Transcript 3rd Global Forum and Inter-Agency Expert Group Meeting on Gender Statistics Manila, Philippines, 11-14 October 2010 Ghana’s Experience in Measuring Maternal Mortality and Maternal Health Ethel.

3rd Global Forum and Inter-Agency Expert Group Meeting
on Gender Statistics
Manila, Philippines, 11-14 October 2010
Ghana’s Experience in Measuring
Maternal Mortality and Maternal
Health
Ethel Koney
Ghana Statistical Service
ESA/STAT/AC.219/22
11/6/2015
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Outline
 Introduction
 Maternal Health
 Maternal Mortality
 Sources of data
GDHS
 GMHS
 Institutional data
 Interventions
 Challenges
 Planned surveys
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Introduction
 Every year more than half a million women die in
pregnancy and childbirth related issues
 In the sub-Saharan Africa one in twenty-two women has
the risk of dying during pregnancy or childbirth
 In Ghana, research and survey conducted reveal that
there are about 451 deaths out of 100,000 live births. This
is largely due to poor access to skilled birth attendance.
 The goal is to “reduce by three quarters, between 1990
and 2015, the maternal mortality ratio” and to “Achieve, by
2015, universal access to reproductive health”
 Government agencies, policy makers and NGOs have
measures to increase maternal health care provided
women during pregnancy and even after delivery.
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MDG Goal 5:
Improve maternal health
Target 5.A: Reduce by three quarters, between 1990
and 2015, the maternal mortality ratio
 5.1 Maternal mortality ratio
 5.2 Proportion of births attended by skilled health
personnel
Target 5.B: Achieve, by 2015, universal access to
reproductive health
 5.3 Contraceptive prevalence rate
 5.4 Adolescent birth rate
 5.5 Antenatal care coverage (at least one visit and at least
four visits)
 5.6 Unmet need for family planning
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Maternal Health
 Maternal health refers to the health of
women during pregnancy, childbirth and
the post-partum period.
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Maternal Mortality
 Health experts refer to maternal mortality as
the death of a woman while pregnant or
within 42 days of termination of pregnancy.
CAUSES
 Hemorrhage
 Infection
 High blood pressure
 Unsafe abortion
 Obstructed labour.
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Sources of data on maternal
mortality and maternal health
The main surveys are:
a) The Ghana Demographic and Health Survey
(GDHS)
b) Ghana Maternal Health Survey (GMHS)
Administrative
a) Institutional data from Centre for Health
Information Management of the Ministry of
Health
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Ghana Demographic and
Health Survey
 Ghana has conducted 5 rounds of
GDHS, in the following periods:
1988, 1993, 1998, 2003, and 2008.
 The surveys covered the whole
country and analysis were done on
national as well as regional basis
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Content of the GDHS
The surveys obtained detailed information on
 fertility
 marriage
 sexual activity
 fertility preferences
 awareness and use of family planning methods
 breastfeeding practices
 nutritional status of women and young children
 childhood mortality
 maternal and child health
 awareness and behavior regarding HIV/AIDS, and other
STIs.
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Some differences in the different
rounds (GDHS)
 1998-included testing of level of iodine
in the salt consumed by the household
 2003-included questions on domestic
violence
 2008-collection of information on
domestic violence, malaria and use of
mosquito net, and carried out anemia
testing.
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Trends in Maternity care indicators
Ghana 1988 -2008
There has been consistent improvement
in the indicators over the 20-year period
82
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Antenatal care from health professional
1988
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One or more tetanus toxoid injections
1993
1998
2003
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Medically assisted delivery
2008
Note: Data for 1988, 1993, and 1998 are with reference to births,
whereas data for antenatal care and tetanus toxoid for 2003 and
2008 are with reference to women who had a live birth
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Ghana Maternal Health Survey,
2007
 This is the first national population-based survey to collect
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information on maternal health and mortality in Ghana through a
combination of methods.
It was conducted to serve as a baseline information for the
Reducing Maternal Morbidity and Mortality (R3M) program
initiated in 2006 in some three regions in Ghana to increase the
contraceptive prevalence rate (CPR)
Household questionnaires were administered in about 240,000
households to identify female deaths
Individual questionnaires were administered to 10,370 women
age 15-49 about maternity care particularly abortion and
miscarriage, and siblings (sisterhood method), and
Follow-on 4,203 verbal autopsies of women age 12-49 into the
specific causes of female deaths, particularly maternal deaths
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Tracking Indicators (GMHS)
 Delivery care
Place of delivery
 Assistance of delivery
 Complications of delivery
 Postnatal care
 Timing of postnatal check-up
 Service provided and service provider
 Barriers to accessing health care
 Access to skilled birth attendance
 Distance of health care facility from patient
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Institutional data
 In-between surveys, there is the need to
monitor or track changes in maternal health
and mortality levels.
 In Ghana, the main source of data is the
Centre for Health Information Management of
the Ministry of Health
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Trends in maternal mortality ratios, 2006-2009
Source: Ministry of Health
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Interventions
 Safe-Motherhood Initiative
 Ghana VAST Survival Programme
 Prevention of Maternal Mortality Programme (PMMP)
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Making Pregnancy Safer Initiative
Prevention and Management of Safe Abortion Programme
Intermittent Preventive Treatment
Maternal and Neonatal Health Programme and Roll Back
Malaria Programme
Declaring maternal mortality a national emergency in 2008
Free health care for pregnant women including deliveries
through the national health insurance scheme.
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Challenges
 Social, cultural, health systems and economic indicators.
 Unavailability of family planning services and lack of post
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natal care for new born babies and their mothers
Unavailable data set on maternal health care for
systematic investigation into maternal health,
Barriers to access to critical health services by families
and communities
Absence of well-structured plans and procedures to check
and assess where maternal health programmes are
Poor access to health care providers
 Caused by long distance to the health facility
Poor health-seeking behaviors among the poor
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Planned Surveys
 The Ghana Statistical Service will be having
the next round of the Ghana Demographic
and Health Survey in 2013.
 The 2010 Population and Housing Census
currently underway, seeks information on
maternal mortality.
 Data collected will better inform if
interventions and indicators are on track, and
if so, Ghana’s progress towards the 2015
MDG target.
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Maternal Mortality in the 2010
Census
 Has any member of this household died in
the past 12 months.?
 Sex of deceased?
 Age at death
 Was death due to accident, violence,
homicide, suicide?
 For death of FEMALES 12 - 54 YEARS OLD
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Did death occur whilst pregnant, during
delivery or within 6 weeks after the end of a
pregnancy or child birth?
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Thank You.
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