Studying Maternal Mortality

I’m taking a class in the epidemiology of reproductive health this semester.  I like it, but I’m weird like that.  We talk about where the data comes from for the various statistics you hear thrown around, and what that may (or may not mean) for potential bias and the accuracy of the numbers.  No, not at the conspiracy level of a country falsifying the information.  Just the normal problems in trying to get an accurate picture of the reproductive health in an area.

So what does this mean?  Well, how do you figure out the amount of STIs in an area if there is no health care to diagnose it?  If they’ve never been diagnosed, do they have an STI?  You can survey about symptoms, but then you probably overestimate because symptoms can be for more than one disease – or as we learned in the Congo, what is completely normal may be seen as an excessive amount of discharge that needs to be cleaned daily.  So how do you find out the prevelance?

Today we talked abut prenatal care and the problems of studying it.  Because the world is focused on the single outcome of maternal mortality, prenatal care is often pushed aside.  Never mind that prenatal care does lots of wonderful positive things for a woman, and has the potential to not only improve her health but also her family’s health.  Since there is no clear causation line between prenatal care and lower maternal mortality it is seen as “not worth it.”  *Groan*

And so as all this information is swimming in my head, I keep thinking about the new global maternal mortality numbers.  Have you heard, the new estimate is lower than the old.  Now I said newer estimate because this isn’t necessarily an indication of improvement in prevention of maternal mortality.  The way the calculations were done is different, so this may only be an improvement in estimation. You can’t really compare the old number of 536, 000 maternal deaths annually with the new number of 342,900.  Even though you will often hear it compared and perhaps as proof that what “we” as the human race are doing is actually working to reach the millennium development goals.