[Multiple causes of death].
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Biomedical subjects
Publications and source records attributed to R Laurenti.
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This paper describes the evolution of disease frequency statistics and techniques used to present them. Beginning in the 17th century were the first specific references to causes of death and proceeding practically until the mid-20th century as mortality statistics by causes, the instrument for a methodical description of diseases was classification of causes of death. From the latter half of the 20th century on, in addition to mortality statistics by cause, morbidity statistics became routine, with the adoption of disease classification and no longer only classification by cause of death. More recently, classification has been adapted to medical specialties, resulting in what has been termed "disease family classification", including classification of the consequences of diseases, with statistics on disability. Disease classification, both for mortality and morbidity, fostered the development of various types of epidemiological studies (both descriptive and analytical) that expanded knowledge on health.
The maternal mortality rate is a highly sensitive indicator for the health level of both women and the general population in a given geographical area. There is extensive variability among different countries, and rates are high in underdeveloped or developing areas, as in Brazil. Health authorities from various countries have launched programs aimed at reducing maternal deaths and have thus needed to estimate the actual rates to allow for a proper assessment and to control the programs' progress. However, there are many obstacles and difficulties in obtaining the real values of these measures, mainly because of incomplete data. The aim of this paper is to present some of the proposed methodologies for estimating maternal mortality rates and to call attention to the limits and biases of these methods. Based on the Brazilian case, the article also recommends an improvement in the quality and coverage of the Civil Registry, the official source of data on births and deaths.
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