Transcript Document

Maternal Mortality Ratio
Comparison of Philippines and International
Data and Metadata
Presented by
Ms. Mildred B. Addawe
Philippine National Statistical Coordination Board
UN Workshop on MDG Monitoring 2015 and Beyond
10 July 2012
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Outline of Presentation
I. Background
II. Philippine Methodology on the Interim Estimates of MMR
III. Comparison of Philippine and International MMR data
and metadata
A.
B.
C.
D.
E.
Definition
Methodology
Sources of Data/Agency
Data Availability/Frequency of Release
Limitations
IV. Way forward
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I. Background
Goal 5 of the Millennium Development Goals:
Improve maternal health
Target 5.A: Reduce by three quarters, between 1990 and
2015 the maternal mortality ratio
Indicators for monitoring progress
•
•
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Maternal mortality ratio; and
Proportion of births attended by skilled health personnel
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I. Background
Maternal Mortality Ratio
The UN defines maternal mortality ratio (MMR) as the ratio of the
number of maternal deaths during a given time period per
100,000 live births during the same time-period.
A maternal death refers to a female death from any cause
related to or aggravated by pregnancy or its management
(excluding accidental or incidental causes) during
pregnancy and childbirth or within 42 days of termination of
pregnancy, irrespective of the duration and site of the
pregnancy.
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II. Philippine Interim Estimation Methodology Used in
Generating MMR for 1990 and 2000-2010
Philippine MMR was measured through national
surveys
• 1993 National Demographic Survey
• 1998 National Demographic and Health Survey
• 2006 Family Planning Survey
Interim MMR Methodology
• Methodology was developed in recognition of the need
for updated national-level MMR estimates for assessing the
Philippine’s performance in meeting the MDG Goal 5
• Developed by the Technical Working Group on Mortality
Statistics and approved by the Philippine National
Statistical Coordination Board Executive Board in 2010
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II. Philippine Interim Estimation Methodology Used in
Generating MMR for 1990 and 2000-2010
Interim MMR Methodology
Used an indirect estimation procedure for coming up with
updated MMR using:
• Boerma’s method based on general levels of fertility
and female mortality according to constructed life
tables; and
• Assumed proportions of maternal deaths to total
female deaths (PDMF) based on data from the civil
registration system
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II. Philippine Interim Estimation Methodology Used in
Generating MMR for 1990 and 2000-2010
Interim MMR Methodology
For establishing the trend since 1970 and baseline
estimates based on 1990 and 2000:
• The level of completeness of birth registration for the years
1970, 1980, 1990 and 2000 were estimated using the P/F ratio
method for true cohorts as prescribed by the UN Manual X.
• The general fertility rates (GFRs) were then calculated
using the corrected births and female population in the
reproductive age group (15 to 49 years) for 1970, 1980, 1990
and 2000.
• The general mortality rate for females aged 15 to 49
years was estimated from the existing female life tables for
1970, 1980, 1990 and 2000.
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II. Philippine Interim Estimation Methodology Used in
Generating MMR for 1990 and 2000-2010
Interim MMR Methodology
For estimating MMR for 2001 to 2010:
• Female life expectancy and GFRs for 2001 to 2010
was estimated using straight line extrapolation of the female
life expectancy and GFR for 1990 and 2000 consistent with the
observed trends since 1970.
• General mortality rate for females aged 15-49
years for 2001 to 2010 was estimated using the 2001 to
2010 female life expectancy to locate the corresponding agespecific female death rates from the 1982 UN model life tables
and the 2000-based projected female population
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II. Philippine Interim Estimation Methodology Used in
Generating MMR for 1990 and 2000-2010
Interim MMR Methodology
For estimating MMR for 2001 to 2010:
• Maternal mortality rates were then calculated based on :
o different assumptions on the PMDF based on Boerma’s
linear regression results
o the unadjusted PMDF from 1970 to 2006 from the vital
registration systems
o lower and upper 95 percent confidence limits of 128 and
196 MMR according to the 2006 Family Planning Survey
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II. Philippine Interim Estimation Methodology Used in
Generating MMR for 1990 and 2000-2010
Interim MMR Methodology
For estimating MMR for 2001 to 2010:
• The corresponding maternal mortality ratios were then
computed by applying Boerma’s formula for each of the
assumed PDMFs:
Maternal mortality ratio = Maternal mortality rate
General fertility rate
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II. Philippine Interim Estimation Methodology Used in
Generating MMR for 1990 and 2000-2010
Comparison of survey-based and indirect estimates
of Philippine MMR: 1990 - 2011
Year
Survey
estimates1/
1990
Indirect interim
estimates2/
121 - 207
1991
1992
1993
209
1994
1995
1996
1997
1998
172
1999
2000
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II. Philippine Interim Estimation Methodology Used in
Generating MMR for 1990 and 2000-2010
Comparison of survey-based and indirect estimates
of Philippine MMR: 1990 - 2011
Year
Indirect interim
estimates2/
2001
118 - 203
2002
115 - 198
2003
112 - 193
2004
109 - 188
2005
106 - 182
2006
162
103 - 177
2007
101 - 172
2008
99 - 169
2009
96 - 164
2010
95 - 163
2011
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Survey
estimates1/
221
1/ Source from 1993 NDS, 1998 NDHS, 2006 FPS and 2011 FHS
2/ Source from the Interim MMR estimates of the TWG-MS
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III. Comparison of Philippine and International Data/Metadata
Philippine
International
1. Definition of
MMR
Ratio between the
number of women who
died (for reasons of
pregnancy, childbirth and
puerperium) to the
number of maternal
deaths per 100,000 live
births
Ratio of the number of
maternal deaths during a
given time period per
100,000 live births
2. Methodology
Indirect estimation
Multilevel regression
procedure using Boerma’s model
prescribed method for
developing countries
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III. Comparison of Philippine and International Data/Metadata
Philippine
International
3. Source of
data/agency
Technical Working Group
on Mortality Statistics
Trends in Maternal
Mortality:
WHO/UNICEF/UNFPA/WB
4. Years available
1990, 2000-2010
1990, 1995, 2000, 2005,
2010
5. Limitations
Estimates are based on
interim methodology
Need to further review
PMDF assumptions and
MMR estimates
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III. Comparison of Philippine and International Data/Metadata
Year
Philippines1/
International
1990
121 - 207
170
1991
1992
1993
1994
1995
140
1996
1997
1998
1999
2000
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130 - 222
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III. Comparison of Philippine and International Data/Metadata
Year
Philippines1/
2001
118 - 203
2002
115 - 198
2003
112 - 193
2004
109 - 188
2005
106 - 182
2006
103 - 177
2007
101 - 172
2008
99 - 169
2009
96 - 164
2010
95 - 163
International
110
99
1/ Indirect interim MMR estimates
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IV. Way Forward
On the Philippine Interim MMR Methodology
• For further review by the TWG-MS, particularly the PMDF
assumptions
• Additional computational exercises shall be done to firm up
the MMR estimates
• Use the updated results of population censuses and surveys
and from the CRS as soon as made available
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Maraming Salamat po!
URL: http://www.nscb.gov.ph
e-mail: [email protected]
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