Maternal mortality in a rural district of southeastern Tanzania: an application of the sisterhood method

Background Deaths from maternal causes represent the leading cause of death among women of reproductive age in most developing countries. It is estima ted that the highest risk occurs in Africa, with 20% of world births but 40 % of the world maternal deaths. The level of maternal mortality is difficul t to assess especially in countries without an adequate vital registration system, Indirect techniques are an attractive cost-effective tool to provid e estimates of orders of magnitude for maternal mortality. Method The level of maternal mortality estimated by the sisterhood method i s presented for a rural district in the Morogoro Region of Southeastern Tan zania and the main causes of maternal death are studied. Information from r egion-specific data using the sisterhood method is compared to data from ot her sources. Results The maternal mortality ratio (MMR) was 448 maternal deaths per 100 000 live births (95% CI : 363-534 deaths per 100 000 live births). Maternal causes accounted for 19% of total mortality in this age group. One in 39 w omen who survive until reproductive age will die before age 50 due to mater nal causes. The main cause of death provided by hospital data was puerperal sepsis (35%) and postpartum haemorrhage (17%); this is compatible with the main causes reported for maternal death in settings with high levels of ma ternal mortality, and similar to data for other regions in Tanzania. The si sterhood method provides data comparable with others, together with a cost- effective and reliable estimate for the determination of the magnitude of m aternal mortality in the rural Kilombero District.