Child and Maternal Mortality
in Islamic Countries
19
However, the data on the number of live births are not available in the mortality population
sample in the survey.
So, MMRs are estimated fromMMRate and general fertility rate (GFR) estimates from the survey.
The MMRate is expressed as -
ℎ
15 − 49
1000 =
The DHS estimates the maternal mortality rate using the following formula:
ℎ
−
1000 =
The MMRate and MMRatio can be calculated from each other by applying the general fertility
rate (GFR) in a country using the following formula:
=
ℎ
15 − 49
15 − 49
ℎ
=
The GFR is the ratio of live births to women aged 15-49 years.
In addition, Lifetime Risk of Maternal Death (LTR) which is defined as the risk of a woman dying
from maternal causes during the 35 years of her reproductive lifetime, are often used in
literature. LTR is estimated in the DHS country reports with the following formula:
(1 − ) = (1 − )
The UNICEF’s MICS surveys use indirect sisterhood method, which estimates MMR based on few
questions but for a longer period (~13 years). Consequently, the MICS’ MMR estimates are not
suitable for tracking maternal mortality trends over a reasonably shorter period.
The MMR estimates in selected OIC countries, based on direct sisterhood method, are shown in
Figure 2.4. These results are available only for the OIC countries where DHS surveys were
conducted with sisterhood modules. The Afghanistan Demographic and Health Survey in 2015
estimated MMR of 1291 deaths per 100,000 live births. In contrast, the model-based UNMMEIG
estimates of MMR in Afghanistan was 396 deaths per 100,000 live births in 2015 (Table 2.1).
It is difficult to track progress in MMR reductions from the DHS estimates, particularly due to
small sample sizes in the surveys. In statistical sense, maternal mortality is a rare event, which
requires very large sample sizes for assessing a significant difference between two time periods
with an acceptable level of statistical power and precision level. Conducting such large surveys
is beyond the scopes of the DHS.
In many of these countries, health information systems are not fully functional. Although some
countries have implemented the District Health Information Systems (e.g., DHIS2) for collecting
data from the subnational lower administrative areas, the reporting of maternal and neonatal