Despite various programmes aimed at reducing the maternal mortality ratio (MMR) and improving reproductive health globally, and in Malawi especially, the 2000 Malawi Demographic and Health Survey (DHS) reported an MMR for Malawi as 1221 deaths per 100 000 live births. This represented an almost 80% rise from the 620 maternal deaths/100 000 live births estimated in the 1992 DHS. The possible reasons behind the rise in the MMR include: the growing HIV/AIDS pandemic in Malawi with an estimated infection rate of 14%; and the deteriorating healthcare situation and inherent inaccuracies in the estimation of maternal mortality. Continued surveillance and identification of factors responsible for the deterioration of Malawi's MMR are suggested. It is necessary to design, implement and evaluate corrective measures in order to improve the situation.
Get full access to this article
View all access options for this article.
References
1.
World Health Organization and United Nations Children's Fund. Revised 1990 Estimates of Maternal Mortality: A New Approach by WHO and UNICEF. Geneva: WHO and UNICEF, 1996.
2.
World Health Organization. Coverage of Maternity Care: A Tabulation of Available Information, 3rd edn.Geneva: WHO, 1993.
ShiffmanJ. Can poor countries surmount high maternal mortality?Stud Fam Planning2000;31:274–89.
5.
Program of Action adopted at the International Conference on Population and Development, Cairo 5–13 September 1994. New York: United Nations, 1994.
6.
CampbellOGrahamW. Measuring Maternal Mortality and Morbidity: Levels and Trends. London: London School of Hygiene and Tropical Medicine, 1991:26.
7.
Malawi Population and Housing Census 1998. Zomba: National Statistical Office, 2000.
8.
Malawi National Health Plan 1999–2004. Lilongwe: Ministry of Health and Population, 1999.
9.
Malawi Government. Economic Report 2001. Lilongwe: National Economic Council, 2002.
10.
UNDP. Malawi Human Development Report 2001. Lilongwe: United Nations Development Programme, 2002.
11.
Malawi Demographic and Health Survey. Zomba: Malawi National Statistical Office and ORC Macro, 2000.
12.
World Health Organization. Alma Ata Meeting. Health for All Series, No. 1. Geneva: WHO, 1978.
13.
KalumbiCTadesseE. An audit of deliveries and outcomes at Queen Elizabeth Central Hospital, Blantyre 1999. Malawi Med J2001;13:34–5.
14.
TahaTEDallabettaGAHooverDRTrends of HIV-1 and sexually transmitted diseases among pregnant and postpartum women in urban Malawi. AIDS1998;12:197–203.
15.
HendersonRAMiottiPGSaavedraJMLongitudinal growth during the first 2 years of life in children born to HIV-infected mothers of Malawi, Africa. Paediatr AIDS HIV Infect1996;7:91–7.
16.
LuleGSMtitimilaE. Intention to deliver and delivery outcome. Malawi Med J1993;9:15–17.
17.
VaahteraMKulmalaTNdekhaMAntenatal and perinatal predictors of infant mortality in rural Malawi. Arch Dis Child Fetal Neonatal Ed2000;82:F200–4.
18.
LunguKKamfosaVHusseinJAshwood-SmithH. Are bicycle ambulances and community transport plans effective in strengthening obstetric referral plans in Southern Malawi?Malawi Med J2001;13:16–18.
19.
HillKAbouzahrCWardlawT. Estimates of maternal mortality in 1995. Bull World Health Organ2001;79:182–93.
20.
GrahamWBrassWSnowRW. Estimating maternal mortality: The Sisterhood Method. Stud Fam Planning1989;20:125–35.
21.
Malawi Demographic and Health Survey 1992. Zomba: Malawi National Statistical Office and ORC, 1994.
22.
Ministry of Economic Planning and Development, National Statistical Office and Centre for Social Research. Malawi Social Indicators Survey: A survey of the State of Health, Nutrition, Water, Sanitation and Education of Children in Malawi. Lilongwe: Malawi Government, 1996.
23.
StantonCAbderrahimNHillK. DHS Maternal Mortality Indicators: an Assessment of Data Quality and Implications for Data Use. Demographic and Health Surveys Analytical Report No. 4. Claverton: Macro International Inc, 1997.
24.
StantonCAbderrahimNHillK. An assessment of DHS maternal mortality indicators. Stud Fam Planning2000;31:111–13.
25.
MtimavalyeLARMalungaE. The complexity of issues in the battle against maternal mortality: the Malawi example. In: Proceedings of the University of Malawi College of Medicine Third Research Dissemination Conference. Blantyre: University of Malawi, 1999:10.
26.
RatsmaEManjoloEPSimonJ. Voices from the Epidemic. Malawi Med J1992;8:60–6.
27.
NeedhamD. The reality of despair: AIDS in Malawi. Canadian Medical Association Journal1996;155:91–2.
28.
CampbellOGrahamW. Measuring Maternal Mortality and Morbidity: Levels and Trends. London: London School of Hygiene and Tropical Medicine, 1991:26.
29.
WhiteFSaleemS. Maternal mortality estimates are useful. Bull World Health Organ2001;79:900.
