science

Sisterhood method

Sisterhood method is a science topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Sisterhood method rather than just read about it. In short: The Sisterhood Method is a household survey to estimate maternal deaths recommended by the World Health Organization (WHO). Although maternal deaths are a major problem in developing countries, high quality data are rare.

Key takeaways

Sisterhood method belongs to science; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Sisterhood method to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Sisterhood method from memory before moving on to harder problems.

Reference excerpt

The Sisterhood Method is a household survey to estimate maternal deaths recommended by the World Health Organization (WHO). Although maternal deaths are a major problem in developing countries, high quality data are rare. Yet, numbers are needed for planning in order to reduce the problem of maternal death. Several methods have been used to estimate maternal deaths. According to the WHO, "The approach was designed to overcome the problem of large sample sizes and thus reduce cost."

Background The death of a woman during or shortly after a pregnancy is an important medical problem in developing countries. 99% of all maternal deaths occur in developing countries. In the poorest countries in the world, e.g. Sierra Leone, the lifetime risk for a woman dying because of a maternal death is approx 1 in 6, whereas in developed countries, e.g. Sweden, the same lifetime risk is approx 1 in 30,000. Half of all maternal deaths occur in six countries only: Afghanistan, Democratic Republic of Congo, Ethiopia, India, Nigeria, and Pakistan. Worldwide, maternal deaths decreased from approx 500,000 in 1980 to approx 350,000 in 2008. This decline in maternal deaths was associated mainly with better maternal education, maternal income, increased availability of trained birth attendants, and decreased pregnancy rates.

Estimating maternal deaths Although maternal deaths are a major problem in developing countries, seen globally, the numbers are not very large, and there is an absence of high quality data. Yet, numbers are needed for planning in order to reduce maternal deaths. Several methods have been used to estimate maternal deaths. They include analysing census records and medical/death certificates, and Reproductive Age Mortality Studies (RAMOS). Also, household surveys are used. All of these methods are not totally precise, but they can provide some useful information to decrease maternal mortality. In contrast, full surveillance programmes would be too costly and too unrealistic for many developing countries.

Sisterhood Method The Sisterhood Method is the most common household survey for estimating maternal deaths. It is time- and cost-effective, and reduces sample size requirements; in countries or areas with high levels of maternal deaths, i.e. over 500 maternal deaths per 100,000 live births, a sample size of 4000 households or less is acceptable for this method. But the method still provides a useful means of assessing maternal mortality. This method includes four questions about the sisters of the woman in question:

How many sisters have you ever had, born to the same mother, who ever reached the age 15 (or who were ever married), including those who are now dead? How many of your sisters who reached the age of 15 are alive now? How many of these sisters are dead? How many of your sisters who are dead died during a pregnancy or during childbirth, or during the six weeks after the end of a pregnancy?

Application Deaths occurring over a large interval of time are documented. The overall estimate of maternal mortality is determined for 10–12 years before the survey. The Sisterhood Method is useful because usually maternal mortality changes slowly. It provides some meaningful data in countries or areas where there are no alternative means of generating estimates.

When should the Sisterhood Method not be used The Sisterhood Method is not appropriate in countries or areas where the total fertility rate is less than four children per family, in areas of significant migration, as well as during civil war, civil unrest or other significant social disruption.

Variant The original Sisterhood Method is an indirect method. The newer Direct Sisterhood Method targets a more limited reference period for sister deaths and uses more in depth questions (e.g., deaths among all siblings, all deaths that are pregnancy related, and when these deaths occurred). This variant relies on fewer assumptions than the original Sisterhood Method. However, it requires a larger sample size, data gathering and analysis are more complex, and has large confidence intervals. Despite these limitations, the Direct Sisterhood Method can result in greater specificity of information. A retrospective maternal mortality ratio (MMR) can be calculated. This variant is used by Demographic and Health Surveys (DHS).

References

Worked examples

Example 1 — a first encounter with Sisterhood method

Start with the simplest possible case. Write down what Sisterhood method claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In science, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Sisterhood method before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Sisterhood method ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Sisterhood method

In research: Sisterhood method appears in science research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Sisterhood method in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Sisterhood method is common in secondary-school and first-year university syllabi. It links to neighbouring topics Death, Demography, Midwifery, so understanding it makes those chapters shorter.
In everyday life: Look for Sisterhood method outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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How to study Sisterhood method in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Sisterhood method means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Sisterhood method out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Sisterhood method in simple terms?

Why does Sisterhood method matter?

Because it connects several science ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Sisterhood method?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Sisterhood method.