An innovative approach to measuring maternal mortality at the community level in low-resource settings using mid-level providers: a feasibility study in Tigray, Ethiopia

Type Journal Article - Reproductive health matters
Title An innovative approach to measuring maternal mortality at the community level in low-resource settings using mid-level providers: a feasibility study in Tigray, Ethiopia
Author(s)
Volume 20
Issue 39
Publication (Day/Month/Year) 2012
Page numbers 196-204
URL http://www.tandfonline.com/doi/full/10.1016/S0968-8080(12)39606-7
Abstract
This paper proposes a new, community-based approach to the measurement of maternal mortality, and presents results from a feasibility study in 2010–11 of that approach in rural Tigray, Ethiopia. The study was implemented in three health posts and one health centre with a total catchment area of approximately 22,000 people. Priests, traditional birth attendants and community-based reproductive health agents were responsible for locating and reporting all births and deaths in their areas and assisted mid-level providers in locating key informants for verbal autopsy. Community-based health workers were trained to report all births and deaths to the local health post, where vital registries were kept. Once a month, each health post compiled a list of all deaths of women aged 12–49, which were registered in government logbooks. Nurses and nurse-midwives were trained to administer verbal autopsies on these deaths, and assign primary cause of death using WHO ICD-10 classifications. The study drew on the theory of task-shifting, shifting the task of cause-of-death attribution from physicians to mid-level providers. It aimed to build a sustainable methodology for maximizing existing local health care infrastructure and human capacity, leading to community-based solutions to improve maternal health. While the approach has not yet been implemented outside the initial study area, the results are promising as regards its feasibility.

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