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Bangladesh Maternal Mortality and Maternal Health Care Survey (BMMS, 2010)

The BMMS 2010 was designed to assess progress in Bangladesh toward millennium development goal 5 and to enhance understanding of the factors that contribute to maternal death. BMMS was funded by GoB, USAID, Australian agency for International development and the United nations population fund.It was conducted by NIPORT with technical assistance from Measure Evaluation, ICDDR, B, USAID/ Bangladesh. Mitra and Associates along with ACPR implemented the survey.


Description of Project: The major objectives were to provide a national estimate of the maternal mortality ratio (MMR) for the period from 2007 to 2010, to identify the causes of maternal and non maternal deaths in adult women and to determine whether MMR declined significantly from the 1998 to 2001 when an MMR for Bangladesh was estimated.


Additional objectives were to collect information on birth planning, to assess the levels of use of antenatal care, postnatal care and skilled birth attendance at delivery and to assess the experience of and care seeking for maternal complications and changes in care seeking patterns for the five years preceding the survey.

ACPR was responsible for implementing the survey in Barisal, Khulna, and Rajshahi divisions and Mitra and Associates were responsible for Dhaka, Chittagong and Sylhet divisions.


Tasks carried out by Mitra and Associates:


Methodology (sample size & tools): To compare directly maternal mortality indicators between 2001 and 2010 required a large sample size to detect changes from the 2001 BMMS MMR estimate with acceptable statistical precision and adherence. The target sample size for BMMS 2010 was 175000 households, a figure thought large enough to detect a roughly 20 percent decline in the BMMS 2001 MMR estimate of 322 with 95 percent significance and 80 percent power. The same multi stage selection procedures applied in BMMS 2001 were used to draw samples from the same frame employed in the BMMS 2001, parsed among the same domains. Though the frame was considerably older by the time of the BMMS 2010, this does not represent a source of bias as it is an exhaustive area frame. The frame was parsed into three domains: urban, rural and other urban areas. For urban areas the primary sampling unit was ward, for the outside of the formal cities was union, In each selected urban PSU, two mohallas selected, segmented and a cluster was selected from each. The process in the rural and urban domain was the same, except that mouzas served as the secondary sampling unit. Each selected mohalla and mouza was segmented into clusters one of these clusters was selected from each selected mohalla and mouza.A total of 654 urban, 488 other urban and 1566 rural clusters were selected for a grand total of 2708 clusters overall. Sixty five households were randomly selected in each cluster to receive a household instrument. Then women in 23 of these households from per PSU were randomly selected to receive long questionnaire. Mitra and Associates conducted fieldwork in the 1,452 clusters selected from the divisions (Dhaka, Chittagong, and Sylhet). Mitra and Associates interviewed 65 households from per cluster. This implies a total sample size of 93,654 households across 1,452 clusters. Of these, the individuals in 33,060 households received a lengthier instrument, while those in 60,594 households received a briefer instrument.


Questionnaire: There were five questionnaires: women’s short questionnaire, women’s long questionnaire, verbal autopsy questionnaire, CSBA questionnaire, service availability roster questionnaire and manuals were translated in Bengali, pre-tested and finalized along with the partner NGO.


Training: All interviewers, supervisors and quality control officers were trained for 21 days.


Data collection and quality control: Data collection needed approximately 7 months including both listing and HH part and monitored the fieldwork and insured the quality of data.


Data processing: The data processing operation consisted of data entry personnel training, office editing, coding of open ended questions, data entry, producing miss match report and resolving inconsistency between 1st and 2nd entry & cleaning. Cs-pro 4.0 was used in all stage of data entry and processing.


Client Reference: Macro International/USA and funded by USAID.


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