnitude of the omission of recorded maternal deaths and their leading causes in Argentine health institutions.
Methodology: Cross-sectional study, with a retrospective review of medical records of deaths of women of childbearing age from causes suspected of concealing maternal deaths occurring in public, social security, and private health facilities in the 23 Argentine provinces and the Federal District, between 1 January and 31 December 2014. These were matched and the causes of death stated in the Mortality Statistics Report were reclassified. Outcome measures included the percentage of omissions of maternal deaths in the official records, the structure of the causes, the place, and the time of death with regard to the reproductive process and gestational age. Argentina’s 2014 maternal mortality rate was re-estimated based on these results.
Results: Of a sample of 1,176 cases, 942 medical records were reviewed (82.4%), and 60 omitted cases were identified as maternal deaths (48 maternal deaths, 12 late maternal deaths). The percentage of omission was 14.2% for maternal deaths and 33.3% for late maternal deaths. The new estimated maternal mortality rate for 2014 ranged from 43.3 to 47.2 deaths per 100,000 live births.
Conclusions: The omission of maternal deaths from Argentine records may be lower than the level reported by international agencies. This study showed that omission of deaths due to childbirth was distributed unevenly among the country’s different jurisdictions, and was very low or nonexistent in those jurisdictions whose statistics offices routinely conducted deliberate searches for maternal deaths. Moreover, the study proved that detected omissions were distributed very evenly among the different causes of maternal death. Efforts need to focus on the importance of correctly filling out death certificates.
Dr. Mariana Duhau
Physician, School of Medicine of the University of Buenos Aires.
Master’s in Public Health. Public Health Research Institute, University of Buenos Aires. Member of the Argentine Pediatrics Society (SAP).
Coordinator of the Monitoring and Evaluation Area since 2011.
National Ministry of Health, National Directorate of Maternity, Childhood, and Adolescence.
Sociologist, graduate of the National University of Buenos Aires, specialist in Information Systems.
Director of the Bureau of Statistics and Health Information of the National Ministry of Health, December 1983 to December 2015, and member of the Argentine Disease Classification Center (CACE), Collaborating Center for the WHO Family of International Classifications (FIC).