Maternal mortality rates can vary significantly around the world. For example, in 2022, Estonia had a maternal mortality rate of zero per 100,000 live births, while Mexico reported a rate of 38 deaths per 100,000 live births. However, the regions with the highest number of maternal deaths are Sub-Saharan Africa and Southern Asia, with differences between countries and regions often reflecting inequalities in health care services and access. Most causes of maternal mortality are preventable and treatable with the most common causes including severe bleeding, infections, complications during delivery, high blood pressure during pregnancy, and unsafe abortion. Maternal mortality in the United States In 2022, there were a total of 817 maternal deaths in the United States. Women aged 25 to 39 years accounted for 578 of these deaths, however, rates of maternal mortality are much higher among women aged 40 years and older. In 2022, the rate of maternal mortality among women aged 40 years and older in the U.S. was 87 per 100,000 live births, compared to a rate of 21 among women aged 25 to 39 years. The rate of maternal mortality in the U.S. has risen in recent years among all age groups. Differences in maternal mortality in the U.S. by race/ethnicity Sadly, there are great disparities in maternal mortality in the United States among different races and ethnicities. In 2022, the rate of maternal mortality among non-Hispanic white women was about 19 per 100,000 live births, while non-Hispanic Black women died from maternal causes at a rate of almost 50 per 100,000 live births. Rates of maternal mortality have risen for white and Hispanic women in recent years, but Black women have by far seen the largest increase in maternal mortality. In 2022, around 253 Black women died from maternal causes in the United States.

The number of maternal deaths and maternal mortality rates for selected causes, 2000 to most recent year.

Maternal mortality ratio is defined as the number of female deaths due to obstetric causes (ICD-10 codes: A34, O00-O95, O98-O99) while pregnant or within 42 days of termination of pregnancy. The maternal mortality ratio indicates the likelihood of a pregnant person dying of obstetric causes. It is calculated by dividing the number of deaths among birthing people attributable to obstetric causes in a calendar year by the number of live births registered for the same period and is presented as a rate per 100,000 live births. The number of live births used in the denominator approximates the population of pregnant and birthing people who are at risk. Data are not presented for geographies with number of maternal deaths less than 11.Compared to other high-income countries, women in the US are more likely to die from childbirth or problems related to pregnancy. In addition, there are persistent disparities by race and ethnicity, with Black pregnant persons experiencing a much higher rate of maternal mortality compared to White pregnant persons. Improving the quality of medical care for pregnant individuals before, during, and after pregnancy can help reduce maternal deaths.For more information about the Community Health Profiles Data Initiative, please see the initiative homepage.

Between 2007 and 2016, the rate of pregnancy-related deaths in the U.S. for women aged 20 to 24 years was 12.2 per 100,000 live births. The statistic illustrates pregnancy-related death rates in the U.S. from 2007 to 2016, by age. Roughly 700 women in the U.S. die every year due to pregnancy or its resulting complications.

Between 2014 and 2018, the rate of gestational diabetes among pregnant women aged 18 to 44 years increased from 126.6 to 147.5 per 1,000 pregnant women in the U.S. This statistic shows the prevalence rates of pregnancy complications among adult women in the U.S. in 2014 and 2018.

In 2021, a total of 13 deaths were reported to have occurred as a result of complications following an abortion in Argentina, down from 23 deaths registered a year earlier. Abortion is one of the leading causes of pregnancy-related deaths in Argentina.

In December 2020, abortion in Argentina was legalized up until the 14th week of pregnancy. Before the law passed, abortion was only decriminalized in cases where the pregnant person's life or health was in danger, or if the pregnancy was the result of rape.

