Item request has been placed!
×
Item request cannot be made.
×
![loading](/sites/all/modules/hf_eds/images/loading.gif)
Processing Request
Development of a new model for estimating maternal mortality ratio at national and sub-national levels and its application for describing sub-national variations of maternal death in Ethiopia.
Item request has been placed!
×
Item request cannot be made.
×
![loading](/sites/all/modules/hf_eds/images/loading.gif)
Processing Request
- المؤلفون: Gebremedhin S;Gebremedhin S
- المصدر:
PloS one [PLoS One] 2018 Aug 06; Vol. 13 (8), pp. e0201990. Date of Electronic Publication: 2018 Aug 06 (Print Publication: 2018).
- نوع النشر :
Journal Article
- اللغة:
English
- معلومة اضافية
- المصدر:
Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
- بيانات النشر:
Original Publication: San Francisco, CA : Public Library of Science
- الموضوع:
- نبذة مختصرة :
Background: In developing countries lacking functional vital registration system, statistical models are being increasingly used for estimating maternal mortality ratio (MMR). Yet, most of the models have limited applicability at sub-country level. This paper introduces a new model for estimating MMR at national and sub-national levels based on maternal health-related indicators. Further, it applies the model for explaining sub-national variations of MMR in Ethiopia.
Methods: Country level data on MMR and other nine potential predictors of maternal death were extracted from 248 national Demographic and Health Surveys and other related surveys conducted in 80 low- and middle-income countries since 1990. Additional data were obtained from the World Bank and the World Health Organization databases. The potential model predictors were: contraceptive prevalence rate (CPR); utilizations of antenatal care (ANC), health institution delivery (HID), Caesarian section (CS) and postnatal care (PNC); and prevalence of maternal anemia, thinness (Body Mass Index (BMI < 18.5 kg/m2), short stature (height less than 145 cms) and HIV. Stepwise Generalized Estimating Equation (GEE) with Negative Log-binomial link was employed to model MMR as a function of the covariates.
Results: The ultimate model comprised six significant predictors and the equation is provided as: Ln (MMR) = 6.464-0.013(CPR)- 0.006(HID)- 0.003(PNC)- 0.027(CS rate) + 0.060(HIV prevalence) + 0.011 (thinness prevalence). The variation explained by the model was 54.3%) and the mean (±SD) relative standard error (8.6±2.6%) suggested the model has a reasonable precision. Application of the model to describe sub-national variation of maternal mortality in Ethiopia indicated, in 2016 the highest MMRs per 100,000 live births were in Somali (805) and Afar (795) regions. Between 2000 and 2016, all the regions of Ethiopia have significantly reduced MMRs; yet the rate of decline was lower in the aforementioned two regions. Oromiya region contributed for 46% of all maternal deaths in Ethiopia.
Conclusion: In developing countries lacking dependable maternal mortality data; the model can be used to estimate national and sub-national MMR with reasonable accuracy and precision.
Competing Interests: The author has declared that no competing interests exist.
- References:
World J Surg. 2016 Jul;40(7):1537-41. (PMID: 26932877)
Lancet. 2016 Oct 8;388(10053):1775-1812. (PMID: 27733286)
Paediatr Perinat Epidemiol. 2001 Jan;15 Suppl 1:1-42. (PMID: 11243499)
Lancet. 2013 May 18;381(9879):1763-71. (PMID: 23683643)
Stat Politics Policy. 2012 Jul 13;3(2):null. (PMID: 24416714)
Int J Gynaecol Obstet. 2014 Nov;127(2):213-5. (PMID: 25097142)
Am J Clin Nutr. 2000 Jul;72(1 Suppl):212S-240S. (PMID: 10871588)
Trop Med Int Health. 2013 Mar;18(3):357-65. (PMID: 23289440)
Int J Gynaecol Obstet. 1996 Jul;54(1):1-10. (PMID: 8842811)
Lancet Glob Health. 2014 Jun;2(6):e323-33. (PMID: 25103301)
Bull World Health Organ. 2006 Mar;84(3):173-80. (PMID: 16583075)
Lancet. 2001 May 19;357(9268):1565-70. (PMID: 11377643)
Stud Fam Plann. 1992 Jan-Feb;23(1):23-33. (PMID: 1557792)
Lancet. 2012 Jul 14;380(9837):111-25. (PMID: 22784531)
Lancet. 2013 Aug 3;382(9890):427-451. (PMID: 23746772)
Lancet. 2002 Nov 2;360(9343):1347-60. (PMID: 12423980)
Bull World Health Organ. 2011 Jan 1;89(1):12-21. (PMID: 21346886)
Eur J Obstet Gynecol Reprod Biol. 2005 Jun 1;120(2):175-8. (PMID: 15925047)
Lancet. 2013 Aug 3;382(9890):452-477. (PMID: 23746776)
JAMA. 2017 Nov 14;318(18):1777-1786. (PMID: 29136442)
- الموضوع:
Date Created: 20180807 Date Completed: 20190208 Latest Revision: 20190215
- الموضوع:
20231215
- الرقم المعرف:
PMC6078313
- الرقم المعرف:
10.1371/journal.pone.0201990
- الرقم المعرف:
30080902
No Comments.