scholarly journals Protocol for analysing the epidemiology of maternal mortality in Zimbabwe: A civil registration and vital statistics trend study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252106
Author(s):  
Reuben Musarandega ◽  
Rhoderick Machekano ◽  
Robert Pattinson ◽  
Stephen Peter Munjanja ◽  
Keyword(s):  
Maternal Mortality ◽  
Causes Of Death ◽  
International Classification Of Diseases ◽  
Vital Statistics ◽  
Sub Saharan Africa ◽  
Maternal Deaths ◽  
Civil Registration ◽  
Classification Of Diseases ◽  
Sub Saharan ◽  
Ssa Countries

Background Sub-Saharan Africa (SSA) carries the highest burden of maternal mortality, yet, the accurate maternal mortality ratios (MMR) are uncertain in most SSA countries. Measuring maternal mortality is challenging in this region, where civil registration and vital statistics (CRVS) systems are weak or non-existent. We describe a protocol designed to explore the use of CRVS to monitor maternal mortality in Zimbabwe—an SSA country. Methods In this study, we will collect deliveries and maternal death data from CRVS (government death registration records) and health facilities for 2007–2008 and 2018–2019 to compare MMRs and causes of death. We will code the causes of death using classifications in the maternal mortality version of the 10th revision to the international classification of diseases. We will compare the proportions of maternal deaths attributed to different causes between the two study periods. We will also analyse missingness and misclassification of maternal deaths in CRVS to assess the validity of their use to measure maternal mortality in Zimbabwe. Discussion This study will determine changes in MMR and causes of maternal mortality in Zimbabwe over a decade. It will show whether HIV, which was at its peak in 2007–2008, remains a significant cause of maternal deaths in Zimbabwe. The study will recommend measures to improve the quality of CRVS data for future use to monitor maternal mortality in Zimbabwe and other SSA countries of similar characteristics.

scholarly journals Baseline Data on Trend of Maternal Mortality in Tanzania using Administrative Data and its Policy Implication. 2018 Report

2020 ◽  
pp. 5-12 ◽  
Author(s):  
Dr. Ahmad Mohamed Makuwani ◽  
Dr. Phineas Ferdinand Sospeter ◽  
Dr. Leonard Subi ◽  
Dr. Mukome Anthony Nyamhagatta ◽  
Dr. Ntuli Kapologwe ◽  
...  
Keyword(s):  
Developing Countries ◽  
Maternal Mortality ◽  
Confidence Intervals ◽  
Disease Surveillance ◽  
Vital Statistics ◽  
Maternal Deaths ◽  
Civil Registration ◽  
The Past ◽  
Sisterhood Method ◽  
Surveillance And Response

Background: Globally, Civil Registration, and Vital Statistics is the recommended method to track births and deaths. This system is weak in developing countries, including Tanzania. Other systems that may be used to report deaths, especially maternal mortality include integrated Disease Surveillance and Response (IDSR) and DHIS 2. Tanzania has been using Demographic and Health Survey to track maternal deaths from as early as 2000. This study uses a sisterhood method which is conducted every five years, tracking events of the past ten years. It collects maternal deaths related from sisters of the same mother from sampled 10,000 households out of 11,000,000 available in Tanzania. The methodology uses wide confidence intervals, which affect its reliability. Therefore, the presented data is the outcome of tracking maternal deaths data using routine system from health facilities and communities in Tanzania Mainland.

scholarly journals Magnitude, Trends and Causes of Maternal Mortality: A 7-year Review at a Tertiary Hospital in Rivers State, Nigeria

2020 ◽  
pp. 103-109
Author(s):  
P. A. Awoyesuku ◽  
D. A. MacPepple ◽  
B. O. Altraide
Keyword(s):  
Maternal Mortality ◽  
Postpartum Haemorrhage ◽  
Maternal Mortality Ratio ◽  
Tertiary Hospital ◽  
Sub Saharan Africa ◽  
Annual Reports ◽  
Maternal Deaths ◽  
Middle Income ◽  
Mortality Ratio ◽  
Sub Saharan

Background: Maternal mortality ratios (MMR) are still unacceptably high in many low- and middle-income countries especially in sub-Saharan Africa. Background Data for the causes of maternal deaths are needed to inform policies to improve maternal healthcare and reduce maternal mortality. Objective: This study sought to determine the magnitude and trend in maternal mortality and the causes at a tertiary hospital over a seven-year study period. Methodology: This was a retrospective review of maternal mortality and causes from 2012 to 2018. Data on number of maternal deaths, deliveries and causes of death were retrieved from the departmental annual reports and hospital records and entered into Microsoft Excel 2013. Data were presented as line graphs, charts and frequency tables. Results: One hundred and ten (110) maternal deaths occurred out of 17,080 total births during the study period giving an overall MMR of 644. The MMR increased progressively from 580 in 2012 to 785 in 2018 with a sharp rise to the highest and subsequent decline to the lowest, values at the midpoint. The commonest causes of maternal deaths were Pre-eclampsia (PET) and Eclampsia 44(40%), Postpartum Haemorrhage (PPH) 25(22.7%) and Ruptured Uterus 13(11.8%). Conclusion: The maternal mortality ratio is high and the trend is worsening. The leading causes of maternal deaths were PET/Eclampsia and Postpartum haemorrhage accounting for about two-thirds of all deaths. Efforts must be geared towards improvements in the management of these cases, if this trend is to be reversed.