Pregnancy complications, such as hypertensive disorders, present a substantial global public health challenge, with significant long-term implications for maternal and offspring health. This cross-sectional study aims to determine the level of awareness regarding long-term health risks among women who experienced preeclampsia during pregnancy in Cyprus and Greece. The study participants included adult women with a history of preeclampsia, while women with normal pregnancies were used as the comparison group. Data collection took place between June 2021 and February 2022, utilizing an online, self-administered questionnaire. The study included 355 women, with 139 (39.2%) in the preeclampsia group and 216 (60.8%) in the comparison group. Findings revealed that more than half of the women with prior preeclampsia (55.4%) were not aware of hypertensive disorders that can occur during pregnancy before their diagnosis, and a similar percentage (45.2%) had not received information about the long-term health risks following their diagnosis. Remarkably, only 3 participants (4.7%) with a history of preeclampsia were aware of the risk of developing cardiovascular diseases. There were no statistically significant differences between the preeclampsia and the comparison group regarding their concerns about long-term health risks, frequency of health checks, perceptions of factors influencing cardiovascular disease development, and doctor communication about different health topics, except from hypertension or high blood pressure. The study underscores the low level of awareness of long-term health risks among women with prior preeclampsia in Cyprus and Greece. This emphasizes the importance of implementing public health programs aimed at promoting cardiovascular risk assessment and effective management, both for clinicians and women with have experienced preeclampsia.

Abstract

The Government of The Gambia has always been committed to the “Health for All” year 2000 and beyond Alma Ata Declaration (1978) as well as other conventions such as the 1987 Global Conference on Safe Motherhood, the 1990 Convention on the Rights of the Child and the 1994 ICPD-Cairo Plan of Action, amongst others. A unique recommendation from all these conventions was the reduction of maternal mortality by half by the year 2000 and the provision of a comprehensive reproductive health programme using the life cycle approach from birth to death.

The 1987 conference on safe motherhood brought about increased awareness in the health sector on the issue of maternal mortality following which the “sisterhood” method of estimating levels of maternal mortality was first tested in The Gambia in 1987. This field test was done by the MRC field station located in one of the rural divisions of The Gambia and a total of 90 maternal deaths were identified. The lifetime risk of maternal death was estimated to be higher than one woman in twenty (Greenwood et al.). Subsequently, this revelation by the MRC study sparked a new impetus into the “silent epidemic” of maternal mortality following which the Department of State for Health through its MCH/FP programme commissioned a national survey in 1990. The results, which were quite startling, revealed a maternal mortality level of 1,050 per 100,000 live births nationally. There were variations between urban (600 per 100,000) and rural communities with trained birth attendants (894 per 100,000), and communities without trained birth attendants (1,600 per 100,000).

Recent isolated studies on maternal mortality have suggested a general decline in those areas. However, in the absence of a viable vital registration system in The Gambia, there has been a felt need to conduct another national survey, since the 1990 survey. Furthermore, the Department of State for Health’s proposed shift from MCH/FP service provision into a broad-focussed reproductive health programme also requires the availability of current baseline information and the identification of relevant process indicators, all of which justify the need to establish current levels of mortality and use of contraceptives.

It should be noted that current national policies and programmes continue to refer to data obtained from the 1990 maternal mortality study, the 1990 Gambia contraceptive prevalence and fertility determinants survey as well as the 1993 population and housing census as baseline benchmarks both for programme intervention and implementation. This long period to some extent renders the data quite obsolete and unsuitable for many national and development purposes. A simple compromise has been that of making comprehensive demographic, health and socio-economic projections. However, one important limitation of statistical projections is the period between the time the base data were collected and the time span of the projections. The probable margin of error in making projections with reference periods of eight or more years ago could be so large to warrant the acceptance of such projections within any reasonable statistical intervals.

Since there has been no comprehensive national survey on maternal, infant and child mortality during the past 10 years, and given that it would take a number of years before the final analyses of data obtained from the forthcoming census, it was found prudent to carry out a comprehensive study that would collect information on key reproductive health indicators. Furthermore, the complexity involved in studying maternal mortality compounded by its rarity of occurrence in the general population has necessitated conduction of a specialised study. Such a study would be useful in filling in the data deficiencies and providing baseline data for programme intervention and evaluation, especially in an era of a general shift of emphasis of population programmes from vertical family planning activities in favour of a more generally accepted concept - reproductive health.

Objectives of the survey: a) To establish current levels of maternal, peri-natal, neonatal and infant mortality rates. b) To establish the current levels of contraceptive prevalence rates and barriers to use. c) To elicit how the situation has improved or otherwise during the last ten years. d) Make practical recommendations to Department of State for Health for subsequent and long-term actions required.

Geographic coverage

National.

Analysis unit

• Households
• Women and men (both in child-bearing age)

Universe

The survey covered women age 15 to 49 years old and men age 18 years and over.

