The estimate of maternal mortality for the period 1996-1998, derived from theprocedures described in this report, is 184 maternal deaths per 100,000 live births (186for 1998). The procedure yields results that are consistent with estimates available for earlier periods, both at the national and departmental level from other special studies.These studies have found ratios that range from 160 to 230 maternal deaths per100,000 live births. Unadjusted official figures, from INE and SIGSA for the period 1988–1998, range from 87 to 111. These official statistics reflect the high level ofunderreporting of maternal deaths at the departmental and national level, that has been documented in several studies.All the data sources analyzed for the preparation of this report confirm that maternalmortality levels have remained stable during the last decade1. This may be due to thefact that the implementation of interventions aimed at reducing maternal mortality beganduring the last 5–7 years. The implementation of interventions has been slow and doesnot cover the entire country yet.The methodology described in this report was designed to produce an estimate ofGuatemala’s maternal mortality ratio at the national level. The estimation procedure was developed by the Measure Evaluation project at Macro International and implemented byGSD Consultores Asociados. The methodology is based on the application of a nationallevel adjustment factor to SIGSA and MSPAS’s recent official figures. This adjustment factor was taken from a detailed study of underreporting of maternal deaths at the departmental level carried out by Dr. Medina of the MSPAS in 1989. Dr. Medina extensively studied data collected from the civil registers at the departmental level on all deaths of women of reproductive age, with the goal of identifying maternal deaths that had not been previously reported. This methodology is based on the assumption that thequality of the civil register and the MSPAS in Guatemala has not changed during recent years.