Constructing maternal morbidity – towards a standard tool to measure and monitor maternal health beyond mortality. Issue 1 (December 2016)

• Record Type: Journal Article
• Authors: Chou, Doris; Tunçalp, Özge; Firoz, Tabassum; Barreix, Maria; Filippi, Veronique; von Dadelszen, Peter; van den Broek, Nynke; Cecatti, Jose; Say, Lale
• Is Part Of: BMC pregnancy and childbirth. Volume 16:Issue 1(2016)
• Page Start: 1
• Page End: 10
• Publication Date: 2016-12
• Subjects: Maternal morbidity -- Definition -- Measurement -- Sustainable Development Goals (SDGs); Pregnancy -- Periodicals; Childbirth -- Periodicals; Obstetrics -- Periodicals; 618.2005
• DOI: 10.1186/s12884-015-0789-4
• Languages: English
• ISSNs: 1471-2393

Abstract

Abstract Background 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. Discussion 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. Summary 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.