Reduction of maternal deaths1 is one of the main goals of the Tanzanian Poverty Reduction Strategy and the health sector reform program, but progress has been slow. According to the 1996, 2004 and 2010 Demographic and Health Surveys (DHS), the maternal mortality ratios(MMR) or maternal deaths per 100,000 live births were529, 578, and 454 per 100,000 live births respectively for the 10-year period prior to the surveys [1, 2].Maternal mortality levels by age, education or wealth often reveal major inequities, highlighting the need to reach the most vulnerable. But such information is not available from national surveys because the DHS applies the ‘‘sisterhood method’’, an indirect technique used\ud
to estimate maternal mortality (see box). We assessed maternal mortality in a large household census including all 225,000 households in five districts, giving timely mortality data by relative wealth, educational levels and distance to the nearest health facility\ud
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We used information collected during a 2007 household survey of all households in five districts of Tandahimba and Newala in Mtwara Region and Lindi Rural, Ruangwa and Nachingwea in Lindi Region [5, 6]. A questionnaire recorded all household members and information on age and education. Also, household assets, including possession of a bed net, bicycle or phone, the type of roofing, cooking power and others, were recorded as proxy indicators of household socioeconomic status. In addition, the geographic location was recorded and used to calculate distance to the nearest hospital. Live births in the three years before the survey were recorded through interviews with women of reproductive age (13–49 years).\u
