Correlates of maternal mortality in developing countries: an ecological study in 82 countries

Abstract

BACKGROUND Maternal mortality is a major public health issue in developing countries due to its shocking magnitude and lower declining pattern. With appropriate strategy and intensive implementation programs, some countries have made remarkable progress, however in developing countries where 99% of maternal death is occurring; little or no progress has been made. Identifying determinants and designing intervention will have important role to overcome the problem. Therefore this study aimed to identify correlates of maternal mortality in developing countries. METHODS This study was conducted using international data bases of health metrics from 2008 to 2016 using aggregates of health indicator data from WHO, World Bank, UNDP and UNICEF data bases for 82 developing countries. The dependent variable was the maternal mortality ratio, while the independent variable was socio-economic, health care related and morbidity variables. Data was compiled in excel and analyzed using SPSS version 21. RESULTS Maternal mortality ratio is very high in developing countries and enormously varies among countries. A significant relationship between the maternal mortality ratio and socio-economic, health care and morbidity indicator variables was observed. There was an inverse and significant correlation of the maternal mortality ratio with Antenatal care coverage, skilled birth attendance, access to an improved water source and sanitation, adult literacy rate, the Gross National Income per capita and positive relation with disease incidence, unmet need and others. CONCLUSIONS Maternal mortality is correlated with multiples of socio-economic factors, health care system associated factors, disease burden and their complex interactions. Therefore Policy and programs targeted to improve maternal health and reduce maternal deaths should consider population dynamics, socio-economic influence and health system factors that impose a major risk on mothers.