Validating the Verbal Autopsy Questionnaire for Maternal Mortality in Pakistan

Maternal mortality represents the largest and the most persistent gap between developed and developing countries. The maternal mortality ratio (MMR), which measures the risk of death at each pregnancy, is up to 40 times higher in some African countries than the countries of Northern Europe. MMR is believed to be the most sensitive indicator of women s status in the society and of the quality and accessibility of maternal health services available to women. The primary purpose of the study was to determine the level of agreement in the cause and the category of death assigned by the hospital and the obstetrician who reviewed the completed VA questionnaire. The validation study was conducted during July-September 2006 by the National Institute of Population Studies (NIPS), which is also the executing agency for PDHS 2007. The primary objective of the study was to test the sensitivity and specificity of the VA questionnaire developed for PDHS 2007. An important lesson learned from this study is that the sensitivity of the VA technique can be further enhanced by rigorous training of the review panelists in the utilization of the information contained in the coded parts of the questionnaire.