Immpact Toolkit: Module 4
Version 2
Rapid Ascertainment Process for Institutional Deaths (RAPID)
Under-reporting of maternal deaths is common in both developing and developed countries. Even in countries where all or most deaths are medically certified, institutional maternal mortality can still be grossly underestimated. Hospital studies have shown that routine methods of identifying maternal deaths underestimate the number by one-half to two-thirds (Berg et al, 1998; Bouvier-Colle et al, 1991; Atrash et al, 1995; Salanave et al, 1999), the main problem being the misclassification of indirect maternal deaths as non-maternal.
Accurate estimates are important for several reasons: in the context of evaluation it is essential that any changes attributable to an intervention can be quantified precisely; and, in general, it is necessary to define the scale of the problem so that adequate resources can be allocated to address it.
This tool describes a technique for measuring pregnancy-related mortality in health institutions. The information is intended to help anyone in the process of commissioning a study of maternal death to decide whether the Rapid Ascertainment Process for Institutional Deaths (RAPID) will be a useful method, and if so, to help researchers with the design and execution of the study.