BACKGROUND & OBJECTIVE:Estimation of maternal mortality has been difficult because of large sample size requirement. A study using snowball technique for identification of households where maternal death has taken place and its related causes was conducted. We present here the feasibility of carrying out the snowball technique for capturing maternal deaths as against house-to-house survey and to obtain the estimates of maternal mortality ratio (MMR) in some selected States of India. METHODS:Five states representing high MMR (Uttar Pradesh), medium MMR (Maharashtra, Karnataka, Uttranchal) and low MMR (Delhi) were selected. A total of 8 PHCs and 3 (UFS) were covered. Study used both house-to-house survey and snowball technique to enumerate the maternal deaths in the selected PHCs in rural area and urban frame survey (UFS) in urban area. RESULTS:In all, 94 maternal deaths were captured through snowball technique as against 83 through house-to-house survey. The estimate of MMR for the five States combined was 356 per 100,000 live births, as compared to assumed 400 per 100,000 live births for the country as a whole. The relative standard error of the estimate of MMR was about 10 per cent. INTERPRETATION & CONCLUSION:Snowball technique captured more maternal deaths than those in house-to-house survey particularly in rural areas. The estimates also indicated the feasibility of replicating the proposed methodology for estimation of MMR as a time and cost-effective methodology.

译文

背景与目的:由于样本量大,难以估计产妇死亡率。进行了一项使用雪球技术来识别已发生产妇死亡及其相关原因的家庭的研究。我们在这里介绍了进行雪球技术来捕获孕产妇死亡的可行性,而不是逐户进行调查,并获得了印度某些选定州的孕产妇死亡率比(MMR)的估计值。
方法:选择代表高MMR(北方邦),中等MMR(马哈拉施特拉邦,卡纳塔克邦,北方邦)和低MMR(德里)的五个州。总共涵盖了8个PHC和3个(UFS)。该研究使用逐户调查和滚雪球技术来枚举农村部分重点城市的孕产妇死亡人数,以及城市地区的城市框架调查(UFS)。
结果:通过滚雪球技术共捕获了94名孕产妇死亡,而通过逐户调查获得了83名孕产妇死亡。五个国家的MMR估算合计为每100,000例活产356例,而整个国家的假设为每100,000例活产400例。 MMR估计值的相对标准误差约为10%。
解释与结论:雪球技术捕获的孕产妇死亡人数比逐户调查的死亡人数高,尤其是在农村地区。估算还表明,将拟议的MMR估算方法复制为一种既省时又具有成本效益的方法是可行的。

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