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Bulletin of the World Health... Mar 2015
Topics: Female; Health Services Misuse; Healthcare Disparities; Humans; Maternal Health Services; Maternal Mortality; Morbidity; Pregnancy; Pregnancy Complications; United States
PubMed: 25838608
DOI: 10.2471/BLT.14.148627 -
BMC Pregnancy and Childbirth Jul 2022Maternal mortality in the Middle East and North Africa (MENA) region decreased significantly between 1990 and 2017. This was uneven, however, with some countries faring...
BACKGROUND
Maternal mortality in the Middle East and North Africa (MENA) region decreased significantly between 1990 and 2017. This was uneven, however, with some countries faring much better than others.
METHODS
We undertook a trend analysis of Maternal Mortality Ratios (MMRs) of countries in the region in order to understand differences in reduction across countries. Data were extracted from several databases for 23 countries and territories in the region on measures of women's empowerment, availability of vehicles and human resources for health (as a proxy to the three delays model). We identified factors associated with MMR by grouping countries into five different Stages (I-V) of obstetric transition from high to low MMRs.
RESULTS
Among the four Stage II countries, MMR is associated with "antenatal care coverage (% with at least one visit)" and "medical doctors per 10,000 population". Among the eight Stage III countries, MMR is associated with "Gender Parity Index in primary and secondary level school enrolment" and with "nursing and midwifery personnel per 10,000 population". Among the 10 countries and one territory in Stages IV and V, MMR is associated with "GDP per capita", "nursing and midwifery personnel", and "motor vehicle ownership/motorization rate". Two factors were associated with changes in MMR from the period 2006-2010 to 2011-2015: 1) change in adolescent birth rate (r = 0.90, p = 0.005) and 2) Gender Parity Index in primary level school enrolment (r = - 0.51, p = 0.04).
CONCLUSION
Though impressive reductions in MMR have been achieved across countries in the MENA region since 1990, governments should realize that there exists an opportunity to learn from each other to bring MMRs as close to zero as possible. Immediate steps in the right direction would include investment in human resources for health, particularly nurses and midwives; measures to improve adolescent sexual and reproductive health; and greater investments in achieving gender equity in education.
Topics: Adolescent; Birth Rate; Educational Status; Female; Humans; Maternal Mortality; Midwifery; Pregnancy; Prenatal Care
PubMed: 35804313
DOI: 10.1186/s12884-022-04886-7 -
Circulation. Cardiovascular Quality and... Feb 2022
Topics: Female; Humans; Maternal Mortality; Pre-Eclampsia; Pregnancy
PubMed: 35098731
DOI: 10.1161/CIRCOUTCOMES.121.008727 -
Journal of Global Health Jun 2017In 2015 the proposed period ended for achieving the Millennium Development Goals (MDG) of the United Nations targeting to lower maternal mortality worldwide... (Review)
Review
Maternal mortality as a Millennium Development Goal of the United Nations: a systematic assessment and analysis of available data in threshold countries using Indonesia as example.
BACKGROUND
In 2015 the proposed period ended for achieving the Millennium Development Goals (MDG) of the United Nations targeting to lower maternal mortality worldwide by ~ 75%. 99% of these cases appear in developing and threshold countries; but reports mostly rely on incomplete or unrepresentative data. Using Indonesia as example, currently available data sets for maternal mortality were systematically reviewed.
METHODS
Besides analysis of international and national data resources, a systematic review was carried out according to Cochrane methodology to identify all data and assessments regarding maternal mortality.
RESULTS
Overall, primary data on maternal mortality differed significantly and were hardly comparable. For 1990 results varied between 253/100 000 and 446/100 000. In 2013 data appeared more conclusive (140-199/100 000). An annual reduction rate (ARR) of -2.8% can be calculated.
CONCLUSION
Reported data quality of maternal mortality in Indonesia is very limited regarding comprehensive availability and methodology. This limitation appears to be of general importance for the targeted countries of the MDG. Primary data are rare, not uniformly obtained and not evaluated by comparable methods resulting in very limited comparability. Continuous small data set registration should have high priority for analysis of maternal health activities.
Topics: Adolescent; Adult; Developing Countries; Female; Global Health; Humans; Indonesia; Maternal Mortality; Middle Aged; Organizational Objectives; United Nations; Young Adult
PubMed: 28400953
DOI: 10.7189/jogh.07.010406 -
National Vital Statistics Reports :... Jan 2020This report describes changes in how the National Center for Health Statistics (NCHS) will code, publish, and release maternal mortality data and presents official 2018...
