Maternal and childhood mortality in the Nuba mountains, Sudan: A pilot study.
The aim of the pilot study was to establish baseline levels for maternal mortality ratio (MMR) and childhood mortality rates measured prospectively in the Nuba Mountains, an under-privileged area of the Sudan, and compare them to pervious national retrospective surveys. A communal vital registration system was established as a pilot study in a defined community in the Nuba Mountains area, Sudan, including two strata, Dilling and Um Ruwaba Provinces. Live events were registered for 6-months. 1,913 live births, 268 childhood (0-4 years) deaths and 13 maternal deaths were registered during the period of study, July 2001-June 2002. Childhood mortality rates per 1,000 live births were: Infant (IMR) 85, child (CMR) 55, and under-five (U5MR) 140. There was no significant difference between Dilling stratum and Um Ruwaba stratum in IMR (x/2 = 1.56; P > 0.05). CMR and U5MR were significantly higher in Um Ruwaba stratum (x/2 = 6.619; P < 0.05 and x/2 = 7.2; P < 0.01, respectively). MMR per 100,000 live births was 680 with no significant difference between Dilling stratum and Um Ruwaba stratum (x/2 = 1.861; P > 0.05). All rates were much higher than those quoted for the country by previous retrospective survey estimates. Prospectively determined childhood and maternal mortality rates using a communal vital registration system appear to be higher but more realistic for a disadvantaged area compared to retrospective estimates. The wide discrepancy indicates the need for debating the limitations and relevance of the latter. (author's)