Kind of data

Sample survey data [ssd]

Sampling procedure

A multi-stage stratified cluster sampling procedure was used for this study. The country is divided into 41 Districts and each of these districts was identified as a stratum. Stratification by districts increases the efficiency of the sample given the homogeneity of the districts. The sample size for the study was 4000 households and was based on the level of maternal mortality which was estimated at 1050 per 100,000 at the time of the study. According to WHO/UNICEF, 1997 publication on Sisterhood Method in Estimating Maternal Mortality, 4,000 households or less would be adequate for study of maternal mortality if the level of maternal mortality is at least 500 per 100,000.

Based on the Rule of Thumb, a 15 per cent sample of EAs (240) was selected for this study, which is also more than adequate for the study of other variables like contraceptive prevalence, infant mortality, fertility and its determinants. The selection of population elements were done at two stages; a representative sample of 240 Enumeration Areas (EAs) were randomly selected and allocated based on the Probability Proportional to the Size (PPS) of the district using random numbers. The EA is a cluster of settlements with an estimated population of 500 peoples.

A total of 4,000 households were then allocated to the districts with probability proportional to the size of each district. For the 240 selected EAs, a specified number of households were randomly selected for interview using a systematic sampling procedure. A complete listing of selected household members was done and all eligible male and female respondents were interviewed.

Sampling deviation

There were no discrepancies between the sample units obtained and the iniitial planned samples.

Mode of data collection

Face-to-face [f2f]

Research instrument

The survey tools included a compound and household schedules, female and male questionnaires. The compound and household schedules were used to collect information on local government area, health division and household number, together with residence, sex, age, education and eligibility status of the household members. The female and male questionnaires were administered to women aged 15-49 years and men aged 18 years and above respectively. The survey instruments were similar to the core modules of the Demographic and Health Survey questionnaires (Macro International), with adaptation to suit The Gambian needs. In addition a review of medical records in the three main hospitals in The Gambia (Royal Victoria Hospital, Farafenni Hospital and Bansang Hospital) was carried out in November 2001 to undertake first-hand assessment of the maternal mortality situation at the major referral facilities.

The Survey team with support and guidance of the Technical Team prepared the survey instruments by adapting the Demographic and Health survey modules. The main instruments for this study are: - Male questionnaire which was used to obtain information from males 18 years and above; - Female questionnaire, which obtained information from females, 15-49 years ; - Household questionnaire contains information on Local Government Area (LGA), Districts and Household numbers.

For each person listed on the household questionnaire, relationship to head of household, age, and sex are recorded.

The female questionnaire contains the following key information: - Respondent's background - Reproduction - Contraception - Marriage - Fertility preferences - Maternal mortality

The male questionnaire on the other hand, contained the following information: - Respondent's background - Contraception - Marriage - Maternal mortality

Response rate

All respondents with missing age were excluded from the model. There were about 15 percent of the responses with missing information on the deaths. Imputations were made to establish whether or not they qualified to be classified as maternal deaths. For instance, those missing sex of the sibling but had correctly answered maternal death-related questions, the sex was taken to be female and therefore included in the maternal mortality model. Responses with no information on the type of maternal death, but had indicated the death as having been as a result of complications of pregnancy or child birth, were imputed to be pregnancy-related. On the other hand, responses on symptoms before death were used to impute the type of death in case it was missing.

Data appraisal

All respondents with missing age were excluded from the model. There were about 15 percent of the responses with missing information on the deaths.

In 2018, the maternal mortality rate in Morocco stood at 72.6 deaths per 100,000 live births. The risk of death for pregnant women in the country remained higher among the rural population. For instance, in 2018, around 111 mothers in every 100,000 live births died in rural areas due to complications related to pregnancy. In contrast, the rate was roughly 45 women per every 100,000 live births in urban areas.

Abstract This article explores women’s reproductive health in early twentieth-century Rio de Janeiro, showing that elevated and sustained stillbirth and maternal mortality rates marked women’s reproductive years. Syphilis and obstetric complications during childbirth were the main causes of stillbirths, while puerperal fever led maternal death rates. Utilizing traditional sources such as medical dissertations and lesser-used sources including criminal investigations, this article argues that despite official efforts to medicalize childbirth and increase access to clinical healthcare, no real improvements were made to women’s reproductive health in the first half of the twentieth century. This, of course, did not make pregnancy and childbirth any easier for the women who embodied these statistics in their reproductive lives.

