Abstract
BackgroundThailand uses cause of death records in civil registration to summarize maternal mortality statistics. A report by the Department of Health using the Reproductive Age Mortality Studies (RAMOS) reported that the maternal mortality ratio (MMR) in 1997 was approximately three to four times higher than MMR based on the civil registration cause of death records. Here, we used multiple data sources to systematically measure maternal mortality in Thailand and showed a disparity between age groups and regions.MethodsWe calculated the number of maternal deaths using a two-stage method. In the first stage, we counted the number of deceased mothers who successfully gave live births. In the second stage, we counted the number of women who died during the pregnancy, delivery, or the postpartum period without a live birth.ResultsThe number of maternal deaths dropped from 268 in 2007 to 226 in 2014. Nearly 50 % of the deaths occurred in Stage 1. The maternal mortality ratio in 2007 was 33.6 per 100,000 live births; the rate fell to 31.8 in 2014. The age ranges of women observed were 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, and 45-49, and the MMR averages were 21.5, 23.8, 27.0, 42.1, 67.7, 115.4, and 423.4 per 100,000 live births, respectively. The Southern region consistently exhibited the highest MMR compared to other regions for every year analyzed, except 2012. Women in Bangkok had a lower risk of dying during pregnancy, delivery, and the postpartum period than women from other regions.ConclusionsWe demonstrated that using multiple administrative data sources in the two-stage method was an efficient method that provided systematic measurement and timely reporting on the maternal mortality ratio. An additional benefit of the method was that information provided from the combined data sources, (e.g., the number of maternal deaths by age group and region) was relevant to the safe motherhood policy.
Highlights
Thailand uses cause of death records in civil registration to summarize maternal mortality statistics
From the 2007 to 2014 time period, maternal mortality ratio (MMR) increased by 0.2 % annually
We found that the maternal mortality ratios calculated using the two-stage method were about three to four times higher than the official MMR reported by the Bureau of Policy and Strategy (BPS) in 2007-2011 [6]
Summary
Thailand uses cause of death records in civil registration to summarize maternal mortality statistics. The Bureau of Health Promotion (BHP) reported in 1990 that maternal mortality was 36.0 per 100,000 live births This ratio declined until 1997, when it reached 14.2; it subsequently increased until it reached 28.0 by 2000 [1]. The Bureau of Policy and Planning (BPP), which was later named the Bureau of Policy and Strategy (BPS), reported that the maternal mortality ratio in 1990 was 25.0 per 100,000 live births. They observed a decline to 7.0 in 1998 and a subsequent increase to 13.2 in 2000 [1]. The BPP reported values are nearly half of the BHP values
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