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Improving the Measurement of Maternal Mortality: The Sisterhood Method Revisited

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  • Leena Merdad
  • Kenneth Hill
  • Wendy Graham

Abstract

Background: Over the past several decades the efforts to improve maternal survival and the consequent demand for accurate estimates of maternal mortality have increased. However, measuring maternal mortality remains a difficult task especially in developing countries with weak information systems. Sibling histories included in household surveys (most notably the Demographic and Health Surveys (DHS)) have emerged as an important source of maternal mortality data. Data have been mainly collected from women and have not been widely collected from men due to concerns about data quality. We assess data quality of histories obtained from men and the potential to improve the efficiency of surveys measuring maternal mortality by collecting such data. Methods and Findings: We used data from 10 Demographic and Health Surveys (DHS) that have included a full sibling history in both their women’s and men’s questionnaires. We estimated adult and maternal mortality indicators from histories obtained from men and women. We assessed the completeness and accuracy of these histories using several indicators of data quality. Our study finds that mortality estimates based on sibling histories obtained from men do not systematically or significantly differ from those obtained from women. Quality indicators were similar when comparing data from men and women. Pooling data obtained from men and women produced narrower confidence intervals. Conclusion: From experience across nine developing countries, sibling history data obtained from men appear to be a reliable source of information on adult and maternal mortality. Given that there are no significant differences between mortality estimates based on data obtained from men and women, data can be pooled to increase efficiency. This finding improves the feasibility for countries to generate robust empirical estimates of adult and maternal mortality from surveys. Further we recommend that male sibling histories be collected from all sample households rather than from a subsample.

Suggested Citation

  • Leena Merdad & Kenneth Hill & Wendy Graham, 2013. "Improving the Measurement of Maternal Mortality: The Sisterhood Method Revisited," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-12, April.
    • Handle: RePEc:plo:pone00:0059834
    DOI: 10.1371/journal.pone.0059834
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    References listed on IDEAS

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    1. Ziad Obermeyer & Julie Knoll Rajaratnam & Chang H Park & Emmanuela Gakidou & Margaret C Hogan & Alan D Lopez & Christopher J L Murray, 2010. "Measuring Adult Mortality Using Sibling Survival: A New Analytical Method and New Results for 44 Countries, 1974–2006," PLOS Medicine, Public Library of Science, vol. 7(4), pages 1-17, April.
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    3. Jon Pedersen & Jing Liu, 2012. "Child Mortality Estimation: Appropriate Time Periods for Child Mortality Estimates from Full Birth Histories," PLOS Medicine, Public Library of Science, vol. 9(8), pages 1-13, August.
    4. Emmanuela Gakidou & Gary King, 2006. "Death by survey: Estimating adult mortality without selection bias from sibling survival data," Demography, Springer;Population Association of America (PAA), vol. 43(3), pages 569-585, August.
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