Abstract

The 2007 Ghana Maternal Health Survey (GMHS) is intended to serve as a source of data on maternal health and maternal death for policymakers and the research community involved in the R3M program. Specifically, the data collected in the GMHS is intended to help the GoG and the consortium of organizations participating in the R3M program to launch a series of collaborative efforts to significantly expand women’s access to modern family planning services and comprehensive abortion care (CAC), reduce unwanted fertility, and reduce severe complications and deaths resulting from unsafe abortion.

The GMHS collected data from a nationally representative sample of households and women of reproductive age (15-49). The data were collected in two phases. The primary objectives of the 2007 GMHS were: • To collect data at the national level that will allow an assessment of the level of maternal mortality in Ghana for the country as a whole, for the R3M program regions (Greater Accra, Ashanti and Eastern Regions), and for the non-program regions; • To identify specific causes of maternal and non-maternal deaths, and specifically to be able to identify deaths due to abortion-related causes, among adult women; • To collect data on women’s perceptions and experience with antenatal, maternity, and emergency obstetrical care, especially with regard to care received before, during, and after the termination or abortion of a pregnancy; • To measure indicators of the utilization of maternal health services and especially post-abortion care services in Ghana; and • To provide baseline data for the R3M program and for follow-on studies and surveys that will be used to observe possible reductions in maternal mortality as well as reductions in abortion-related mortality.

Geographic coverage

National

Analysis unit

• Household
• Women age 15-49

Kind of data

Sample survey data [ssd]

Sampling procedure

Sample size: Phase I:240,000 households, Phase II: 4,203 verbal autopsies,10,858 households and 10,370 women age 15-49

Note: See detailed sample implementation tables is provided in APPENDIX B of the report which is presented in this documentation.

Mode of data collection

Face-to-face [f2f]

Research instrument

The GMHS involved four questionnaires: (1) a Phase I short household questionnaire administered at the time of listing; (2) a Phase II verbal autopsy questionnaire administered in households identified at listing as having experienced the death of a female household member age 12-49; (3) a Phase II long-form household questionnaire administered in independently selected households chosen for the individual woman’s interview, and (4) a Phase II questionnaire for individual women age 15-49 in the same phase two selected households.

The primary purpose of the short household questionnaire administered at the time of listing during Phase I was to identify deaths to women age 12-49, for administering the verbal autopsy questionnaire on the causes of female deaths, particularly maternal deaths and abortion-related deaths. Unique identifiers for households in phase one and households in phase two were not maintained; therefore households cannot be matched across both phases of the survey.

Response rate

A total of 11,579 households were selected for the sample, of which 10,994 were occupied at the time of the survey and 10,858 (or 99 percent) were successfully interviewed. The difference is primarily due to dwellings being vacant or the inhabitants being gone for an extended period at the time of the survey. In the interviewed households, 10,627 women were identified as eligible for the individual interview (women age 15-49), and interviews were completed for 10,370, or 98 percent. The principal reason for nonresponse among eligible women was the failure to find them at home, despite repeated visits to the household. The refusal rate was low in both urban and rural areas.

Note: See summarized response rates in Table 1.2 of the report which is presented in this documentation.

Sampling error estimates

See detailed sampling error tables in APPENDIX D of the report which is presented in this documentation.

Data appraisal

Data Quality Tables - Household age distribution - Age distribution of eligible and interviewed women - Completeness of reporting - Births by calendar years - Reporting of age at death in days - Reporting of age at death in months - Data on siblings - Indicators of data quality - Sibship size and sex ratio of siblings - Additional data on siblings - Imputation of data on living female siblings by age group

Note: See detailed tables in APPENDIX C of the report which is presented in this documentation.

The number and proportion (%) of maternal deaths (the first row) and the MMR per 100,000 live births by cause (the second row) in Wuhan between 2001 and 2012.

In the U.S., the rate of pregnancy complications among those aged 18 to 24 years was 149.9 per 1,000 pregnant women in 2018, compared to a rate of 230.7 per 1,000 pregnant women aged 34 to 44. This statistic shows the rate of pregnancy complications among adult women in the U.S. in 2018, by age.

