Maternal Health Services and Maternal Mortality Survey 2001
Bangladesh, 2001
Created on
Apr 25, 2019
Last modified
Apr 25, 2019
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Identification
Survey ID Number
BGD_2001_BMMS_v01_M
Title
Maternal Health Services and Maternal Mortality Survey 2001
Country
| Name | Country code |
|---|---|
| Bangladesh | BGD |
Study type
Other Household Health Survey [hh/hea]
Abstract
The 2001 Bangladesh Maternal Health Services and Maternal Mortality Survey (BMMS) is the first nationally representative sample survey designed to provide information on the level of maternal mortality, causes of maternal and nonmaternal deaths, and perception, experience, and utilization of maternal health care in Bangladesh.
The Bangladesh Maternal Health Services and Maternal Mortality Survey (BMMS) is intended to serve as a source of maternal health and maternal death data for policymakers and the research community.
In general, the objectives of the BMMS are to:
• Collect data at the national level, which will facilitate an assessment of the level of maternal mortality in Bangladesh;
• Identify specific causes of maternal and nonmaternal deaths to adult women;
• Collect data on women’s perception of and experience with antenatal, maternity, and emergency obstetrical care;
• Measure indicators of utilization of maternal health services in Bangladesh.
The Bangladesh Maternal Health Services and Maternal Mortality Survey (BMMS) is intended to serve as a source of maternal health and maternal death data for policymakers and the research community.
In general, the objectives of the BMMS are to:
• Collect data at the national level, which will facilitate an assessment of the level of maternal mortality in Bangladesh;
• Identify specific causes of maternal and nonmaternal deaths to adult women;
• Collect data on women’s perception of and experience with antenatal, maternity, and emergency obstetrical care;
• Measure indicators of utilization of maternal health services in Bangladesh.
Kind of Data
Sample survey data [ssd]
Scope
Notes
The 2001 Bangladesh Maternal Health Services and Maternal Mortality Survey includes the follwoing topics:
HOUSEHOLD
- Household Demographic Characteristics
- Mortality
WOMAN
- Background Characteristics
- Maternal Mortality (Sisterhood)
- Reproduction
- Pre and Postnatal Care
VERBAL AUTOPSY
- Selection of People
- Background Information
- General Information about Events Preceding Death
- Descriptive Report of Illness and Events That Led to The Death
- General Illness Leading to Death
- For Death During Pregnancy Prior to Onset of Labor or Within 1Year of Abortion/ Miscarriage
- For Deaths During Labor, Delivery of After Delivery
- General Care Seeking
HOUSEHOLD
- Household Demographic Characteristics
- Mortality
WOMAN
- Background Characteristics
- Maternal Mortality (Sisterhood)
- Reproduction
- Pre and Postnatal Care
VERBAL AUTOPSY
- Selection of People
- Background Information
- General Information about Events Preceding Death
- Descriptive Report of Illness and Events That Led to The Death
- General Illness Leading to Death
- For Death During Pregnancy Prior to Onset of Labor or Within 1Year of Abortion/ Miscarriage
- For Deaths During Labor, Delivery of After Delivery
- General Care Seeking
Producers and sponsors
Primary investigators
| Name |
|---|
| Mitra and Associates |
| National Institute of Population Research and Training (NIPORT) |
| ICDDR,B: Centre for Health and Population Research Dhaka, Bangladesh |
| Associates for Community and Population Research (ACPR) |
Producers
| Name | Role |
|---|---|
| ORC Macro | Technical assistance |
| Johns Hopkins University | Technical assistance |
Funding Agency/Sponsor
| Name | Abbreviation | Role |
|---|---|---|
| United State Agency for International Development | USAID | Financial support |
Sampling
Sampling Procedure
Survey Design
Administratively, Bangladesh is divided into six divisions. Each division is divided into districts (zilas), and then thanas or upazilas. Each urban area in a thana or upazila is divided into wards, and each ward is divided into mohallas; each rural area in a thana or upazila is divided into union parishadas, and each union is divided into mouzas.
