Protocol for analysing the epidemiology of maternal mortality in Zimbabwe: A civil registration and vital statistics trend study.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2021
Historique:
received: 15 03 2021
accepted: 24 04 2021
entrez: 3 6 2021
pubmed: 4 6 2021
medline: 28 10 2021
Statut: epublish

Résumé

Sub-Saharan Africa (SSA) carries the highest burden of maternal mortality, yet, the accurate maternal mortality ratios (MMR) are uncertain in most SSA countries. Measuring maternal mortality is challenging in this region, where civil registration and vital statistics (CRVS) systems are weak or non-existent. We describe a protocol designed to explore the use of CRVS to monitor maternal mortality in Zimbabwe-an SSA country. In this study, we will collect deliveries and maternal death data from CRVS (government death registration records) and health facilities for 2007-2008 and 2018-2019 to compare MMRs and causes of death. We will code the causes of death using classifications in the maternal mortality version of the 10th revision to the international classification of diseases. We will compare the proportions of maternal deaths attributed to different causes between the two study periods. We will also analyse missingness and misclassification of maternal deaths in CRVS to assess the validity of their use to measure maternal mortality in Zimbabwe. This study will determine changes in MMR and causes of maternal mortality in Zimbabwe over a decade. It will show whether HIV, which was at its peak in 2007-2008, remains a significant cause of maternal deaths in Zimbabwe. The study will recommend measures to improve the quality of CRVS data for future use to monitor maternal mortality in Zimbabwe and other SSA countries of similar characteristics.

Sections du résumé

BACKGROUND
Sub-Saharan Africa (SSA) carries the highest burden of maternal mortality, yet, the accurate maternal mortality ratios (MMR) are uncertain in most SSA countries. Measuring maternal mortality is challenging in this region, where civil registration and vital statistics (CRVS) systems are weak or non-existent. We describe a protocol designed to explore the use of CRVS to monitor maternal mortality in Zimbabwe-an SSA country.
METHODS
In this study, we will collect deliveries and maternal death data from CRVS (government death registration records) and health facilities for 2007-2008 and 2018-2019 to compare MMRs and causes of death. We will code the causes of death using classifications in the maternal mortality version of the 10th revision to the international classification of diseases. We will compare the proportions of maternal deaths attributed to different causes between the two study periods. We will also analyse missingness and misclassification of maternal deaths in CRVS to assess the validity of their use to measure maternal mortality in Zimbabwe.
DISCUSSION
This study will determine changes in MMR and causes of maternal mortality in Zimbabwe over a decade. It will show whether HIV, which was at its peak in 2007-2008, remains a significant cause of maternal deaths in Zimbabwe. The study will recommend measures to improve the quality of CRVS data for future use to monitor maternal mortality in Zimbabwe and other SSA countries of similar characteristics.

Identifiants

pubmed: 34081727
doi: 10.1371/journal.pone.0252106
pii: PONE-D-21-07325
pmc: PMC8174727
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0252106

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Reuben Musarandega (R)

School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.

Rhoderick Machekano (R)

Biostatistics and Epidemiology Department, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Robert Pattinson (R)

Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, SAMRC Maternal and Infant Health Care Strategies Research Unit, University of Pretoria, Pretoria, South Africa.

Stephen Peter Munjanja (SP)

Department of Obstetrics and Gynaecology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe.

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