The number of abortion-related deaths in the U.S. has decreased dramatically since 1973. In 1973, the number of deaths related to abortions was 47. In 2021, the number of reported deaths related to abortions had decreased to just five. Abortion is the act of ending a pregnancy so that it does not result in the birth of a baby. Abortions in the U.S. Abortions can be performed in a surgical setting or a medical setting (the pill). The number of legal abortions reported in the U.S. has generally declined yearly since 1990. The most frequently performed kind of abortion in the U.S. in 2022 were medical abortions. Abortion and the legality and morality of the procedure has been a publicly debated topic in the United States for many years. Public opinions on abortion Opinions on abortion in the United States can be divided into two campaigns. Pro-choice is the belief that women have the right to decide when they want to become pregnant and if they want to terminate the pregnancy through an abortion. Pro-life, is the belief that women should not be able to choose to have an abortion. As of 2023, around 52 percent of the U.S. population was pro-choice, while 44 percent considered themselves pro-life. However, these shares have fluctuated over the past couple decades, with a majority of people saying they were pro-life as recently as 2019.

This report presents the latest results and trends from the women's smoking status at time of delivery (SATOD) data collection in England. A new interactive tool has been published which allows users to select and view information for individual Clinical Commissioning Groups. This is available at the link below. These provisional results provide a measure of the prevalence of smoking among pregnant women at Commissioning Region, Region, Sustainability and Transformation Partnership and Clinical Commissioning Group level. Finalised results will be published in July 2018. Smoking during pregnancy can cause serious pregnancy-related health problems. These include complications during labour and an increased risk of miscarriage, premature birth, low birth-weight and sudden unexpected death in infancy. Reports in the series prior to 2011-12 quarter 3 are available from the Department of Health website (see below). Error Notification On 10/05/2018, NHS Digital identified an error in a small number of confidence intervals for the percentage of women smoking at the time of delivery in this report. The confidence intervals were incorrect for: The England total and the four regional totals in table 2b. As the report contains provisional data, the errors will be corrected in the Q4 report which will be published on 3 July 2018 and will contain final data for 2017/18 Q1, Q2, Q3 and Q4. NHS Digital apologise for any inconvenience caused.

