Maternal Mortality in Colombia in 2011: A Two Level Ecological Study
نویسندگان
چکیده
OBJECTIVE Maternal mortality reduction is a Millennium Development Goal. In Colombia, there is a large disparity in the maternal mortality ratio (MMR) between and into departments (states) and also between municipalities. We examined socioeconomics variables at the municipal and departmental levels which could be associated to the municipal maternal mortality in Colombia. METHODS A multilevel ecology study was carried out using different national data sources in Colombia. The outcome variable was the MMR at municipal level in 2011 with multidimensional poverty at municipal and department level as the principal independent variables and other measures of the social and economic characteristics at municipal and departmental level were also considered explicative variables (overall fertility municipal rate, percentage of local rural population, health insurance coverage, per capita territorial participation allocated to the health sector, transparency index and Gini coefficient). The association between MMR and socioeconomic contextual conditions at municipal and departmental level was assessed using a multilevel Poisson regression model. RESULTS The MMR in the Colombian municipalities was associated significantly with the multidimensional poverty (relative ratio of MMR: 3.52; CI 95%: 1.09-11.38). This association was stronger in municipalities from departments with the highest poverty (relative ratio of MMR: 7.14; CI 95%: 2.01-25.35). Additionally, the MMR at municipal level was marginally associated with municipally health insurance coverage (relative ratio of MMR: 0.99; CI 95%: 0.98-1.00), and significantly with transparency index at departmental level (relative ratio of MMR: 0.98; CI 95%: 0.97-0.99). CONCLUSION Poverty and transparency in a contextual level were associated with the increase of the municipal MMR in Colombia. The results of this study are useful evidence for informing the public policies discussion and formulation processes with a differential approach.
منابع مشابه
Analysis of the Maternal Mortality in Iran, 2007-2012
Background & Aims: Maternal mortality is a tragedy which threatens human life. It is an indicator of womenʼs health and development of society as well. Therefore, prevention of maternal deaths is one of the main goals in many countries, including Iran. The aim of this study was to review and analyze the recorded data on maternal mortality in the country, in order to improve the management of ma...
متن کاملThe Correlation of Human Development Index on Fertility and Mortality Rate: a Global Ecological Study
BackgroundSeveral studies have examined the relationship between Human Development Index (HDI) and various health outcomes. The aim of this study was to investigate the relationship between HDI, and infant mortality rate, mortality rate of children under one year and under 5 years, maternal mortality rate, and total fertility rate.Materials and MethodsIn this ecologic study, data on HDI, total ...
متن کاملGeneration and evaluation of an indicator of the health system’s performance in maternal and reproductive health in Colombia: An ecological study
OBJECTIVE To generate and evaluate an indicator of the health system's performance in the area of maternal and reproductive health in Colombia. MATERIALS AND METHODS An indicator was constructed based on variables related to the coverage and utilization of healthcare services for pregnant and reproductive-age women. A factor analysis was performed using a polychoric correlation matrix and the...
متن کاملPrevalence and effective factors of maternal mortality in Hormozgan Province from 2007 until 2011
Introduction: Maternal death caused by pregnancy and childbirth complications is one of the most important indicators of development of a society, and most countries are committed to reduce its rate. The reason for choosing this index as a development profile is the impact of various social and economic factors on it. Maternal mortality in Hormozgan Province, as one of the most disadvantaged pr...
متن کاملH1N1 influenza pandemic and maternal mortality in Antioquia, Colombia.
OBJECTIVE To evaluate the impact of the H1N1 influenza pandemic on maternal mortality in the province of Antioquia, Colombia, in 2009. METHODS The present study was a descriptive, retrospective, cross-sectional study of maternal deaths in Antioquia in 2009 caused by H1N1-related pneumonia. The study formed part of the epidemiologic surveillance process undertaken by the Health and Social Prot...
متن کامل