Maternal mortality in South Africa: lessons from a case study in the use of deaths reported by households in censuses and surveys

Rob Dorrington, University of Cape Town
Debbie Bradshaw, Medical Research Council of South Africa

South Africa is unique in being a developing country which has asked questions on pregnancy related deaths in both its 2001 census and 2007 household survey, and monitors maternal and pregnancy related mortality via vital registration and an annual survey into maternal deaths. These sources of data provide a wide range of estimates of maternal mortality for the country. This paper examines these estimates to assess to what extent the differences between them are due to data deficiencies, methodological deficiencies or definitional differences. The results show that being relatively rare it is fairly difficult to establish the maternal mortality rate with a great degree of accuracy in a setting where data are less than perfect. They also show that to some extent the differences are due to differences and errors in processing of data but that pregnancy related mortality should not be treated as synonymous with maternal mortality.