Smaller subdivisions called enumeration areas (EAs) were created for the 1991 census based on the number of dwellings units. However, experience with the 1999-2000 Bangladesh Demographic and Health Survey (BDHS) showed that EA maps and sketch maps were not easily accessible. For this reason, EAs were not considered suitable as primary sampling units for the 2001 BMMS survey. Also, it was not feasible to obtain a computer file of the census information with the codes for the different subdivisions and their corresponding basic household or population information. However, the complete basic census information is available in published reports, from the division level down to the mouza level, but not at the EA level. Consequently, it was decided to make use of the published census reports and to use wards and unions as the primary sampling units. The second stage of sampling for urban areas involved selecting two mohallas in each ward, while for rural areas, two mouzas were selected in each selected union (with a few exceptions of one mouza or one mohalla per union or per ward, respectively). The third stage involved selecting households. In summary, in each division, the list of wards constituted the initial sample frame for urban areas and the list of unions was the sample frame for rural areas. A total of 808 primary sampling units were selected: 134 urban and 674 rural.
The field organizations (ACPR and Mitra and Associates) conducted a household listing operation in all of the sample points from November 2000 to April 2001. To obtain an accurate estimate of the maternal mortality rate at the national level (as well as to achieve other objectives of the survey), a stratified national sample of 104,323 households was systematically selected from a total of 1,616 clusters.
All ever-married women age 13-49 were eligible to be interviewed. It was expected that the sample would yield interviews with more than 100,000 ever-married women.
Note: See sample implementation table in APPENDIX D of the report which is presented in this documentation.
Administratively, Bangladesh is divided into six divisions. Each division is divided into districts (zilas), and then thanas or upazilas. Each urban area in a thana or upazila is divided into wards, and each ward is divided into mohallas; each rural area in a thana or upazila is divided into union parishadas, and each union is divided into mouzas.
Smaller subdivisions called enumeration areas (EAs) were created for the 1991 census based on the number of dwellings units. However, experience with the 1999-2000 Bangladesh Demographic and Health Survey (BDHS) showed that EA maps and sketch maps were not easily accessible. For this reason, EAs were not considered suitable as primary sampling units for the 2001 BMMS survey. Also, it was not feasible to obtain a computer file of the census information with the codes for the different subdivisions and their corresponding basic household or population information. However, the complete basic census information is available in published reports, from the division level down to the mouza level, but not at the EA level. Consequently, it was decided to make use of the published census reports and to use wards and unions as the primary sampling units. The second stage of sampling for urban areas involved selecting two mohallas in each ward, while for rural areas, two mouzas were selected in each selected union (with a few exceptions of one mouza or one mohalla per union or per ward, respectively). The third stage involved selecting households. In summary, in each division, the list of wards constituted the initial sample frame for urban areas and the list of unions was the sample frame for rural areas. A total of 808 primary sampling units were selected: 134 urban and 674 rural.
The field organizations (ACPR and Mitra and Associates) conducted a household listing operation in all of the sample points from November 2000 to April 2001. To obtain an accurate estimate of the maternal mortality rate at the national level (as well as to achieve other objectives of the survey), a stratified national sample of 104,323 households was systematically selected from a total of 1,616 clusters.
All ever-married women age 13-49 were eligible to be interviewed. It was expected that the sample would yield interviews with more than 100,000 ever-married women.
Note: See sample implementation table in APPENDIX D of the report which is presented in this documentation.
Response Rate
A total of 104,323 households were selected for the sample, of which 99,202 were successfully interviewed. The shortfall is primarily due to dwellings being vacant or the inhabitants being gone for an extended period at the time of the survey. Of the 100,379 households occupied, 99 percent were successfully interviewed. In these households, 106,789 women were identified as eligible for the individual interview (i.e., ever-married women age 13-49), and interviews were completed for 103,796, or 97 percent. The principal reason for nonresponse among eligible women was the failure to find them at home, despite repeated visits to the household. The refusal rate was low.
See summarized response rate by residence in Table 1.2 which is presented in the final report.
See summarized response rate by residence in Table 1.2 which is presented in the final report.
