MANILA, August 30, 2011–Indeed, maternal deaths are a problem
requiring a real solution. But is it true that 11 women die each day due
to childbirth? Based on hard statistics from the Philippine government,
international agencies, and experts abroad, the answer is no.
In fact, data from the National Statistical Coordination Board (NSCB)
show that the real figure ranges from just 4.8 to 8.3 based on 2008
figures, the latest available. That year, the maternal mortality ratio
was estimated at 99-169 per 100,000 live births.
A total of 1,784,316 live births were recorded in the country in 2008.
The NSCB defines maternal mortality ratio or MMR as the “ratio
between the number of women who died (for reasons of pregnancy,
childbirth and puerperium) to the number of reported live births in a
given year, expressed as the number of maternal deaths per 100,000 live
births.”
The period 1990 to 2010 showed a marked decline in maternal
mortality, government data showed. MMR declined by 21% from 121 in
1990, to just 95 in 2010, even in the absence of a “reproductive
health” (RH) law.
What other studies show
For those who prefer not to rely solely on government statistics, two
separate studies released in 2010 provide even lower estimates of MMR
for the Philippines.
“Trends in Maternal Mortality: 1990 to 2008,” with estimates
developed by the World Health Organization (WHO), the United Nations
Children’s Fund (UNICEF), the UN Population Fund (UNFPA), and the World
Bank, estimated the Philippines’ MMR at 94 per 100,000 live births in
2008, equivalent to 4.6 a day.
The same report estimated maternal deaths at 2,100 in 2008, and based on this figure, there were 5.75 deaths a day.
The Philippines is in fact “making progress” in reducing maternal
mortality, with the estimated MMR plunging by 48% – nearly half – from
1990 to 2008, the report by five international agencies showed.
The Philippines also did a better job of reducing maternal deaths –
in terms of the percentage drop in MMR – than Russia, Malaysia, Hungary,
Israel, and even Germany, the report indicated.
Maternal death is defined by the WHO as the “death of a woman while
pregnant or within 42 days of termination of pregnancy, irrespective of
the duration and site of the pregnancy, from any cause related to or
aggravated by the pregnancy or its management but not from accidental or
incidental causes.”
Meanwhile the study “Maternal mortality for 181 countries, 1980–2008:
a systematic analysis of progress towards Millennium Development Goal
5,” published in the respected journal The Lancet and funded by
Bill & Melinda Gates Foundation, placed the Philippines’ maternal
mortality ratio at just 84 per 100,000 live births.
This is equivalent to 4.1 deaths per day – a far cry from the 11 a
day that RH lobbyists are using in their bid to push for the
controversial and divisive RH bill.
The Lancet article was written by Margaret Hogan, Kyle Foreman,
Mohsen Naghavi, Stephanie Ahn, Mengru Wang, Susanna Makela, Alan Lopez,
Rafael Lozano, and Christopher J. L. Murray. Most of the researchers
came from the Institute for Health Metrics and Evaluation of the
University of Washington in Seattle.
Based on their data, the Philippines, even without an RH law, reduced
its MMR by 81% between 1980 and 2008, and 52% between 1990 and 2008.
“Our analysis of all available data for maternal mortality from 1980
to 2008 for 181 countries has shown a substantial decline in maternal
death,” the researchers concluded.
“Compared with previous assessments of maternal mortality, we have
narrowed the uncertainty around global and national estimates of the
MMR. This improved accuracy is a result of an extensive database and the
use of analytical methods with increased explanatory power and improved
out-of-sample predictive validity,” they added.
The source of ‘11 maternal deaths a day’
Now, where did the “11 a day” figure come from? It is from the
outdated report “Maternal Mortality in 2000: Estimates developed by WHO,
UNICEF and UNFPA.”
It estimated the Philippines’ MMR at 200 in the year 2000, equivalent
to 9.8 a day. It placed the number of maternal deaths that year at
4,100, or 11.2 a day.
The report, however, is seven years old, published way back in 2004.
The outdated report carried an important caveat: “The 2000 estimates
cannot be used to analyze trends because of the wide margins of
uncertainty associated with the estimates.”
“The margins of uncertainty associated with the estimated MMRs are
very large, and the estimates should not, therefore, be used to monitor
trends in the short term. In addition, cross country comparisons should
be treated with considerable circumspection because different strategies
have been used to derive the estimates for different countries, making
it difficult to draw comparisons,” the 2004 report said.
The same international agencies, in their 2010 report, pointed out that the latest (2008) estimates are more reliable.
“[I]t should be noted that the data and methods have improved over
time. The 2008 estimates should not be compared with those from the
previous exercises to assess changes in time. Trends in maternal
mortality calculated using the same improved methodology and presented
for years 1990, 1995, 2000, 2005, and 2008 in this report show the
changes over time.” (Dominic Francisco)
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