{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T01:53:38Z","timestamp":1778810018557,"version":"3.51.4"},"reference-count":54,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T00:00:00Z","timestamp":1620000000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Gobally, Sub\u2010Saharan Africa (SSA) has the largest maternal mortality burden, but the region lacks accurate data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To review methods historically used to measure maternal mortality in SSA to inform future study methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>We searched databases: PubMed, Medline, WorldCat and CINHAL, using keywords \"maternal mortality,\" \"pregnancy\u2010related death,\" \"reproductive age mortality,\" \"ratio,\" \"rate,\" and \"risk,\" using Boolean operators \"OR\" and \"AND\" to combine the search terms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>We searched for empirical and analytical studies that: (1) measured maternal mortality levels, (2) were in SSA, (3) reported original results, and (4) were not duplicate studies. We included studies published in English since 1980.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>We screened the studies using titles and abstracts, reading the full text of selected studies. We analyzed the estimates and strengths, and limitations of the methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>We identified 96 studies that used nine methods: demographic surveillance (<jats:italic>n<\/jats:italic>\u00a0=\u00a04), health record reviews (<jats:italic>n<\/jats:italic>\u00a0=\u00a018), confidential enquiries and maternal death surveillance and response (<jats:italic>n<\/jats:italic>\u00a0=\u00a07), prospective cohort (<jats:italic>n<\/jats:italic>\u00a0=\u00a09), reproductive age mortality survey (RAMOS) (<jats:italic>n<\/jats:italic>\u00a0=\u00a06), sisterhood method (<jats:italic>n<\/jats:italic>\u00a0=\u00a035), mixed methods (<jats:italic>n<\/jats:italic>\u00a0=\u00a04), and mathematical modeling (<jats:italic>n<\/jats:italic>\u00a0=\u00a013).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Sisterhood method studies and RAMOS studies that combined institutional records and community data produced maternal mortality ratios more comparable with WHO estimates.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.13695","type":"journal-article","created":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T15:45:54Z","timestamp":1617464754000},"page":"206-215","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Methods used to measure maternal mortality in Sub\u2010Saharan Africa from 1980 to 2020: A systematic literature review"],"prefix":"10.1002","volume":"156","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0622-2195","authenticated-orcid":false,"given":"Reuben","family":"Musarandega","sequence":"first","affiliation":[{"name":"School of Health Systems and Public Health Faculty of Health Sciences University of Pretoria  Pretoria South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhoderick","family":"Machekano","sequence":"additional","affiliation":[{"name":"Biostatistics and Epidemiology Department Faculty of Medicine and Health Sciences Stellenbosch University  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen Peter","family":"Munjanja","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Department College of Health Sciences University of Zimbabwe  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Pattinson","sequence":"additional","affiliation":[{"name":"Maternal, Fetal, Newborn &amp; Child Health Care Strategies Research Centre University of Pretoria  Pretoria South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,5,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-019-2337-0"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69385-9"},{"key":"e_1_2_9_4_1","volume-title":"MDG5 Maternal Health (A): One Maternal Death Every Two Minutes in 2013","author":"Ramani KV","year":"2017"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00838-7"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61572-4"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/958262"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1258\/td.2012.120062"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1214\/16\u2010AOAS1014"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20103156.2010.02601.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20103156.2002.00892.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2017.1336752"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.21106\/ijma.263"},{"key":"e_1_2_9_14_1","unstructured":"MunjanjaSP NyandoroM MagwaliT.Maternal and perinatal mortality study 2007\u20102008: the short report. 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