Data Collection
Dates of Data Collection
| Start | End |
|---|---|
| 2001-01 | 2001-06 |
Data Collection Mode
Face-to-face [f2f]
Data Collection Notes
Training and Fieldwork
The BMMS questionnaires were pretested in November 2000. Pretest teams from both ACPR and Mitra and Associates were trained jointly at NIPORT. After training, the teams conducted interviews at various locations in the field under the observation of staff from the two field organizations and members of the technical task force. Before the pretest, the verbal autopsy methodology was validated in a field trial in Matlab, Bangladesh, during October-November 2000. ACPR was responsible for recruiting a field trial team and conducting fieldwork, with assistance from ICDDR,B, to pretest the methodology in a sample of households with a disproportionate number of maternal deaths as reported by the Demographic Surveillance System. Based on observations in the field and suggestions made by the pretest and field trial teams, the technical task force revised the wording of the questionnaires and adjusted the translations.
In December 2000, candidates for field staff positions for the main survey were recruited. Recruitment criteria included educational attainment, maturity, experience with other surveys, and a firm commitment to spend one month in training and at least five months in the field. Training for the main survey was conducted at two different sites by each field organization from December 3 to January 7, 2001. Initially, training consisted of lectures on how to complete the questionnaires, with mock interviews between participants to gain practice in asking questions. Toward the end of the training course, the participants spent several days carrying out practice interviews in places close to Dhaka. Trainees whose performance was considered superior were selected as supervisors and field editors.
Fieldwork for the BMMS was carried out by 50 interviewing teams (23 teams from ACPR and 27 teams from Mitra and Associates) in five phases. Each team consisted of a male supervisor, a female field editor, and four female interviewers. During fieldwork, emphasis was placed on the quality of data. ACPR and Mitra and Associates also fielded quality control teams to check on the fieldwork. Feedback was given to teams after each phase to improve on the quality of data collection. In addition, staff from USAID, NIPORT, and ORC Macro monitored the fieldwork by visiting teams in the field. Fieldwork started on January 9, 2001 and was completed in the second week of June 2001.
The BMMS questionnaires were pretested in November 2000. Pretest teams from both ACPR and Mitra and Associates were trained jointly at NIPORT. After training, the teams conducted interviews at various locations in the field under the observation of staff from the two field organizations and members of the technical task force. Before the pretest, the verbal autopsy methodology was validated in a field trial in Matlab, Bangladesh, during October-November 2000. ACPR was responsible for recruiting a field trial team and conducting fieldwork, with assistance from ICDDR,B, to pretest the methodology in a sample of households with a disproportionate number of maternal deaths as reported by the Demographic Surveillance System. Based on observations in the field and suggestions made by the pretest and field trial teams, the technical task force revised the wording of the questionnaires and adjusted the translations.
In December 2000, candidates for field staff positions for the main survey were recruited. Recruitment criteria included educational attainment, maturity, experience with other surveys, and a firm commitment to spend one month in training and at least five months in the field. Training for the main survey was conducted at two different sites by each field organization from December 3 to January 7, 2001. Initially, training consisted of lectures on how to complete the questionnaires, with mock interviews between participants to gain practice in asking questions. Toward the end of the training course, the participants spent several days carrying out practice interviews in places close to Dhaka. Trainees whose performance was considered superior were selected as supervisors and field editors.
Fieldwork for the BMMS was carried out by 50 interviewing teams (23 teams from ACPR and 27 teams from Mitra and Associates) in five phases. Each team consisted of a male supervisor, a female field editor, and four female interviewers. During fieldwork, emphasis was placed on the quality of data. ACPR and Mitra and Associates also fielded quality control teams to check on the fieldwork. Feedback was given to teams after each phase to improve on the quality of data collection. In addition, staff from USAID, NIPORT, and ORC Macro monitored the fieldwork by visiting teams in the field. Fieldwork started on January 9, 2001 and was completed in the second week of June 2001.
Questionnaires
Questionnaires
Three questionnaires were used for the BMMS: a Household Questionnaire, a Women’s Questionnaire (for ever-married women age 13-49), and a Verbal Autopsy Questionnaire (for deaths of women age 13-49).
