Posts Tagged ‘Margaret C Hogan’

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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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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