Selected maternal health indicators obtained by geographical reconnaissance

Abstract

We calculated maternal mortality ratio estimates and proportion of facility-based deliveries using large-scale population-based data collected by the fieldworkers of the Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh under an activity termed geographical reconnaissance. We then compared these estimates with those from the Bangladesh Maternal Health Services and Mortality Survey, and the results obtained through the sample vital registration system of the Bangladesh Bureau of Statistics. The national estimate of the maternal mortality ratio using geographical reconnaissance was 50% lower than the other estimates, but divisional estimates vary greatly and the number of facility-based deliveries is increasing in some areas. We also assessed whether annual changes in maternal mortality can be monitored at the sub-district level. Substantial yearly variation in the number of maternal deaths and large confidence intervals characterize sub-district maternal mortality ratio estimates. The government commits substantial resources for the geographical reconnaissance and the quality of the mortality data it collects deserves critical examination that will support important decision-making about the future of geographical reconnaissance.