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2.19

About the data Reproductive health is a state of physical and mental

estimates of maternal mortality that it produces per-

using contraception. • Contraceptive prevalence rate

well-being in relation to the reproductive system and its

tain to 12 years or so before the survey, making them

is the percentage of women married or in union ages

functions and processes. Means of achieving reproduc-

unsuitable for monitoring recent changes or observ-

15–49 who are practicing, or whose sexual partners

tive health include education and services during preg-

ing the impact of interventions. In addition, measure-

are practicing, any form of contraception. • Pregnant

nancy and childbirth, safe and effective contraception,

ment of maternal mortality is subject to many types of

women receiving prenatal care are the percentage of

and prevention and treatment of sexually transmitted

errors. Even in high-income countries with vital regis-

women attended at least once during pregnancy by

diseases. Complications of pregnancy and childbirth

tration systems, misclassification of maternal deaths

skilled health personnel for reasons related to preg-

are the leading cause of death and disability among

has been found to lead to serious underestimation.

nancy. • Births attended by skilled health staff are the

women of reproductive age in developing countries.

The national estimates of maternal mortality ratios

percentage of deliveries attended by personnel trained

Total and adolescent fertility rates are based on data

in the table are based on national surveys, vital regis-

to give the necessary care to women during pregnancy,

on registered live births from vital registration systems

tration records, and surveillance data or are derived

labor, and postpartum; to conduct deliveries on their

or, in the absence of such systems, from censuses

from community and hospital records. The modeled

own; and to care for newborns. • Maternal mortality

or sample surveys. The estimated rates are generally

estimates are based on an exercise by the World

ratio is the number of women who die from pregnancy-

considered reliable measures of fertility in the recent

Health Organization (WHO), United Nations Children’s

related causes during pregnancy and childbirth per

past. Where no empirical information on age-specific

Fund (UNICEF), United Nations Population Fund

100,000 live births. • Lifetime risk of maternal death

fertility rates is available, a model is used to estimate

(UNFPA), and World Bank. This year’s estimates of

refers to the probability that a 15-year-old girl will

the share of births to adolescents. For countries with-

maternal mortality include country-level time-series

eventually die from a maternal cause if throughout her

out vital registration systems fertility rates are gener-

data for the first time. For countries with complete

lifetime she experiences the risks of maternal death

ally based on extrapolations from trends observed in

vital registration systems with good attribution of

and the overall level of fertility and mortality that are

censuses or surveys from earlier years.

cause of death, the data are used to directly estimate

observed for a given population. Data are presented

More couples in developing countries want to limit

maternal mortality. For countries without complete

as 1 in the number of women who are likely to die from

or postpone childbearing but are not using effective

registration data but with other types of data and for

a maternal cause.

contraception. These couples have an unmet need for

countries with no empirical national data, maternal

contraception. Common reasons are lack of knowledge

mortality is estimated with a multilevel regression

about contraceptive methods and concerns about pos-

model using available national-level maternal mortal-

sible side effects. This indicator excludes women not

ity data and socioeconomic information, including

Data on total fertility are compiled from the United

exposed to the risk of unintended pregnancy because

fertility, birth attendants, and GDP. The methodol-

Nations Population Division’s World Population

of menopause, infertility, or postpartum anovulation.

ogy of this year’s interagency estimates differs from

Prospects: The 2008 Revision, census reports

Data sources

Contraceptive prevalence reflects all methods—

previous years’, so the data should not be compared

and other statistical publications from national

ineffective traditional methods as well as highly effec-

with data in previous editions. For further information

statistical offices, household surveys conducted

tive modern methods. Contraceptive prevalence rates

on methodology, see the original source.

by national agencies, Macro International, and the

are obtained mainly from household surveys, includ-

Neither set of ratios can be assumed to provide an

U.S. Centers for Disease Control and Prevention,

ing Demographic and Health Surveys, Multiple Indicator

exact estimate of maternal mortality for any of the

Eurostat’s Demographic Statistics, and the U.S.

Cluster Surveys, and contraceptive prevalence surveys

countries in the table.

Bureau of the Census International Data Base.

(see Primary data documentation for the most recent

In countries with a high risk of maternal death,

Data on adolescent fertility are from World Popu-

survey and year). Unmarried women are often excluded

many girls die before reaching reproductive age. Life-

lation Prospects: The 2008 Revision, with annual

from such surveys, which may bias the estimates.

time risk of maternal mortality refers to the prob-

data linearly interpolated by the Development

ability that a 15-year-old girl will eventually die from

Data Group. Data on women with unmet need for

a maternal cause.

contraception and contraceptive prevalence are

Good prenatal and postnatal care improves maternal health and reduces maternal and infant mortality. Indicators on use of antenatal care services, however,

For the indicators that are from household surveys,

from household surveys, including Demographic

provide no information on the content or quality of the

the year in the table refers to the survey year. For

and Health Surveys by Macro International and

services. Data on antenatal care are obtained mostly

more information, consult the original sources.

Multiple Indicator Cluster Surveys by UNICEF.

from household surveys, which ask women who have had a live birth whether and from whom they received

Data on pregnant women receiving prenatal Definitions

antenatal care. The share of births attended by skilled

care, births attended by skilled health staff, and national estimates of maternal mortality ratios are

health staff is an indicator of a health system’s ability

• Total fertility rate is the number of children that would

from UNICEF’s State of the World’s Children 2011

to provide adequate care for pregnant women.

be born to a woman if she were to live to the end of

and Childinfo and Demographic and Health Sur-

Maternal mortality ratios are generally of unknown

her childbearing years and bear children in accordance

veys by Macro International. Modeled estimates

reliability, as are many other cause-specific mortality

with current age-specific fertility rates. • Adolescent

of maternal mortality ratios and lifetime risk of

indicators. Household surveys such as Demographic

fertility rate is the number of births per 1,000 women

maternal death are from WHO, UNICEF, UNFPA

and Health Surveys attempt to measure maternal mor-

ages 15–19. • Unmet need for contraception is the

and the World Bank’s Trends in Maternal Mortal-

tality by asking respondents about survivorship of sis-

percentage of fertile, married women of reproductive

ity: 1990–2008 (2010).

ters. The main disadvantage of this method is that the

age who do not want to become pregnant and are not

2011 World Development Indicators

109

people

Reproductive health

World Development Indicators 2011 Part 1 of 2  

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