A comparison of vital registration and reproductive-age mortality survey in Bukidnon, Philippines, 2008

Objective: To determine the accuracy of reported maternal deaths for 2008 in a province in the Philippines. Methods: A reproductive-age mortality survey (RAMOS) was conducted to identify deaths of women aged 15-49 years from Bukidnon, Philippines, in 2008. Sources included various health and community reporting units. Verbal autopsies were carried out to ascertain maternal deaths. Results: The survey found 58 pregnancy-related deaths in 2008, of which 52 were maternal deaths. Of the 52, 14 were found in local civil registries but 4 were not classified as maternal deaths. No single reporting unit identified all deaths. Local civil registries provided an estimated maternal mortality ratio (MMR) of 49 per 100 000 live births. The present RAMOS estimated an MMR of 209 (95% confidence interval, 191-226) per 100 000 live births. Conclusion: Official reports led people using the data to believe that the MMR in the province was on track for Millennium Development Goal 5 (to reduce MMR by three-quarters by 2015). The present survey showed that local civil registries missed three-quarters of all maternal deaths. All countries engaged in addressing maternal mortality reduction should consider similar approaches to improve data quality. (C) 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.