This report describes changes in how the National Center for Health Statistics (NCHS) will code, publish, and release maternal mortality data and presents official 2018 maternal mortality estimates using a new coding method. Due to the incremental implementation of the pregnancy status checkbox item on the 2003 revised U.S. Standard Certificate of Death, NCHS last published an official estimate of the U.S. maternal mortality rate in 2007. As of 2018, implementation of the revised certificate, including its pregnancy checkbox, is complete for all 50 states (noting that California implemented a different checkbox than that on the U.S. Standard Certificate of Death), allowing NCHS to resume the routine publication of maternal mortality statistics. However, an evaluation of data quality indicated some errors with the reporting of maternal deaths (deaths within 42 days of pregnancy) following adoption of the checkbox, including overreporting of maternal deaths among older women. Therefore, NCHS has adopted a new method (to be called the 2018 method) for coding maternal deaths to mitigate these probable errors. The 2018 method involves further restricting application of the pregnancy checkbox to decedents aged 10-44 years from the previous age group of 10-54. In addition, the 2018 method restricts assignment of maternal codes to the underlying cause alone when the checkbox is the only indication of pregnancy on the death certificate, and such coding would be applied only to decedents aged 10-44 based solely on the checkbox when no other pregnancy information is provided in the cause-of-death statement. Based on the new method, a total of 658 deaths were identified in 2018 as maternal deaths. The maternal mortality rate for 2018 was 17.4 deaths per 100,000 live births, and the rate for non-Hispanic black women (37.1) was 2.5 to 3.1 times the rates for non-Hispanic white (14.7) and Hispanic (11.8) women. Rates also increased with age. Maternal mortality rates calculated without using information obtained from the checkbox are also presented for 2002, 2015, 2016, 2017, and 2018 to provide comparisons over time using a comparable coding approach across all states.
Topics: Adolescent; Adult; Cause of Death; Child; Death Certificates; Female; Humans; Information Dissemination; Maternal Mortality; Middle Aged; National Center for Health Statistics, U.S.; Pregnancy; Publications; United States; Young Adult
PubMed: 32510319
DOI: No ID Found -
Revista Brasileira de Ginecologia E... Sep 2021
Topics: Brazil; Female; Humans; Maternal Health Services; Maternal Mortality; Pregnancy
PubMed: 34670297
DOI: 10.1055/s-0041-1736537 -
Reviews on Environmental Health Jun 2018In the year 2000, the World Health Organization launched the Millennium Development Goals (MDGs) which were to be achieved in 2015. Though most of the goals were not... (Review)
Review
In the year 2000, the World Health Organization launched the Millennium Development Goals (MDGs) which were to be achieved in 2015. Though most of the goals were not achieved, a follow-up post 2015 development agenda, the Sustainable Development Goals (SDGs) was launched in 2015, which are to be achieved by 2030. Maternal mortality reduction is a focal goal in both the MDGs and SDGs. Achieving the maternal mortality target in the SDGs requires multiple approaches, particularly in developing countries with high maternal mortality. Low-income developing countries rely to a great extent on macro determinants such as public health expenditure, which are spent mostly on curative health and health facilities, to improve population health. To complement the macro determinants, this study employs the systematic review technique to reveal significant micro correlates of maternal mortality. The study searched MEDLINE, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Science Direct, and Global Index Medicus of the World Health Organization. Our search was time framed from the 1st January, 2000 to the 30th September, 2016. In the overall search result, 6758 articles were identified, out of which 33 were found to be eligible for the review. The outcome of the systematic search for relevant literature revealed a concentration of literature on the micro factors and maternal mortality in developing countries. This shows that maternal mortality and micro factors are a major issue in developing countries. The studies reviewed support the significant relationship between the micro factors and maternal mortality. This study therefore suggests that more effort should be channelled to improving the micro factors in developing countries to pave the way for the timely achievement of the SDGs' maternal mortality ratio (MMR) target.
Topics: Developing Countries; Female; Humans; Maternal Mortality; Public Health; Socioeconomic Factors; World Health Organization
PubMed: 29729149
DOI: 10.1515/reveh-2017-0050 -
Journal of Perinatal Medicine Feb 2023
Topics: Humans; Maternal Mortality; Female
PubMed: 36395478
DOI: 10.1515/jpm-2022-0540 -
Journal of the American Heart... Aug 2021Maternal mortality has been increasing in the United States over the past 3 decades, while decreasing in all other high-income countries during the same period....
Maternal mortality has been increasing in the United States over the past 3 decades, while decreasing in all other high-income countries during the same period. Cardiovascular conditions account for over one fourth of maternal deaths, with two thirds of deaths occurring in the postpartum period. There are also significant healthcare disparities that have been identified in women experiencing maternal morbidity and mortality, with Black women at 3 to 4 times the risk of death as their White counterparts and women in rural areas at heightened risk for cardiovascular morbidity and maternal morbidity. However, many maternal deaths have been shown to be preventable, and improving access to care may be a key solution to addressing maternal cardiovascular mortality. Medicaid currently finances almost half of all births in the United States and is mandated to provide coverage for women with incomes up to 138% of the federal poverty level, for up to 60 days postpartum. In states that have not expanded coverage, new mothers become uninsured after 60 days. Medicaid expansion has been shown to reduce maternal mortality, particularly benefiting racial and ethnic minorities, likely through reduced insurance churn, improved postpartum access to care, and improved interpregnancy care. However, even among states with Medicaid expansion, significant care gaps exist. An additional proposed intervention to improve access to care in these high-risk populations is extension of Medicaid coverage for 1 year after delivery, which would provide the most benefit to women in Medicaid nonexpanded states, but also improve care to women in Medicaid expanded states.
Topics: Adult; Ethnicity; Female; Health Policy; Health Services Accessibility; Healthcare Disparities; Humans; Maternal Mortality; Medicaid; Policy Making; Postpartum Period; Pregnancy; Pregnancy Complications, Cardiovascular; United States
PubMed: 34323114
DOI: 10.1161/JAHA.121.022040 -
British Medical Journal Jul 1960
Topics: Humans; Maternal Mortality
PubMed: 13856718
DOI: No ID Found