Revista Brasileira de Epidemiologia
Print version ISSN 1415-790X
ELIZALDE, Eduardo Gustavo. Occurrence analysis of Maternal Mortality in the Province of Santa Fe - Argentina, due to an intervention. Rev. bras. epidemiol. [online]. 2004, vol.7, n.4, pp.435-447. ISSN 1415-790X. http://dx.doi.org/10.1590/S1415-790X2004000400007.
INTRODUCTION: Maternal Mortality (MM) shows differences in population health and life conditions, therefore it becomes not only a good socioeconomic indicator but also an indicator of health service providers and health care service quality in the assistance to women at reproductive age. Official Health Statistics do not reveal the size of MM problem due to the under-report that has this death cause. This deficiency or lack of data is highly marked especially in underdeveloped countries. It has been estimated that Argentina is not out of this under-report problem. In 1994, the Province of Santa Fe decided to add a specific ITEM to the Death Certificate for Maternal Death cause with the aim of amending the under-report. OBJECTIVES: The main objective of this study was to evaluate changes that Maternal Mortality Ratio (MMR) registered between 1988 and 2001 as a consequence of adding the "33 ITEM" regarding Maternal Death to the Death Certificate of the Province of Santa Fe from 1995 on. MATERIAL AND METHODS: Bibliography was reviewed as regards the MM under-report. The MM occurrence in the Province of Santa Fe was studied from 1988 to 2001. Changes produced by the 33 ITEM appearance in the Death Certificate of the Province of Santa Fe during the period 1995 - 2001 were analyzed. RESULTS: It was seen an increase in the MM absolute figures and therefore, an increase of MM ratios (41 %) from 1995 to 2001, unlike the lowering trend of this indicator both at national level and at provincial level in the previous period (pre "33 Item"). Besides, it was seen a modification in death distribution in relation to its incidence among diferent age groups. Another important detail is that frequency of pathologies leading to death (death cause) was modified, being Abortion the most frequent cause unlike the previous periods in which Hypertension was first in the rank. CONCLUSION: The "33 ITEM" addition to Death Certificate of the Province of Santa Fe brought about important MM data modifications. These modifications should be attributed to the decrease of under - reporting since there is no valid reason to think of a real increase in maternal death occurrence. Thus, as a conclusion, this instrument for collecting data allows to amend the under-report and obtain higher quality data, which consequently bring the possibility of setting up health policy and programmes based on data showing the real health situation.
Keywords : Maternal Mortality; Underreport; Maternal Mortality Rate; Maternal Mortality Ratio; Death Certificate; Death Cause.