The Household Questionnaire consisted of a schedule for listing all household members. For each listed person, the survey collected basic information such as age, sex, marital status, and education. Information was also collected on household characteristics such as type of housing, source of water, and availability of electricity. The Household Questionnaire asked about any deaths of household members in the three years preceding the survey. The information on age, sex, and marital status of household members was used to identify eligible respondents for the Women’s Questionnaire. The information about female adult deaths identified deaths for which the Verbal Autopsy Questionnaire was used.
The Women’s Questionnaire was administered to all ever-married women age 13-49 who were listed in the Household Questionnaire. These women were asked questions on the following topics:
• Background characteristics (age, education, religion, etc.),
• Reproductive history,
• Use of family planning methods,
• Information about siblings (to calculate the maternal mortality rate),
• Knowledge of maternal health problems,
• Antenatal, delivery, and postnatal care,
• Experience with and treatment of maternal health problems during pregnancy, delivery, and after delivery,
• Treatment-seeking behavior.
The Verbal Autopsy Questionnaire was used to collect information on causes of death for all female adult (age 13-49) deaths in the household in the three years preceding the survey. The questionnaire was both structured (precoded questions) and nonstructured (open-ended questions) in nature, and was answered by the most knowledgeable member of the household.
During the design of the questionnaires, input was sought from various organizations that were expecting to use the data. ORC Macro designed the questionnaires with assistance from JHU, ICDDR,B, and USAID. After preparation of the questionnaires in English, they were translated into Bengali. Then back-translations were done by people other than the initial translators, to verify the accuracy of the translations.
The Household Questionnaire consisted of a schedule for listing all household members. For each listed person, the survey collected basic information such as age, sex, marital status, and education. Information was also collected on household characteristics such as type of housing, source of water, and availability of electricity. The Household Questionnaire asked about any deaths of household members in the three years preceding the survey. The information on age, sex, and marital status of household members was used to identify eligible respondents for the Women’s Questionnaire. The information about female adult deaths identified deaths for which the Verbal Autopsy Questionnaire was used.
The Women’s Questionnaire was administered to all ever-married women age 13-49 who were listed in the Household Questionnaire. These women were asked questions on the following topics:
• Background characteristics (age, education, religion, etc.),
• Reproductive history,
• Use of family planning methods,
• Information about siblings (to calculate the maternal mortality rate),
• Knowledge of maternal health problems,
• Antenatal, delivery, and postnatal care,
• Experience with and treatment of maternal health problems during pregnancy, delivery, and after delivery,
• Treatment-seeking behavior.
The Verbal Autopsy Questionnaire was used to collect information on causes of death for all female adult (age 13-49) deaths in the household in the three years preceding the survey. The questionnaire was both structured (precoded questions) and nonstructured (open-ended questions) in nature, and was answered by the most knowledgeable member of the household.
During the design of the questionnaires, input was sought from various organizations that were expecting to use the data. ORC Macro designed the questionnaires with assistance from JHU, ICDDR,B, and USAID. After preparation of the questionnaires in English, they were translated into Bengali. Then back-translations were done by people other than the initial translators, to verify the accuracy of the translations.
Data Processing
Data Editing
All questionnaires for the BMMS were returned to Dhaka for data processing at ACPR and Mitra and Associates. Data entry personnel were trained in Dhaka in February 2001 by ORC Macro data processing personnel. The processing operation consisted of office editing, coding of open-ended questions, data entry, and resolving inconsistencies found by the computer edit programs. The data were processed on microcomputers working in double shifts. The ISSA (Integrated System for Survey Analysis) program developed by MEASURE DHS+ was used during all stages of data entry and processing. Data processing commenced in mid-February 2001 and was completed by the end of August 2001.
Data Appraisal
Estimates of Sampling Error
Sampling error tables are presented in Appendix E of the final report.
Data Appraisal
Data Quality Tables
- Household age distribution
- Age distribution of eligible and interviewed women
- Completeness of reporting
- Births by western calendar years
- Reporting of age at death in days
- Reporting of age at death in months
Note: See these tables in APPENDIX C of the report which is presented in this documentation.
- Household age distribution
- Age distribution of eligible and interviewed women
- Completeness of reporting
- Births by western calendar years
- Reporting of age at death in days
- Reporting of age at death in months
Note: See these tables in APPENDIX C of the report which is presented in this documentation.
