ArticleCritical public health2017
"Guilty until proven innocent": the contested use of maternal mortality indicators in global health.
Article in Critical public health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- To adjust, reform, or transform? Criteria for distinguishing efforts to change knowledge practices in global health.Global public health · 2026Article
- (Re)considering Discourses of Risk and Responsibility Through the Lens of Healthism: Interpreting the International Response to a Global Health Strategy for Noncommunicable Diseases.Sociology of health & illness · 2026Article
- Beyond the Demographic and Health Survey: on the past and future of population health surveillance.BMJ global health · 2026Article
- Evaluating Maternal Healthcare Quality Through the Lens of Maternal near Miss: A Retrospective Analysis from a High-Volume Tertiary Center.Medicina (Kaunas, Lithuania) · 2025Article
- Reproductive Justice for Adolescent Migrant Girls in the Post-ICPD Era: A Critical Analysis of Contraceptive Care for Venezuelan Girls in Colombia.Studies in comparative international development · 2025Article
- Global Financing Facility investments for vulnerable populations: content analysis regarding maternal and newborn health and stillbirths in 11 African countries, 2015 to 2019.Global health action · 2024Article
- Unfair knowledge practices in global health: a realist synthesis.Health policy and planning · 2024Article
- Travelling numbers and broken loops: A qualitative systematic review on collecting and reporting maternal and neonatal health data in low-and lower-middle income countries.SSM - population health · 2024Review
- In search of a 'good number': knowledge controversy and population estimates in the endgame of hepatitis C elimination.BMJ global health · 2024Article
- "Death audit is a fight" - provider perspectives on the ethics of the Maternal and Perinatal Death Surveillance and Response (MPDSR) system in Ethiopia.BMC health services research · 2022Article
- Imagining the postantibiotic future: the visual culture of a global health threat.Medical humanities · 2022Article
- Effect of a community based social marketing strategy on the uptake of clean delivery kits in peri-urban communities of Karachi, Pakistan.BMC pregnancy and childbirth · 2022Article
- Decolonising global health by decolonising academic publishing.BMJ global health · 2022Article
- Knowledge, attitudes and practices of nurses regarding maternal nutrition in pregnant women at a large hospital and filter clinics, Lesotho.Health SA = SA Gesondheid · 2022Article
- Exploring underutilization of skilled maternal healthcare in rural Edo, Nigeria: A qualitative study.PloS one · 2022Article
- Political economy analysis of universal health coverage and health financing reforms in low- and middle-income countries: the role of stakeholder engagement in the research process.Health research policy and systems · 2021Review
- Article
- A Stalled Revolution? Misoprostol and the Pharmaceuticalization of Reproductive Health in Francophone Africa.Frontiers in sociology · 2021Article
- What post-abortion care indicators don't measure: Global abortion politics and obstetric practice in Senegal.Social science & medicine (1982) · 2020Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The MMR - maternal mortality ratio - has risen from obscurity to become a major global health indicator, even appearing as an indicator of progress towards the global Sustainable Development Goals. This has happened despite intractable challenges relating to the measurement of maternal mortality. Even after three decades of measurement innovation, maternal mortality data are widely presumed to be of poor quality, or, as one leading measurement expert has put it, 'guilty until proven innocent'. This paper explores how and why leading epidemiologists, demographers and statisticians have devoted the better part of the last three decades to producing ever more sophisticated and expensive surveys and mathematical models of globally comparable MMR estimates. The development of better metrics is publicly justified by the need to know which interventions save lives and at what cost. We show, however, that measurement experts' work has also been driven by the need to secure political priority for safe motherhood and by donors' need to justify and monitor the results of investment flows. We explore the many effects and consequences of this measurement work, including the eclipsing of attention to strengthening much-needed national health information systems. We analyse this measurement work in relation to broader political and economic changes affecting the global health field, not least the incursion of neoliberal, business-oriented donors such as the World Bank and the Bill and Melinda Gates Foundation whose institutional structures have introduced new forms of administrative oversight and accountability that depend on indicators.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.