So I’ve finally narrowed down my focus for the final paper to one clear-cut problem definition. I've decided to write about the high maternal mortality rate in the Sub-Saharan African country of Sierra Leone.
One of the main tactics used by public health officials is surveillance. It allows people to see where their resources are most needed. Surveillance, which is the monitoring of the health of a community, is especially important in determining the health of pregnant women and mothers. Surveillance of this one statistic should be the priority of many communities. A few weeks ago we read an article that stressed the importance of improving maternal survival rates because it is one of two major indicators of the health of the community overall.
Assessing the magnitude of a problem is always important for the field of public health. The ways by which problems are measured are through indicators, which can tell you whether your problem is actually one that needs to be addressed. In my research I found some alarming statistics exemplifying that maternal mortality in Sierra Leone is indeed something that needs to be addressed. The maternal mortality ratio, which is calculated by the number of maternal deaths divided by the number of live births times 100,000, was reported to be 860 between the years of 2003 and 2008 (UNICEF: 2010). But this is the unadjusted rate (not including underreporting and misclassifications). The adjusted rate was more than double this at 2100 for the year 2005 (UNICEF: 2010). It is also reported that the lifetime risk of maternal death is 1 in 8 (UNICEF: 2010). These numbers are all direct indicators, which are numbers that directly measure the problem at hand. They clearly show the severity of the problem. But any given public health issue has indirect factors that influence it as well. Some indirect indicators of this problem include the amount of health clinics or hospitals and amount of trained medical personnel in the country. Trained personnel are not always present during births in Sierra Leone, significantly adding to the risk of maternal death (Stanley, Wachuku-king: 1994). Another factor that adds to this problem is state of civil unrest in the country. Although the ten-year civil war has ended, the country remains fragile politically. Pregnant women are far from safe in this country and something needs to be done about it.
Often when doing projects like this, it’s hard to know how much truth there is behind your facts. Although I did find small discrepancies in the statistics I found across various websites, the numbers were all relatively close to each other. However, as I mentioned earlier in the blog, it’s hard to know how many deaths may not have been reported or were declared incorrectly. But I think that the sources I did use are recognized as pretty reliable resources globally.
I really find my topic interesting and enjoyed doing all this research this week! I’m excited to actually start writing the paper soon! Check back next week to hear more about my topic and paper!
Sources:
"Sierra Leone: At a Glance." UNICEF, 2 Mar. 2010. Web. 17 Nov. 2010. <http://www.unicef.org/infobycountry/sierraleone_statistics.html#64>.
"BBC News - Country Profile: Sierra Leone." BBC News - Home. 28 Jan. 2010. Web. 17 Nov. 2010. <http://news.bbc.co.uk/2/hi/africa/country_profiles/1061561.stm>.
Wachuku-king, S., and S. Stanley. "The State of Motherhood in Sierra Leone." PubMed. Sept. 1994. Web. 19 Nov. 2010. <http://www.ncbi.nlm.nih.gov/pubmed/12318870>.
Great job, Dani. Good problem statement. Your direct indicators are good, but you should also compare those numbers to something familiar, perhaps the maternal mortality ratio in the U.S. Otherwise, it is hard to know how bad 860 deaths per 100,000 is (is it twice the rate of the U.S.? or 10 times?). For indirect indicators, the number of hospitals or clinics with obstetric services might be good, as well as the one you brought up (presence or absence of skilled personnel at birth), or perhaps the percentage of women who go to a health facility to give birth. But we need actual numbers for these. I agree that it will be difficult to do the research, but you’ve made a good start so far, and I think even more interesting research awaits as you think about key determinants and possible interventions.
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