TY - JOUR
T1 - No one data source captures all
T2 - A nested case-control study of the completeness of maternal death reporting in Banten Province, Indonesia
AU - Qomariyah, Siti Nurul
AU - Sethi, Reena
AU - Izati, Yulia Nur
AU - Rianty, Tika
AU - Latief, Kamaluddin
AU - Zazri, Ali
AU - Besral,
AU - Bateman, Massee
AU - Pawestri, Eskaning Arum
AU - Ahmed, Saifuddin
AU - Achadi, Endang L.
N1 - Funding Information:
This article is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of the Cooperative Agreement AID-OAA-A-14-00028. The contents are the responsibility of the Maternal and Child Survival Program and do not necessarily reflect the views of USAID or the United States Government. The funders had no role in the decision to publish, or preparation of the manuscript. The authors would like to thank the following organizations and people: the governments and district health offices of Pandeglang District, Serang District, Serang Municipality, and Banten Province; the district hospitals, puskesmas (community health clinics), heads of sub-districts, heads of village, and all respondents in the three study areas. We would like to thank our colleagues from the Indonesian Ministry of Health who served as observers during the training of enumerators and pilot testing for the study. We also would like to thank all the members of the Banten II Study, data management team, data collection team, and the Center for Family Welfare at the University of Indonesia (CFW UI) management team who were instrumental in the implementation of the study. We would like to also thank Dr. Sigit Sulistyo of USAID and Ms. Nancy Caiola, Dr. Claudia Surjadjaja, Ms. Christiana Shinta Widimulyani, Dr. Hannah Tappis, Dr. Eva Bazant, and Ms. Barbara Rawlins from Jhpiego.
Publisher Copyright:
© 2020 Qomariyah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/5
Y1 - 2020/5
N2 - Background Indonesia’s national health information systems collect data on maternal deaths but the completeness of reporting is questionable, making it difficult to design appropriate interventions. This study examines the completeness of maternal death reporting by the district health office (DHO) system in Banten Province. Method We used a nested-control study design to compare data on maternal deaths in 2016 from the DHO reporting system and the MADE-IN/MADE-FOR method in two districts and one municipality in Banten Province, with the aim of identifying and characterizing missed deaths in the DHO reporting system. The capture-recapture method was used to assess the magnitude of underreporting of maternal deaths by both systems. Results A total of 169 maternal deaths were reported in the MADE-IN/MADE-FOR study for calendar year 2016 in the three study areas. The DHO system reported 105 maternal deaths for the same period, of which 90 cases were found in both data sources. Capture-recapture analyses suggest that the MADE-IN/MADE-FOR approach identified 92% (95% CI: 87%–95%) of all maternal deaths, while the DHO system captured 57% (95% CI: 50%–64%) of all maternal deaths. Deaths of women who resided in urban areas had four times higher odds (OR 4.3, 95% CI: 1.52–12.3) of being missed by the DHO system compared to deaths among women who lived in rural or remote areas after adjusting for other covariates. Conclusion The DHO reporting system missed approximately half of the maternal deaths in the 3 study areas, suggesting that the DHO system is likely to grossly underestimate the maternal mortality ratio. The DHO reporting system needs to be improved to capture and characterize all maternal deaths.
AB - Background Indonesia’s national health information systems collect data on maternal deaths but the completeness of reporting is questionable, making it difficult to design appropriate interventions. This study examines the completeness of maternal death reporting by the district health office (DHO) system in Banten Province. Method We used a nested-control study design to compare data on maternal deaths in 2016 from the DHO reporting system and the MADE-IN/MADE-FOR method in two districts and one municipality in Banten Province, with the aim of identifying and characterizing missed deaths in the DHO reporting system. The capture-recapture method was used to assess the magnitude of underreporting of maternal deaths by both systems. Results A total of 169 maternal deaths were reported in the MADE-IN/MADE-FOR study for calendar year 2016 in the three study areas. The DHO system reported 105 maternal deaths for the same period, of which 90 cases were found in both data sources. Capture-recapture analyses suggest that the MADE-IN/MADE-FOR approach identified 92% (95% CI: 87%–95%) of all maternal deaths, while the DHO system captured 57% (95% CI: 50%–64%) of all maternal deaths. Deaths of women who resided in urban areas had four times higher odds (OR 4.3, 95% CI: 1.52–12.3) of being missed by the DHO system compared to deaths among women who lived in rural or remote areas after adjusting for other covariates. Conclusion The DHO reporting system missed approximately half of the maternal deaths in the 3 study areas, suggesting that the DHO system is likely to grossly underestimate the maternal mortality ratio. The DHO reporting system needs to be improved to capture and characterize all maternal deaths.
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U2 - 10.1371/journal.pone.0232080
DO - 10.1371/journal.pone.0232080
M3 - Article
C2 - 32379774
AN - SCOPUS:85084323918
SN - 1932-6203
VL - 15
JO - PloS one
JF - PloS one
IS - 5
M1 - e0232080
ER -