Using the sisterhood method to determine the maternal mortality ratios in six local governments of Ondo State, Nigeria

Onoja, Ali Johnson; Onuche, Simon Peterside; Sanni, Felix Olaniyi; Onoja, Sheila; Umogbai, Theophilus; Abiodun, Paul Olaiya; Mohammed, Seid

doi:10.4103/iahs.iahs_74_20

Cited by 3 publications

(8 citation statements)

References 16 publications

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“…In Onoja et al 22 and Sharma et al, 23 the calculated MMRs were substantially higher than the most recent national DHS estimate, which further justified the rationale for subnational calculations (Table 4). 22,23 In Aminati et al 27 the estimated MMR was lower than the national DHS estimate, which was explained by the authors as the result of regional differences, with the north of Nigeria having higher MMRs.…”

Section: Resultsmentioning

confidence: 75%

“…state) or administrative level 2 (i.e. local government areas) 22,23,27 . In Onoja et al 22 and Sharma et al, 23 the calculated MMRs were substantially higher than the most recent national DHS estimate, which further justified the rationale for subnational calculations (Table 4).…”

Section: Resultsmentioning

confidence: 88%

“…local government areas). 22,23,27 In Onoja et al 22 and Sharma et al, 23 subnational calculations (Table 4). 22,23 In Aminati et al 27 the estimated MMR was lower than the national DHS estimate, which was explained by the authors as the result of regional differences, with the north of Nigeria having higher MMRs.…”

Section: Estimating Subnational Maternal Mortalitymentioning

confidence: 99%

“…Nine papers described successful efforts to calculate more granular mortality estimates using empirical methods, such as verbal autopsy, indirect sisterhood, and a modified direct sisterhood method (Table 3). [19][20][21][22][23][24][25][26][27] Citing wide variation in MMR levels, the need for localized information, and challenges with CRVS data, three papers from Nigeria used the indirect sisterhood method to calculate MMRs at administrative level 1 (i.e. state) or administrative level 2 (i.e.…”

Section: Estimating Subnational Maternal Mortalitymentioning

confidence: 99%

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Approaches to improve and adapt maternal mortality estimations in low‐ and middle‐income countries: A scoping review

Tholandi,

Zethof,

Kim

et al. 2023

Intl J Gynecology & Obste

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BackgroundIn the absence of robust vital registration systems, many low‐ and middle‐income countries (LMICs) rely on national surveys or routine surveillance systems to estimate the maternal mortality ratio (MMR). Although the importance of MMR estimates in ending preventable maternal deaths is acknowledged, there is limited research on how different approaches are used and adapted, and how these adaptations function.ObjectivesTo assess methods for estimating maternal mortality in LMICs and the rationale for these modifications.Search StrategyA literature search with the terms “maternal death”, “surveys” and “low‐ and middle‐income countries” was performed in Medline, Embase, Web of Science, Scopus, CINAHL, APA PsycINFO, ERIC, and IBSS from January 2013 to March 17, 2023.Selection CriteriaStudies were eligible if their main focus was to compare, adapt, or assess methods to estimate maternal mortality in LMICs.Data Collection and AnalysisTitles and abstracts were screened using Rayyan. Relevant articles were independently reviewed by two reviewers against inclusion criteria. Data were extracted on mortality measurement methods, their context, and results.Main ResultsNineteen studies were included, focusing on data completeness, subnational estimates, and community involvement. Routinely generated MMR estimates are more complete when multiple data sources are triangulated, including data from public and private health facilities, the community, and local authorities (e.g. vital registration, police reports). For subnational estimates, existing (e.g. the sisterhood method and reproductive‐age mortality surveys [RAMOS]) and adapted methods (e.g. RAMOS 4 + 2 and Pictorial Sisterhood Method) provided reliable confidence intervals. Community engagement in data collection increased community awareness of maternal deaths, provided local ownership, and was expected to reduce implementation costs. However, most studies did not include a cost‐effectiveness analysis.ConclusionHousehold surveys with community involvement and RAMOS can be used to increase data validity, improve local awareness of maternal mortality estimates, and reduce costs in LMICs.