Background: Sub-Saharan Africa accounts for two-thirds of the global burden of maternal and newborn deaths. Adverse outcomes among postpartum women and newborns occurring in the first six weeks of life are often related, though data co-examining patients are limited. This study is an exploratory analysis describing the epidemiology of postnatal complications among postpartum women and newborns following facility birth and discharge in Mbarara, Uganda. Methods: This single-site prospective cohort observational study enrolled postpartum women following facility-based delivery. To capture health information about both the postpartum women and newborns, data was collected and categorized according to domains within the continuum of care including (1) social and demographic, (2) pregnancy history and antenatal care, (3) delivery, (4) maternal discharge, and (5) newborn discharge. The primary outcomes were readmission and mortality within the six-week postnatal period as defined by the WHO. Multivariable logistic regression was used to identify risk factors. Findings: Among 2930 discharged dyads, 2.8% and 9.0% of women and newborns received three or more postnatal visits respectively. Readmission and deaths occurred among 108(3.6%) and 25(0.8%) newborns and in 80(2.7%) and 0(0%) women, respectively. Readmissions were related to sepsis/infection in 70(88%) women and 68(63%) newborns. Adjusted analysis found that caesarean delivery (OR:2.91; 95%CI:1.5–6.04), longer travel time to the facility (OR:1.54; 95%CI:1.24–1.91) and higher maternal heart rate at discharge (OR:1.02; 95%CI:1.00–1.01) were significantly associated with maternal readmission. Discharge taken on all patients including maternal haemoglobin (per g/dL) (OR:0.90; 95%CI:0.82–0.99), maternal symptoms (OR:1.76; 95%CI:1.02–2.91), newborn temperature (OR:1.66; 95%CI:1.28–2.13) and newborn heart rate at (OR:1.94; 95%CI:1.19–3.09) were risk factors among newborns. Readmission and death following delivery and discharge from healthcare facilities is still a problem in settings with low rates of postnatal care visits for both women and newborns. Strategies to identify vulnerable dyads and provide better access to follow-up care, are urgently required. Data Collection Methods: This prospective cohort study aimed to enroll women presenting in labor at >28 weeks’ gestation who delivered liveborn infants and were routinely discharged together home with their infants. Following delivery, we obtained written consent to complete a structured questionnaire in-person and a follow-up questionnaire over the phone six weeks later. Specifically, following enrolment, research nurses prospectively collected study variables previously identified through two systematic reviews on risk factors for re-admission and mortality among postpartum women and infants, as well as through discussion with colleagues and other experts. Given the interactive health relationship between postpartum women and infants, variables were collected and categorized according to relevant time points across the continuum of care. A total of 86 variables were collected and broadly categorized into five domains: (1) social and demographic, (2) pregnancy history and antenatal care, (3) delivery, (4) maternal discharge, and (5) neonatal discharge (Table 4A-E). Apart from discharge measurements, we prioritized gathering data from the hospital medical record, followed by interviews with the postpartum women and finally confirmation with the medical team if there were discrepancies, missing information, or questions the postpartum woman was unable to answer. With respect to discharge measurements, we obtained and recorded clinical data for both mother and their newborns on every dyad discharged together from the hospital. Blood pressure was measured using a Welch Allyn Vital Signs Monitor 300 Series (Welch Allyn, New York, USA). Oxygen saturation (SpO2) and heart rate was measured using the Masimo iSpO2® (Masimo Corporation, California, USA) and respiratory rates were measured using the RRate Application. Maternal hematocrit was quantified using a microhematocrit centrifuge. Random blood glucose was measured on mother and newborn using the FreeStyle Optimum Xceed (Abbott Healthcare, Massachusetts, USA). Anthropometric data of infants (length, weight, mid-upper arm circumference (MUAC), head circumference) were also measured and recorded. All dyads received routine care during admission and were discharged at the discretion of their medical teams. Six weeks following discharge, women who were discharged with their newborns were contacted by phone to determine the status of the mother and newborn and timing and frequency of postnatal care visits. For children who died, the cause of death was collected, as reported by the caregiver (mother or other family member). In addition to vital status, details surrounding the timing, frequency and length of stay pertaining to readmissions and health seeking were...

Pregnancy complications, labour characteristics and interventions among women with prolapsed membranes at 22–25 vs 26–28 weeks gestation (singleton pregnancies without congenital anomalies).

IntroductionOne of the key strategies to achieve the sustainable development goal by reducing maternal deaths below 70 per 100,000 is improving knowledge of obstetric danger signs (ODS). However, mothers’ knowledge of ODS is low in general and very low in rural settings, regardless of local and national efforts in Ethiopia. Further, there is significant variation of ODS knowledge among women from region to region and urban/rural settings. Most studies are limited only to northern Ethiopia and focused on individual-level determinants. Thus, this study aimed to assess the individual and community-level determinants of knowledge of obstetrics danger signs among women who delivered in the last 12 months in the northern zone of the Sidama region, Ethiopia.MethodsWe conducted a community-based cross-sectional study from October 21 to November 11, 2022. A multi-stage sampling procedure was utilized to select study participants. A structured and pretested questionnaire was utilized to collect data. Open Data Kit (ODK) smartphone application was used to collect data at women’s homes. A multi-level mixed-effects negative binomial regression model was used to control effects of clusters and confounders.ResultsThe overall response rate of this study was 99.12%. The proportion of knowledge of obstetrics danger sign was 22.3% (95% CI: 18.7, 25.9). Government-employed women [adjusted incidence ratio (AIR) = 1.37; 95% CI: 1.20, 1.56], women who had exposure to mass media (AIR = 1.16; 95% CI: 1.08, 1.25), women who had received model family training (AIR = 1.15; 95% CI: 1.10, 1.25), autonomous women (AIR = 1.34; 95% CI: 1.25, 1.46), women who had faced health problems during pregnancy (AIR = 1.21; 95% CI: 1.11, 1.32), and urban women (AIR = 1.22; 95% CI: 1.09, 1.62) were determinants positively affect knowledge of ODS.ConclusionOnly one in five women has good knowledge of ODS in the study setting. Urban residence, mass media exposure, receiving model family training, facing health problems during pregnancy, and women’s autonomy were the main determinants of knowledge of ODS. Any intervention strategies should focus on multi-sectorial collaboration to address determinants of knowledge of ODS at the individual and community level. Reinforcing the existing model family training, particularly focusing on rural women and women who denied autonomy in decision-making about health care, should be considered. Awareness creation should be increased about ODS through mass media exposure.

