In
Pakistan, the vital registration system is weak, and
population-based data on the
maternal mortality ratio are limited. This study was carried out to collect information on
maternal deaths from different existing sources during the current year—2007 (prospective) and the past two years—2005 and 2006—(retrospective), identify gaps in information, and critically analyze
maternal deaths at the
community and
health-facility levels in two districts in
Pakistan. The verbal
autopsy questionnaire was administered to households where a
maternal death had occurred. No single source had complete data on
maternal deaths.
Risk factors identified among 128 deceased
women were
low socioeconomic status,
illiteracy, low-earning jobs,
parity, and bad obstetric
history. These were
similar to the findings of earlier studies. Half of the
women did seek
antenatal care, 34% having made more than four visits. Of the 104
women who died during or after delivery, 38% had delivered in a
private facility and 18% in a
government facility. The quality of services in both private and
public sectors was inadequate. Sixty-nine percent of deaths occurred in the
postpartum period, and 51% took place within 24 hours of delivery. The study identified gaps in
reporting of
maternal deaths and also provided profile of the dead
women and the
causes of death.