maternal mortality ratio comparison of philippines and international data and metadata

Workshop on MDG 2015 and Beyond10 July 2012

NATIONAL STATISTICAL COORDINATION BOARD1

Maternal Mortality RatioComparison of Philippines and International

Data and Metadata

Presented by

Ms. Mildred B. AddawePhilippine National Statistical Coordination Board

UN Workshop on MDG Monitoring 2015 and Beyond10 July 2012



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. Definition B. Methodology

C. Sources of Data/AgencyD. Data Availability/Frequency of Release

E. Limitations

IV. Way forward



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• Maternal mortality ratio; and• Proportion of births attended by skilled health

personnel



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.



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




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





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.





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 age-specific female death rates from the 1982 UN model life tables and the 2000-based projected female population






• 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






• 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




Comparison of survey-based and indirect estimates of Philippine MMR: 1990 - 2011

Year Survey estimates1/

Indirect interim estimates2/

1990 121 - 207

1991

1992

1993 209

1994

1995

1996

1997

1998 172

1999

2000 130 - 222




Comparison of survey-based and indirect estimates of Philippine MMR: 1990 - 2011

Year Survey estimates1/

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 2211/ Source from 1993 NDS, 1998 NDHS, 2006 FPS and 2011 FHS2/ Source from the Interim MMR estimates of the TWG-MS



III. Comparison of Philippine and International Data/Metadata

Philippine International1. 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 procedure using Boerma’s prescribed method for developing countries

Multilevel regression model




Philippine International3. 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




Year Philippines1/ International

1990 121 - 207 1701991

1992

1993

1994

1995 140

1996

1997

1998

1999

2000 130 - 222 120



Year Philippines1/ International

2001 118 - 203

2002 115 - 198

2003 112 - 193

2004 109 - 188

2005 106 - 182 1102006 103 - 177

2007 101 - 172

2008 99 - 169

2009 96 - 164

2010 95 - 163 99

1/ Indirect interim MMR estimates




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



Maraming Salamat po!

URL: http://www.nscb.gov.phe-mail: [email protected]

maternal mortality ratio comparison of philippines and international data and metadata

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