Higher institutional birth rates and improved analytic methods are making it more feasible to use health facility data to estimate maternal mortality and stillbirth in sub-Saharan Africa. Countdown researchers from 10 African countries gathered in Tanzania in September to compare data and identify strategies for improving data analysis and use.
Participants plan to use meeting results to publish country-level and cross-country analysis, to advocate for increased investment in facility assessments of the completeness of reporting, and to improve analytic methods used during the country annual meetings.
Maternal mortality is a key indicator for measuring progress towards global and country targets such as the Sustainable Development Goals, as well as a powerful indicator of health system functioning. However, obtaining timely, accurate measurements of maternal mortality and stillbirth has been a long-running challenge in low and middle income countries.
Health facility reporting on maternal deaths and stillbirths (and neonatal deaths before discharge) are collected routinely, making them a potentially rich data source. Most countries have death reporting as part of the monthly reporting system. If institutional birth coverage is 75% or higher and the mortality based on facility data is known, it is possible to make estimates of population mortality, depending on the completeness of maternal and perinatal death registration and the ratio of community to institutional mortality. Such estimates could become an important input into country monitoring of maternal mortality and stillbirth rates, providing data on an annual basis at the subnational level.
Teams from 10 countdown collaborating countries in sub-Saharan Africa met in Dar es Salaam during 17-18 September 2024 to learn from each other about approaches to measuring maternal and perinatal mortality using health facility data, and to explore how to improve monitoring of these key indicators. Participating countries included: Burkina Faso, Côte d’Ivoire, Ghana, Kenya, Mozambique, Rwanda, Senegal, Tanzania, Uganda and Zimbabwe. Each team consisted of representatives from the ministry of health in charge of monitoring maternal and perinatal mortality and decision-making and an analyst from either academic or public health institutions or the ministry of health. Other participants and facilitators included representatives from African Population & Health Research Center, Johns Hopkins University, University of Manitoba, Karolinska Institute and the National Institute for Medical Research of Tanzania, the Global Financing Facility and the World Health Organization.
Learn more from these meeting documents: