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Posts Tagged ‘Institute for Health Metrics and Evaluation’

In April, the Lancet published new maternal mortality estimates (out of the Institute for Health Metrics and Evaluation) that showed a significant reduction in global maternal deaths, shaking up the global health community’s understanding of the global burden of the issue–and providing new hope. The report also illustrated the important links between HIV/AIDS and maternal mortality.

In the wake of the Lancet report, maternal health professionals from various organizations engaged in robust dialogue (like this one) about measurement methodologies–and raised questions about when the World Health Organization would release their estimates and how they might differ from the IHME estimates.

On September 15th, WHO, UNICEF, UNFPA, and the World Bank released their new maternal mortality estimates in a report, Trends in maternal mortality. Their report also showed a significant drop in maternal deaths—a 34% decrease between 1990 and 2008.

Excerpt from the WHO press release:

“The new estimates show that it is possible to prevent many more women from dying. Countries need to invest in their health systems and in the quality of care.

‘Every birth should be safe and every pregnancy wanted,’ says Thoraya Ahmed Obaid, the Executive Director of UNFPA. ‘The lack of maternal health care violates women’s rights to life, health, equality, and non-discrimination. MDG5 can be achieved,’ she adds, ‘but we urgently need to address the shortage of health workers and step up funding for reproductive health services’…”

More highlights from the report:

  • Ten out of 87 countries with maternal mortality ratios equal to or over 100 in 1990, are on track with an annual decline of 5.5% between 1990 and 2008. At the other extreme, 30 made insufficient or no progress since 1990.
  • The study shows progress in sub-Saharan Africa where maternal mortality decreased by 26%.
  • In Asia, the number of maternal deaths is estimated to have dropped from 315 000 to 139 000 between 1990 and 2008, a 52% decrease.
  • 99% of all maternal deaths in 2008 occurred in developing regions, with sub-Saharan Africa and South Asia accounting for 57% and 30% of all deaths respectively.

Click here to read the press release and here to read the full report.

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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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The symposium, Measuring the Progress on Maternal and Child Mortality: Data, Alternative Methods, and Findings, will be held on May 24th from 11:15am to 5pm at the Washington D.C. Kaiser Family Foundation office, immediately following a 9:30am policy forum on maternal and child health organized by the Kaiser Family Foundation. This all day symposium will bring together several maternal and child health experts and will be moderated by Editor-in-Chief of the Lancet, Richard Horton.

The Institute for Health Metrics and Evaluation

“…The all day event is designed to initiate vigorous scientific dialogue around the data and analytic approaches used in determining maternal and child mortality rates around the world. The symposium will also highlight the critical role that multiple organizations play in analyzing and disseminating mortality findings in order to strengthen overall methods and results…”

Speakers include:

Diego Bassani, Centre for Global Health Research, St. Michael’s Hospital, University of Toronto
Ties Boerma, WHO
Ed Bos, World Bank
Trevor Croft, ICF Macro
Amanda Glassman, Inter-American Development Bank
Alan Lopez, University of Queensland
Rafael Lozano, IHME and former General Director of Health Information at the Ministry of Health in Mexico
Christopher JL Murray, IHME
Kenji Shibuya, University of Tokyo

Click here for the official event announcement.

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The Kaiser Family Foundation is holding a policy forum (open to the public) where experts will comment on progress toward achieving Millennium Development Goals 4 and 5–and explore the role of the U.S. in improving global maternal and child health. The event will take place on May 24th, from 9:30am to 11:00am ET at the Foundation’s Washington D.C. office.

The Kaiser Family Foundation

“…Recently published data from the University of Washington’s Institute for Health Metrics and Evaluation (IHME) show some progress in improving maternal health globally in recent years, though substantially more progress will be needed to achieve the United Nations’ Millennium Development Goals for reducing child mortality and improving maternal health by 2015...

…The expert panel discussion will include Jennifer Klein, senior advisor on global women’s issues at the U.S. Department of State; Flavia Bustreo, director, Partnership for Maternal, Newborn and Child Health, World Health Organization; Ana Langer, president, EngenderHealth; Christopher J.L. Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington; and Jen Kates, vice president and director of Global Health Policy and HIV, Kaiser Family Foundation.  Foundation Executive Vice President Diane Rowland will moderate…”

For event details and information on how to RSVP, click here. You will also find information on how to view the archived webcast of the event.

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Sarah Boseley reflects on the new maternal mortality estimates published today in the Lancet. She talks with Chris Murray , Director of the Institute for Health Metrics and Evaluation (IHME) and Professor of Global Health at the University of Washington, about his research–and raises tough questions regarding the implications of the new data. For example: “Does it mean we need more money for maternal health or less?”

 Sarah Boseley’s Global Health Blog

“…It’s remarkable news – and all the more remarkable because it’s been happening without anyone realising it. It’s like waking up and finding somebody has demolished the ugly old building across the road and planted trees instead. Hard to believe the scenery has changed quite so dramatically. The new optimistic outlook will take some getting used to. This is what Dr Murray told me.

The whole community has been living off 500,000 women dying a year for the last 30 years. That’s fed a sense of almost pessimism that it is difficult to change maternal mortality.

Murray and colleagues have got new data, that has not been systematically put together in the past, and new tools…”

Read the full story, Saving Women’s Lives in Childbirth–It’s More Possible Than We Thought.

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A new paper, Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5, published today in the Lancet Online First, suggests that global maternal deaths have dropped from 526,300 in 1980 to 342,900 in 2008.

The Lancet

The authors of the paper, estimate that the global MMR decreased from 422 maternal deaths/100,000 live births in 1980 to 251 maternal deaths/100,000 live births in 2008. They also conclude that more than 50%  of all maternal deaths in 2008 occurred in six countries alone: India, Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of Congo.

“…Our analysis of all available data for maternal mortality from 1980 to 2008 for 181 countries has shown a substantial decline in maternal deaths. Progress overall would have been greater if the HIV epidemic had not contributed to substantial increases in maternal mortality in eastern and southern Africa. Global progress to reduce the MMR has been similar to progress to reduce maternal deaths, since the size of the global birth cohort has changed little during this period. Across countries, average yearly rates of decline from 1980 to 2008 in the MMR differed widely. This new evidence suggests there is a much greater reason for optimism than has been generally perceived, and that substantial decreases in the MMR are possible over a fairly short time…”

Read the full paper here.

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