Abstract

The purpose of the RHS was to establish a complete statistical data set on fertility, infant mortality, family planning, maternal health related to antenatal care, pregnancy difficulties and delivery complications. Moreover, through this survey some data on child health, breastfeeding, women's and men's attitude towards family planning and AIDS were collected. This information is important firstly, for the evaluation of the current vital statistics on fertility and infant mortality; secondly, for understanding the factors that influence the reproductive health of women and the health and survival of infants and young children. The output of the survey can be used for policies and programs in relation to maternal and child health in Mongolia. In addition, the results of the survey may suggest some changes in the registration of infant deaths and in the reporting system, or in the use of statistical tools for the measuring of fertility and infant mortality levels in Mongolia.The survey findings are especially important now when the country is in the transition period, because it provides some information on awareness of people about family planning and AIDS. During the socialist period people did not have experiences of using family planning, and similarly, they did not know the danger of AIDS. Overall, the findings of RHS will become a useful source of information necessary for health care reform in Mongolia.

A further objective was to instill in the NSO the capacity to carry out large-scale, nationally representative and internationally comparable scientific surveys. It is expected that the survey will provide policy makers, health officials and researchers with data essential for informed policy-making, program execution, and further research.

The RHS has the following objectives: - Gather information on fertility, mortality and family planning at the national level; - Determine fertility, knowledge of contraceptives, and level of contraceptive use by region and rural-urban residence, age, educational level, and other background characteristics of women; - Gather information on specific health issues such as child health, breastfeeding practices, prenatal care, difficulties and complications during pregnancy, and abortion; - Disseminate Mongolian data on reproduction, health and family planning both within the country and internationally; - Provide policy makers and researchers with data essential for informed policy-making and further research.

Geographic coverage

The survey is nationally and regionally (5 regions - West, Central, East, South, Ulaanbaatar) representative and covers the whole of Mongolia.

Analysis unit

• Household
• Women aged 15-49
• Husband of the women
• Children

Universe

All women between the ages of 15 and 49 , three husbands out of five married women and their children above 5 years old.

Kind of data

Sample survey data [ssd]

Sampling procedure

The survey was conducted using a two-stage sampling method, with equal probability of selection of households. The sample frame comprised the listings of households prepared annually in bags and horoos across the country. It was determined from experience of other countries that 25 households per cluster would provide an optimum representation in a country where no such survey has ever before been conducted. (The best cluster "take" depends upon the intra-cluster versus inter-cluster heterogeneity of the principal variables being measured; this can only be determined after carrying out a survey.) For the survey it was planned to select 6000 households, which is a 1,13 percent sample of all households in the country. This implied the selection of 240 clusters of households. Bags and horoos were the primary sampling units (PSUs). All 1684 PSUs were stratified implicitly by aimag and soum, and the selection of the 240 sample PSUs (or clusters) was done systematically with a random start, with probability proportional to the number of registered households. Households were then selected systematically with a random start within each PSU, using an interval directly proportional to the number of households in the PSU. Each registered household in Mongolia had an equal and known probability of being selected in the RHS sample. The selected households were interviewed using the household schedule. All women between the ages of 15 and 49, inclusive, who slept in the household's dwelling the night prior to interview were eligible to be interviewed using the women's interview schedule. Interviewing teams were also instructed to interview 6 husbands of interviewed women in each PSU.

Distribution of the RHS Household Sampling by Aimag, Mongolia 1998

-- Aimag, Clusters, Number of Households 1) Arhangai, 1-12, 300 2) Bayan-Olgii, 13-20, 200 3) Bayanhongor, 21-30, 250 4) Bulgan, 31-37, 175 5) Gobi-Altai, 38-44, 175 6) Dornogobi, 45-49, 125 7) Dornod, 50-57, 200 8) Dundgobi, 58-63, 150 9) Zavhan, 64-73, 250 10) Selenge, 74-83, 250 11) Suhbaatar, 84-89, 150 12) Uvs, 90-99, 249 13) Tov, 100-110, 275 14) Ovorhangai, 111-124, 350 15) Omnogobi, 125-129, 125 16) Hovd, 130-137, 200 17) Hovsgol, 138-150, 325 18) Hentii, 151-158, 200 19) Darhan-Uul, 159-168, 250 20) Orhon, 169-174,149 21) Gobisumber, 175-176, 50 22) Ulaanbaatar, 177-240, 1607 Total number of households 6005

Mode of data collection

Face-to-face [f2f]

Research instrument

There were three questionnaires used in the RHS 1998.

