Constructing maternal morbidity - towards a standard tool to measure and monitor maternal health beyond mortality.


Chou, D; Tunçalp, Ö, ; Firoz, T; Barreix, M; Filippi, V; von Dadelszen, P; van den Broek, N; Cecatti, JG; Say, L; Maternal Morbidity Working Group, ; (2016) Constructing maternal morbidity - towards a standard tool to measure and monitor maternal health beyond mortality. BMC Pregnancy Childbirth, 16 (1). p. 45. ISSN 1471-2393 DOI: https://doi.org/10.1186/s12884-015-0789-4

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Abstract

Maternal morbidity is a complex entity and its presentation and severity are on a spectrum. This paper describes the conceptualization and development of a definition for maternal morbidity, and the framework for its measurement: the maternal morbidity matrix, which is the foundation for measuring maternal morbidity, thus, the assessment tool. We define maternal morbidity and associated disability as "any health condition attributed to and/or complicating pregnancy and childbirth that has a negative impact on the woman's wellbeing and/or functioning." A matrix of 121 conditions was generated through expert meetings, review of the International Classification of Diseases and related health problems (ICD-10), literature reviews, applying the definition of maternal morbidity and a cut-off of >0.1 % prevalence. This matrix has three dimensions: identified morbidity category, reported functioning impact and maternal history. The identification criteria for morbidity include 58 symptoms, 29 signs, 44 investigations and 35 management strategies; these criteria are aimed at recognizing the medical condition, or the functional impact/disability component that will capture the negative impact experienced by the woman. The maternal morbidity matrix is a practical framework for assessing maternal morbidity beyond near-miss. In light of the emerging attention to Universal Health Coverage (UHC) as part of the post-2015 Sustainable Development Goals (SDGs) planning, a definition and standard identification criteria are essential to measuring its extent and impact.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Maternal Health Group
PubMed ID: 26935070
Web of Science ID: 371574100001
URI: http://researchonline.lshtm.ac.uk/id/eprint/2533962

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