Be Careful Which Data You Compare.

fr333Last week the Uganda Bureau of Statistics released the 2016 Uganda Demographic and Health Survey (2016 UDHS). My initial interest in this was to find out how the country has progressed in its aim to reduce maternal mortality, and how likely it is to meet the Strategic Development Goal, SDG, 3.1. This is a global target of reducing the maternal mortality ratio, MMR, to less than 70 per 100,000 live births by 2030, with no country having an MMR greater than 140. Clearly an ambitious target, and for many countries, this will be a significant challenge.

On the first read and, I have to admit, after allowing myself to be misled by one of the Ugandan press, I thought good progress was being made and tweeted so:

#Uganda has made great strides in #maternal health. MMR reduced from 438 deaths per 100,000 live births in 2011 to the current 336 deaths per 100,000 live births. Well done @MinofHealthUG let’s keep this trend going and meet #SDG 3.1. #UDHS2016

but, I was wrong.

@DHSprogram quickly commented back to correct me, in their words:

The definition of MMR changed between the 2011 & 2016 UDHS, so you can’t compare. Previous UDHS surveys show pregnancy-related mortality ratio. The PRMR trend indicates a decline, but the sample size of surveys was not large enough to detect a significant change.

Trends in PRMR

This declining trend is simply not fast enough to reach the SDG 3.1 target. In the fifteen years to 2016, the decline has been ~30%, which if continued until 2030 would mean that the PRMR would still be in the mid-200s.

All of us who are working to deliver maternal healthcare in Uganda will need to do much, much more. We need to determine what is working, which are the initiatives helping to reduce MMR, and how can we do more with these?

About Kevin Duffy

Interim Management and Consulting - Global Healthcare Development. Kevin has over ten years of senior management experience in the delivery of healthcare services in Africa and South Asia. His current focus is on the strategic development of policy, guidance, and tools to help healthcare organisations achieve sustainable impact – balancing the need to become financially sustainable, with the mission of ensuring equitable access to affordable healthcare services.
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