Maternal mortality in Mafraq District in Jordan.

The present study followed a multidimensional approach to determine maternal mortality ratio in Mafraq district in Jordan. It included active case (maternal deaths) surveillance combined with Civil Registry and hospital records review. Mafraq, by virtue of its geographic and demographic characteristics, is supposed to have a very high toll of maternal deaths and hence, generalizations reflecting the maximum expected maternal mortality ratio in Jordan could be made. The ratio, and as an average for the five years 1987-1991 covered in retrospect by the study was 42 deaths per 100,000 live births, very close to the estimated one. Establishing a baseline maternal mortality ratio and outlining risks pertaining to maternal survival as done in this study is an important prerequisite for interventions to reduce these risks and monitor progress towards reduction of maternal mortality ratio by half by the year 2000 which is a global goal to which Jordan is committed. The multidimensional approach followed by this study is shown to be superior to single source approaches in determining maternal mortality ratio in instances where populations are small and death registration is weak. The study suggests that maternal deaths (preferably as circumstances around the death and not as ICD coded, to avoid under reporting) should be reported in the same manner as notifiable diseases until improvements in death registration are completed and registries are accurate and valid.