{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:48:40Z","timestamp":1790725720255,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"s4","license":[{"start":{"date-parts":[[2014,9,18]],"date-time":"2014-09-18T00:00:00Z","timestamp":1410998400000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000278","name":"Department for International Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000278","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UNICEF Bangladesh"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:p>Verbal autopsy used at community level is an accepted method to identify cause of death and factors contributing to death. Maternal deaths occurring in four districts in Bangladesh over a period of 24\u00a0months were identified and community health workers were trained to conduct a verbal autopsy. Of 571 maternal deaths identified almost half (273, 47.8%) occurred at facility level, 97 (17.0%) died en route to a healthcare facility and 201 (35.2%) maternal deaths occurred at home. The majority of maternal deaths occurred in the postpartum period (78.8%) in the first 6\u00a0hours after giving birth (41.6% of all postpartum deaths). Women who had accessed care at a healthcare facility were less likely to die in the first 6\u00a0hours when compared with women who died at home (relative risk 0.70; 95% confidence interval 0.56\u20130.88) 70.4% (402) of deaths were classified as direct maternal deaths, 12.4% (71) as indirect and 13.8% (79) as unspecified. The most common cause of death was haemorrhage (38%), followed by eclampsia (20%) and sepsis (8.1%). Almost three out of four women who died had sought care for complications during the index pregnancy. Most mothers who died in Bangladesh had accessed care. It is now crucial that the quality of care received at health facility level is improved. This includes a refocus on strengthening healthcare providers' knowledge and skills to recognise and manage complications and provide emergency obstetric care. The enabling environment must be in place as well as ensuring a fully functional referral pathway between healthcare facilities.<\/jats:p>","DOI":"10.1111\/1471-0528.13010","type":"journal-article","created":{"date-parts":[[2014,9,18]],"date-time":"2014-09-18T11:11:00Z","timestamp":1411038660000},"page":"86-94","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Cause of and contributing factors to maternal deaths; a cross\u2010sectional study using verbal autopsy in four districts in Bangladesh"],"prefix":"10.1111","volume":"121","author":[{"given":"A","family":"Halim","sequence":"first","affiliation":[{"name":"Centre for Injury Prevention and Research Bangladesh (CIPRB) Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Utz","sequence":"additional","affiliation":[{"name":"Centre for Maternal and Newborn Health Liverpool School of Tropical Medicine Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Biswas","sequence":"additional","affiliation":[{"name":"Centre for Injury Prevention and Research Bangladesh (CIPRB) Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Rahman","sequence":"additional","affiliation":[{"name":"Centre for Injury Prevention and Research Bangladesh (CIPRB) Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"van den Broek","sequence":"additional","affiliation":[{"name":"Centre for Maternal and Newborn Health Liverpool School of Tropical Medicine Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,9,18]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"ICDDRB.Bangladesh Maternal Mortality and Health Care Survey.2010. [www.icddrb.org\/what-we-do\/health-programmes\/population-sciences\/bmms-2010-Final-Report]. Accessed 29 November 2013."},{"key":"e_1_2_7_3_1","first-page":"280","article-title":"Reducing maternal mortality and improving maternal health: Bangladesh and MDG 5","volume":"26","author":"Koblinsky M","year":"2008","journal-title":"J Health Popul Nutr"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(94)90226-7"},{"key":"e_1_2_7_5_1","unstructured":"WHO.Verbal autopsy standards: the 2012 WHO verbal autopsy instrument.2010. [www.who.int\/healthinfo\/statistics\/WHO_VA_2012_RC1_Instrument.pdf]. Accessed 4 February 2014."},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/27.4.660"},{"key":"e_1_2_7_7_1","unstructured":"National Institute of Population Research and Training.Bangladesh Demographic and Health Survey 2011.2013. [www.measuredhs.com\/publications\/publication-FR265-DHS-Final-Reports.cfm]. Accessed 6 January 2014."},{"key":"e_1_2_7_8_1","volume-title":"Baseline Survey Report 2008","author":"Ministry of Health and Family Welfare","year":"2008"},{"key":"e_1_2_7_9_1","unstructured":"WHO.Beyond the numbers.2004. [http:\/\/whqlibdoc.who.int\/publications\/2004\/9241591838.pdf]. Accessed 10 January 2014."},{"key":"e_1_2_7_10_1","unstructured":"WHO.The WHO Application of ICD\u201010 to deaths during pregancy childbirth and the puerperium: ICD\u2010MM.2012. [http:\/\/apps.who.int\/iris\/bitstream\/10665\/70929\/1\/9789241548458_eng.pdf]. 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An analysis of quality of public sector maternal health services, District Multan, Pakistan","volume":"56","author":"Fikree FF","year":"2006","journal-title":"J Pak Med Assoc"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68397-9"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.3109\/01443615.2010.533218"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2012.01.015"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0968-8080(06)27229-X"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.03119.x"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.05.029124"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12012"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.13010","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.13010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T05:02:39Z","timestamp":1694581359000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.13010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9]]},"references-count":28,"journal-issue":{"issue":"s4","published-print":{"date-parts":[[2014,9]]}},"alternative-id":["10.1111\/1471-0528.13010"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.13010","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9]]},"assertion":[{"value":"2014-06-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-09-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}