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Section: Resultsmentioning

confidence: 75%

Section: Resultsmentioning

confidence: 88%

Section: Estimating Subnational Maternal Mortalitymentioning

confidence: 99%

Section: Estimating Subnational Maternal Mortalitymentioning

confidence: 99%

See 2 more Smart Citations

Approaches to improve and adapt maternal mortality estimations in low‐ and middle‐income countries: A scoping review

Tholandi,

Zethof,

Kim

et al. 2023

Intl J Gynecology & Obste

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show abstract

“…The first section was used to obtain information on socio-demographic characteristics like age, sex, address, marital status, and educational level. The second section was used to extract adverse pregnancy history by case definitions using the method adopted and adapted from the WHO indirect sisterhood method of maternal mortality estimate in a rural community [26].…”

Section: Data Sources/measurementmentioning

confidence: 99%

Link between Oil Pollution and Adverse Pregnancy Outcomes in the Niger Delta Region of Nigeria

Kanu,

Iwunze

2024

AJMAH

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Oil exploration in the Niger Delta has led to severe environmental pollution. This study investigates the association between exposure to crude oil and adverse pregnancy outcomes. Study Design: This was a comparative cross-sectional study of the differences in adverse pregnancy outcomes of people living in heavily oil polluted and non-polluted communities Place and Duration of Study: Kegbara Dere (K-Dere), a rural Community in Ogoniland, Gokana Local Government Area, Rivers State and Obohia community in Ndoki kingdom, Ukwa East LGA of Abia state between June 2022 and Jan 2023. Methodology: We recruited 900 study participants (450 each from the crude oil impacted and the non-oil polluted communities) using multi-stage random sampling. Questionnaires were used to collect data on socio-demographics and adverse pregnancy history by case definitions using the adapted WHO indirect sisterhood method of maternal mortality estimate. Data was analyzed using IBM Statistical Package for Social Sciences (SPSS) version 25. Differences in proportions were compared using Chi Square test. The association between living in an oil polluted community or exposure to crude oil pollutants and adverse pregnancy outcomes was determined using crude odds ratio. Confidence intervals were determined at 95% level and a p-value of less than 0.05 was considered significant. Results: Pregnant women in the polluted community experienced a significantly higher prevalence of adverse outcomes, including stillbirth, abortion, and birth defects. The risk of experiencing an adverse pregnancy outcome was 30 times higher in the polluted area. Conclusion: This study suggests a strong link between oil pollution and pregnancy complications. Further research with robust designs is needed to confirm causality. Environmental cleanup and protective measures for pregnant women are crucial in these areas.

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A population-based estimation of maternal mortality in Lagos State, Nigeria using the indirect sisterhood method

Wright,

Fagbemi,

Omoera

et al. 2024

BMC Pregnancy Childbirth

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Background Pregnancy and delivery deaths represent a risk to women, particularly those living in low- and middle-income countries (LMICs). This population-based survey was conducted to provide estimates of the maternal mortality ratio (MMR) in Lagos Nigeria. Methods A community-based, cross-sectional study was conducted in mapped Wards and Enumeration Areas (EA) of all Local Government Areas (LGAs) in Lagos, among 9,986 women of reproductive age (15–49 years) from April to August 2022 using a 2-stage cluster sampling technique. A semi-structured, pre-tested questionnaire adapted from nationally representative surveys was administered using REDCap by trained field assistants for data collection on socio-demographics, reproductive health, fertility, and maternal mortality. Data were analysed using SPSS and MMR was estimated using the indirect sisterhood method. Ethical approval was obtained from the Lagos State University Teaching Hospital Health Research and Ethics Committee. Results Most of the respondents (28.7%) were aged 25–29 years. Out of 546 deceased sisters reported, 120 (22%) died from maternal causes. Sisters of the deceased aged 20–24 reported almost half of the deaths (46.7%) as due to maternal causes, while those aged 45–49 reported the highest number of deceased sisters who died from other causes (90.2%). The total fertility rate (TFR) was calculated as 3.807, the Lifetime Risk (LTR) of maternal death was 0.0196 or 1-in-51, and the MMR was 430 per 100,000 [95% CI: 360–510]. Conclusion Our findings show that the maternal mortality rate for Lagos remains unacceptable and has not changed significantly over time in actual terms. There is need to develop and intensify community-based intervention strategies, programs for private hospitals, monitor MMR trends, identify and contextually address barriers at all levels of maternal care.

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Using the sisterhood method to determine the maternal mortality ratios in six local governments of Ondo State, Nigeria

Cited by 3 publications

References 16 publications

Approaches to improve and adapt maternal mortality estimations in low‐ and middle‐income countries: A scoping review

Approaches to improve and adapt maternal mortality estimations in low‐ and middle‐income countries: A scoping review

Link between Oil Pollution and Adverse Pregnancy Outcomes in the Niger Delta Region of Nigeria

A population-based estimation of maternal mortality in Lagos State, Nigeria using the indirect sisterhood method

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