Estimating Maternal Mortality in Remote Rural Regions: an Application of the Sisterhood Method in Tajikistan

Main Article Content

Kylea Laina Liese
Heather Pauls
Sarah Robinson
Crystal Patil


Introduction: The sisterhood method of maternal mortality data collection and analysis provides a validated framework for estimating maternal mortality ratios in situations of limited infrastructure. The aim of this study is to assess sub-national maternal mortality in the Badakhshan region of Tajikistan using the sisterhood method as part of a larger ethnographic study on maternal risk.

Methods: In 2006-2007, 1004 married women of reproductive age in Gorno-Badakhshan Autonomous Oblast, Tajikistan were surveyed using the sisterhood method. Respondents were asked eleven questions about the sex, age and survivorship of all children born to the respondent’s mother.

Results: Using a national total fertility rate (TFR) estimate of 4.88, the maternal mortality ratio (MMR) in Tajik Badakhshan was 141 maternal deaths per 100,000 live births (95% CI 49-235). The lifetime risk of maternal death was 1 in 141 (95% CI 34-103).

Conclusion: Given the inherent time-lag of the sisterhood method, precise estimates of maternal mortality are dependent on accurate TFRs, which may vary based upon regional experiences of demographic transitions. Socio-political instability and the dismantling of Soviet welfare programs and civil war following Tajikistan’s independence from the Soviet Union in 1991 likely impacted TFR in Tajik Badakhshan. Socio-political trends influencing TFR in rural regions compared to urban, and the investigation of factors associated with maternal mortality, require additional investigation.

Article Details

How to Cite
Liese, K. L., Pauls, H., Robinson, S., & Patil, C. (2019). Estimating Maternal Mortality in Remote Rural Regions: an Application of the Sisterhood Method in Tajikistan. Central Asian Journal of Global Health, 8(1).
Author Biography

Sarah Robinson, Department of Psychology and Educational Sciences, University of Geneva, Switzerland

Faculty of Psychology and Educational Sciences


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