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ADULT AND MATERNAL MORTALITY 9
Since the launch of the Safe Motherhood Initiative in 1987, attention to reproductive health has
increased worldwide and so has the need to provide reliable countrywide estimates of maternal deaths.
In response to this increased interest, DHS surveys began collecting maternal mortality data through a
series of questions designed to gather information and obtain a direct measure of maternal mortality.
These questions were included in the 2000 Ethiopia DHS.
Maternal mortality estimates need a comprehensive and accurate reporting of maternal deaths.
Such estimates can be obtained through vital registration, longitudinal studies of pregnant women, or
repeated household surveys. However, there is no vital registration system in Ethiopia nor has there
been any national household survey carried out for the purpose of estimating maternal mortality. The
Ethiopia DHS is the first population-based national survey to incorporate questions on maternal
mortality. Therefore, the estimates presented in this chapter will play a vital role in filling the vacuum
for a reliable national estimate of maternal mortality. Nevertheless, it is important for users of this
information to understand the inherent problems associated with measuring maternal mortality in order
to avoid serious misinterpretation of the results of the survey.
Direct estimates of maternal mortality use data on the age of surviving sisters of survey
respondents, the age at death of sisters who have died, and the number of years since the death of
sisters. Interviewers in the Ethiopia DHS were asked to list all the brothers and sisters born to the
natural mother of female respondents in chronological order starting with the first. Information was
then obtained on the survivorship of each of the siblings, the ages of surviving siblings, the year of death
or years since death of deceased siblings, and the age at death of deceased siblings. For each sister who
died at age 12 or over, the respondent was asked additional questions to determine whether the death
was maternity related; that is, whether the sister was pregnant when she died, and if so, whether the
sister died during childbirth, and if not, whether the sister died within two months of the termination
of a pregnancy or childbirth. Listing all siblings in chronological order of their birth is believed to result
in better reporting of events than would be the case if only information on sisters were sought.
Moreover, the information collected also allows the direct estimates of adult male and female mortality.
9.1 DATA QUALITY ISSUES
A brief discussion of data quality is warranted here. One measure of the quality of the data
collected is the completeness of information on siblings. Overall, the data on siblings is nearly complete
with less than half of 1 percent of siblings with missing information on age at death and years since
death, with little difference between brothers and sisters (Appendix Table C.7). Rather than exclude
Adult and Maternal Mortality * 107