Access policy
Access authority
| Name | URL | |
|---|---|---|
| MEASURE DHS | archive@measuredhs.com | www.measuredhs.com |
Contacts
| Name | URL | |
|---|---|---|
| General Inquiries | info@measuredhs.com | www.measuredhs.com |
| Data and Data Related Resources | archive@measuredhs.com | www.measuredhs.com |
Access conditions
DISSEMINATION POLICY
MEASURE DHS believes that widespread access to survey data by responsible researchers has enormous advantages for the countries concerned and the international community in general. Therefore, MEASURE DHS policy is to release survey data to researchers after the main survey report is published, generally within 12 months after the end of fieldwork. with few limitations these data have been made available for wide use.
DISTRIBUTION OF DATASETS
MEASURE DHS is authorized to distribute, at no cost, unrestricted survey data files for legitimate academic research, with the condition that we receive a description of any research project that will be using the data.
Registration is required for access to data.
Datasets are available for download to all registered users, free of charge. To download datasets, you must first register online and request the country(ies) and datasets that you are interested in. When submitting a dataset request, users must include a brief description of how the data will be used.
DATASETS TERMS OF USE
Datasets are made available with the following conditions:
- Survey data files are distributed by MEASURE DHS for academic research/statistical analysis. Researchers need to provide a description of any research/analysis that will be using the data, before access is granted to the datasets.
- Once downloaded, the datasets must not be passed on to other researchers without the written consent of MEASURE DHS.
- All reports and publications based on the requested data must be sent to the MEASURE DHS Data Archive as a Portable Format Document (pdf) or a hard copy, for us to forward to the country(ies) whose data have been used.
More information on the access policy and terms of use is available at www.measuredhs.com
MEASURE DHS believes that widespread access to survey data by responsible researchers has enormous advantages for the countries concerned and the international community in general. Therefore, MEASURE DHS policy is to release survey data to researchers after the main survey report is published, generally within 12 months after the end of fieldwork. with few limitations these data have been made available for wide use.
DISTRIBUTION OF DATASETS
MEASURE DHS is authorized to distribute, at no cost, unrestricted survey data files for legitimate academic research, with the condition that we receive a description of any research project that will be using the data.
Registration is required for access to data.
Datasets are available for download to all registered users, free of charge. To download datasets, you must first register online and request the country(ies) and datasets that you are interested in. When submitting a dataset request, users must include a brief description of how the data will be used.
DATASETS TERMS OF USE
Datasets are made available with the following conditions:
- Survey data files are distributed by MEASURE DHS for academic research/statistical analysis. Researchers need to provide a description of any research/analysis that will be using the data, before access is granted to the datasets.
- Once downloaded, the datasets must not be passed on to other researchers without the written consent of MEASURE DHS.
- All reports and publications based on the requested data must be sent to the MEASURE DHS Data Archive as a Portable Format Document (pdf) or a hard copy, for us to forward to the country(ies) whose data have been used.
More information on the access policy and terms of use is available at www.measuredhs.com
Citation requirements
Use of the dataset must be acknowledged using a citation which would include:
- the Identification of the Primary Investigator
- the title of the survey (including acronym and year of implementation)
- the survey reference number
- the source and date of download
Example:
National Institute of Population Research and Training (NIPORT), ORC Macro, Johns Hopkins University and ICDDR,B. Bangladesh Maternal Health Services and Maternal Mortality Survey 2001. Dataset downloaded from www.measuredhs.com on [date].
- the Identification of the Primary Investigator
- the title of the survey (including acronym and year of implementation)
- the survey reference number
- the source and date of download
Example:
National Institute of Population Research and Training (NIPORT), ORC Macro, Johns Hopkins University and ICDDR,B. Bangladesh Maternal Health Services and Maternal Mortality Survey 2001. Dataset downloaded from www.measuredhs.com on [date].
Disclaimer and copyrights
Disclaimer
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Metadata production
DDI Document ID
DDI_WB_BGD_2001_BMMS_v01_M
Producers
| Name | Abbreviation | Role |
|---|---|---|
| World Bank, Development Economics Data Group | DECDG | Generation of DDI documentation |
Date of Metadata Production
2011-02-25