A call for consensus and cooperation to resolve differing estimates of abortion-related deaths

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International Journal of Gynecology & Obstetrics (IJGO) 2016.

by Marge Berer, Iqbal Shah, Carla AbouZahr

In press at: http://dx.doi.org/10.1016/j.ijgo.2016.05.012

This article is about the difference between estimates of maternal deaths from unsafe abortion from the World Health Organization and those from the Institute for Health Metrics and Evaluation (IHME), USA, both published in 2014 in two different Lancet journals. The article begins:

“The publication of two papers with widely differing estimates of abortion-related deaths has caused concern and confusion among individuals who work on mortality and morbidity related to unsafe abortion. Both papers claim to offer correct estimates based on robust and rigorous methodologies. We wish to highlight this issue and discuss how the differences might be overcome.”

The likelihood that the IHME and WHO staff responsible for their respective estimates on deaths from unsafe abortion will sit down together to develop one set of estimates is uncertain. Meanwhile, the rest of us are left not knowing whose figures to use. For those who are even aware that there are conflicting WHO and IHME estimates, few will have the expertise to choose between the two methodologies, but that shouldn’t be necessary.

The article concludes: “As the leader in global health, WHO has a constitutional responsibility to support countries in strengthening their health-information systems. Likewise, IHME has a stature commensurate with its technical expertise and generous funding. Surely it is incumbent upon both organizations to put their differences aside and reach a consensus on the method required to produce one set of estimates that are comparable over time and that everyone accepts as the best possible information to guide clinical practice, policy and program priorities. Yet they remain unwilling to do so. In the absence of a neutral body with comparable responsibility, we believe that WHO should insist that its experts invite IHME experts, and others who might be considered neutral, to reach an agreement on the way forward.”

INFOGRAPHIC: Guttmacher, Kenya 2012