Obstetric Complications

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Model Inputs \(\rightarrow\) Obstetric Complications

The underlying probabilities of obstetric complications incidence and morbidity/mortality are modeled under “natural history” assumptions (i.e. the absence of any intervention). Interventions that occur tacitly at facilities (e.g., active management of labor, clean delivery, etc.) therefore need to be explicitly modeled.

Estimating the incidence of complications under “natural history” conditions is challenging since data based on observed cases in the population include a proportion of women with access to preventive and/or treatment measures. Most estimates have made assumptions about the regional variation in available coverage with maternal health services. These estimates may not be used for the natural history variables in the model without adjustment that accounts for treatment, but they can provide insight into the magnitude of the global burden and also provide a face validity check when we run the model with reported coverage rates (e.g. SBA or proportion of facility births) by country.

We assume that some of the variation reported in the literature is attributable to the heterogeneity in severity, and estimates based on small sample sizes. Case fatality rates are thus adjusted in the model based on complication severity (e.g., life threatening complications requiring CEmOC). We assume that life-threatening complications requiring CEmOC-level services are associated with a higher case fatality rate (in the absence of treatment) than that of non-life-threatening complications.

The following obsetric complications are included in the model:

GMatH (Global Maternal Health) Model - Last updated: 28 November 2022

zward@hsph.harvard.edu