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Posts Tagged ‘measurement’

The controversial research reporting unexpected gains in maternal health, published April 12 in the Lancet, has triggered rigorous debate about the measurement tools used to count maternal deaths globally and at a country level. The paper, Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5, was written by Chris Murray and his team of researchers at the Institute for Health Metrics and Evaluation. The study found a dramatic reduction in the number of women dying from pregnancy complications between 1980 and 2008–and these findings have triggered both celebration and skepticism within the global health community. Some global health leaders are cheering the global progress toward MDG5 indicated by the research. Some are expressing cautious optimism. Others are challenging the paper’s methodology, asking whether it really signals big gains in the struggle against global maternal mortality or just flawed means of estimating how many women are dying.

On June 5th, the Lancet published a reply from Chris Murray in which he addresses some of the concerns voiced by his fellow global health researchers regarding the methodology of the study.

“We appreciate the rich set of letters in response to our paper on maternal mortality. The authors of the letters raise many important points, but we focus our short response on four larger themes that have been raised.

The country graphs in the webappendix to our paper show all the available data points for each country and our best estimates based on these data and the modelling strategy. In the case of the Philippines, Indonesia, Burkina Faso, and Peru, the correspondents have noted that our data-points derived from the analysis of sibling histories in household surveys are different from published figures from the same surveys. The differences stem from two sources. First, we correct for problems of survivor bias in sibling histories, following the published methods of Gakidou and Kingand Obermeyer and colleagues...”

Read the full reply by Chris Murray on the Lancet Online. Be sure to take a look at some of the critiques of the study–linked on the right panel next to Murray’s reply.

For more on this topic, take a look at a recent post, New Maternal Mortality Estimates Published in the Lancet: What’s the Buzz?, on the Maternal Health Task Force’s new MedScape Blog, GlobalMama.


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Horton comments on the new study, Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5, published today in the Lancet Online First, that suggests a dramatic reduction in global maternal mortality between 1980 and 2008. Horton describes additional significant findings in the paper–aside from the overall drop in maternal deaths. He also outlines five lessons to be learned from this paper. 

 The Lancet

“…What lessons can be drawn from these new data? First, the latest figures are, globally, good news. The provide robust reason for optimism. More importantly, these numbers should now act as a catalyst, not a brake, for accelerated action on MDG-5, including scaled-up resource commitments. Investment incontrovertibly saves the lives of women during pregnancy. 

       Second, the intimate connection between HIV and maternal health is now explicitly laid bare. Such an association, including tuberculosis, has been gaining important recent ground. This latest evidence therefore supports growing calls to integrate maternal and child survival programmes into vertical funding mechanisms for the MDGs, such as the Global Fund to fight AIDS, Tuberculosis, and Malaria…”

Read the full commentary, Maternal mortality: Surprise, hope and urgent action.

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