I just wanted to share. Recently while reviewing MDHS for Malawi I noticed that the report said MMR in the 7 years before the 2015-2016 MDHS was 439 (page 245) and then also said the PRMR in the 7 years before the 2015-2016 MDHS was 497 (page 248). I missed the update and I had no idea why they reported the two differently. As I read on their blog I found that DHS has been updating their instrument to capture deaths per WHO definition excluding accidental deaths and deaths between 42 days and 2 months, which they were not doing before. It made me curious though, what could have been the actual rates? It really makes the interpretations tricky, but I am glad they noted that in the blog as well
This the blog: https://blog.dhsprogram.com/dhs7-prmr/
On their blog they state this implication:
"Implications: While the newly added questions allow for a more precise and up-to-date measure of maternal mortality, the change does present challenges for interpretation. DHS has reported on maternal mortality for 30 years, but estimates obtained using the new definition of maternal mortality cannot be directly compared to the old definition of maternal mortality which included deaths up to 2 months after delivery and did not exclude deaths due to accidents and violence. And yet, one of the main objectives for conducting DHS surveys is to provide trend data. Fortunately, the old definition of maternal mortality can still be applied to calculate the mortality ratio estimate comparable to estimates from previously collected mortality data. This less precise measure of mortality is referred to as the pregnancy-related mortality ratio (PRMR).......Keep in mind that the new measure of maternal mortality, by definition, will result in a lower maternal mortality ratio than the old measure because the accidental and violence-related deaths to women during the maternal period and deaths occurring between 42 days and 2 months after childbirth are being excluded from maternal deaths while using the new definition but included while using the old definition."