The contents of the three questionnaires are outlined briefly below.
1. Household Questionnaire: The household questionnaire consists of questions on relationship to the household head, age, sex, educational level and marital status. The questions in the household questionnaire were asked concerning all members of the household, as well as visitors who spent the night before the survey in the household. The household questionnaire was developed in order to obtain general demographic information, information on household amenities and housing conditions, and as a tool for selecting women and husbands for individual interview.

1. Woman's Questionnaire: Background questions Reproduction Maternal health, pregnancy, breastfeeding, and child health Knowledge and use of contraceptive methods Marriage Fertility preferences and abortion Employment, and questions concerning the husband Knowledge about AIDS

3.Husband's Questionnaire: Background questions Reproduction Knowledge and use of contraceptive methods Knowledge about AIDS

All questionnaires are provided as external resources.

Cleaning operations

The computer data entry work was initiated on 20 October 1998 and terminated 1 February 1999. The editing of the computer files finished by the middle of February. The computer software package “Integrated System for Survey Analysis” (ISSA), created and distributed by Macro International, Inc. was used for data entry and data processing. From February 1999, output tables started to be produced, and this activity lasted for two months. Activities such as data entry, quality control and production of output tables were accomplished by the national staff under the supervision of the UN Technical Adviser and an adviser from the UNFPA Country Support Team in Bangkok. Similarly, the main report of RHS has been prepared through the cooperative work of national staff with the Technical Adviser. The tabulation plan follows closely the recommendations contained in Guidelines for the DHS-III Main Survey Report, published by Macro International.

Response rate

Results of the Household and Individual Interviews (Women and Husbands), Mongolia 1998

Number of Dwellings Sampled: Urban 2931, Rural 3074, and Total 6005 Number of Households Interviewed: Urban 2930, Rural 3073, and Total 6003 Household Response Rate: Urban 100.0, Rural 100.0, Total 100.0

Number of Eligible Women: Urban 3943, Rural 3610, and Total 7553 Number of Eligible Women Interviewed: Urban 3904, Rural 3557, and Total 7461 Eligible Women Response Rate: Urban 99.0, Rural 98.5, and Total 98.8

Number of Husbands Selected: Urban 794, Rural 766, and Total 1560 Number of Husbands Interviewed: Urban 793, Rural 764, and Total 1557 Husbands Response Rate: Urban 99.9, Rural 99.7, and Total 99.8

Sampling error estimates

Sampling errors are presented in Tables B.02 - B.16 (refer final survey report) for variables considered to be of major interest. Results are presented for the whole country, for urban and rural areas separately, for each of four education groups, for each of five regions, and for each of three age groups. For each variable, the type of statistic (percentage, mean or rate) and the base population are given in Table B.01 (refer final survey report) . For each variable, Tables B.02 - B.16 (refer final survey report) present the value of the statistic (R), its standard error (SE), the number of cases (N) where relevant, the design effect (DEFT) where applicable, the relative standard error (SE/R), and the 95 percent confidence limits (R-2SE, R+2SE).

The confidence limits have the following interpretation. For the percentage of currently married women using the contraceptive intrauterine device (IUD), the overall value for the full sample is 32.2%, and its standard error is 0.8%. Therefore, to obtain the 95 percent confidence limits, one adds and subtracts twice the standard error to the sample estimate, which means that there is a high probability (95 percent) the true percentage currently using the IUD is between 30.6% and 33.8%.

The relative standard errors for most estimates for the country as a whole

In the U.S., the rate of childbirth complications was 19.4 per 1,000 pregnancies among those aged 18 to 24 years in 2018. A similar rate was found among women aged 34 to 44 years. This statistic shows the rate of childbirth complications among adult women in the U.S. in 2018, by age.