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Sisterhood method
The Sisterhood Method is a household survey to estimate maternal deaths, which includes a series of four questions. The Sisterhood Method is one method recommended by the WHO. Although maternal deaths are a major problem in developing countries, high quality data are rare. Yet, numbers are needed for planning in order to reduce the problem of maternal death. Several methods have been used to estimate maternal deaths. According to the WHO, "The approach was designed to overcome the problem of large sample sizes and thus reduce cost."〔The sisterhood method for estimating maternal mortality: Guidance notes for potential users, page 5. WHO. Geneva, Switzerland. 1997.〕〔Indirect estimation of maternal mortality: The sisterhood method. Graham W, Brass W, Snow RW. Stud Fam Planning. 1989:20(3):125-35.〕
==Background==
The death of a woman during or shortly after a pregnancy is an important medical problem in developing countries. 99% of all maternal deaths occur in developing countries.〔Maternal mortality in 2000: Estimates developed by WHO, UNICEF and UNFPA. AbouZahar C, Wardlaw T (Eds). WHO. Geneva, Switzerland. 2003.〕 In the poorest countries in the world, e.g. Sierra Leone, the lifetime risk for a woman dying because of a maternal death is approx 1 in 6, whereas in developed countries, e.g. Sweden, the same lifetime risk is approx 1 in 30,000.〔Maternal mortality: Who, when, where, and why. Ronsmans C, Graham WJ; Lancet Maternal Survival Series Steering Group. Lancet. 2006;368(9542):1189-200.〕 Half of all maternal deaths occur in six countries only: Afghanistan, Democratic Republic of Congo, Ethiopia, India, Nigeria, and Pakistan. Worldwide, maternal deaths decreased from approx 500,000 in 1980 to approx 350,000 in 2008. This decline in maternal deaths was associated mainly with better maternal education, maternal income, increased availability of trained birth attendants, and decreased pregnancy rates.〔Maternal mortality for 181 countries, 1980-2008: A systematic analysis of progress towards Millennium Development Goal 5. Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, Lopez AD, Lozano R, Murray CJ. Lancet. 2010;375(9726):1609-23.〕
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