scholarly journals The Association between Maternal Mortality and Non-Medical factors in African Countries

2014 ◽  
Vol 6 (5) ◽  
pp. 351-362
Author(s):  
P. Lalthapersad-Pillay
Keyword(s):  
Developing Countries ◽  
Logistic Regression ◽  
Maternal Mortality ◽  
National Income ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Maternal Deaths ◽  
Medical Factors ◽  
Pregnancy And Childbirth ◽  
Sub Saharan

The medical expertise to treat to complications arising from pregnancy and childbirth has not spared girls and women in developing countries from dying of such conditions. Developing countries account for the bulk of the global share of maternal deaths with complications of pregnancy and childbirth being the leading cause of death in young women aged between 15 and 49. Sub-Saharan Africa is responsible for nearly three-fifths of all global maternal deaths which have saddled it with notoriously high levels of maternal mortality ratios, a concern that has been red-flagged internationally and regionally. Most studies on maternal mortality in Africa have been confined to an examination of factors impinging on maternal mortality from both medical and socioeconomic standpoints for individual country’s based on survey data. Our study differs from others as it employs logistic regression to look at the association between non-medical factors and maternal mortality nationally for all African countries. Whilst the results from the logistic regression suggests that there is no statistically significant relationship between any of the variables and maternal mortality, the odds ratio for Human Development Index (HDI) and Gross National Income per capita (GNI) imply that African countries with low HDI are about three time more likely to have high maternal mortality compared to high HDI countries. Similarly, African countries with low GNI are about five times more likely to have high maternal mortality compared to high GNI countries.

scholarly journals A Competing Risk Analysis of Women Dying of Maternal, Infectious, or Non-Communicable Causes in the Kintampo Area of Ghana

2021 ◽  
Vol 2 ◽  
Author(s):  
Sulemana Watara Abubakari ◽  
Delali Margaret Badasu ◽  
Edward Anane Apraku ◽  
Seeba Amenga-Etego ◽  
Kwaku Poku Asante ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Maternal Mortality ◽  
Causes Of Death ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Major Health Problem ◽  
Relative Risks ◽  
International Statistical Classification ◽  
Sub Saharan

Background: Maternal, infectious, and non-communicable causes of death combinedly are a major health problem for women of reproductive age (WRA) in sub-Saharan Africa (SSA). Little is known about the relative risks of each of these causes of death in their combined form and their demographic impacts. The focus of studies on WRA has been on maternal health. The evolving demographic and health transitions in low- and middle-income countries (LMICs) suggest a need for a comprehensive approach to resolve health challenges of women beyond maternal causes.Methods: Deaths and person-years of exposure (PYE) were calculated by age for WRA within 15–49 years of age in the Kintampo Health and Demographic Surveillance System (KHDSS) area from January 2005 to December 2014. Causes of death were diagnosed using a standard verbal autopsy questionnaire and the 10th Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). Identified causes of death were categorized into three broad areas, namely, maternal, infectious, and non-communicable diseases. Multiple decrements and associated single decrement life table methods were used.Results: Averting any of the causes of death was seen to lead to improved life expectancy, but eliminating infectious causes of death leads to the highest number of years gained. Infectious causes of death affected all ages and the gains in life expectancy, assuming that these causes were eliminated, diminished with increasing age. The oldest age group, 45–49, had the greatest gain in reproductive-aged life expectancy (RALE) if maternal mortality was eliminated.Discussion: This study demonstrated the existence of a triple burden. Infectious causes of death are persistently high while deaths from non-communicable causes are rising and the level of maternal mortality is still unacceptably high. It recommends that attention should be given to all the causes of death among WRA.

scholarly journals Prevalence and determinants of the place of delivery among reproductive age women in sub–Saharan Africa

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244875
Author(s):  
Kenneth Setorwu Adde ◽  
Kwamena Sekyi Dickson ◽  
Hubert Amu
Keyword(s):  
Maternal Mortality ◽  
Health Facility ◽  
Facility Delivery ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Health Facility Delivery ◽  
Place Of Delivery ◽  
Reproductive Age Women ◽  
Sub Saharan ◽  
Ssa Countries

Introduction Maternal mortality is an issue of global public health concern with over 300,000 women dying globally each year. In sub-Saharan Africa (SSA), these deaths mainly occur around childbirth and the first 24hours after delivery. The place of delivery is, therefore, important in reducing maternal deaths and accelerating progress towards attaining the 2030 sustainable development goals (SDGs) related to maternal health. In this study, we examined the prevalence and determinants of the place of delivery among reproductive age women in SSA. Materials and methods This was a cross-sectional study among women in their reproductive age using data from the most recent demographic and health surveys of 28 SSA countries. Frequency, percentage, chi-square, and logistic regression were used in analysing the data. All analyses were done using STATA. Results The overall prevalence of health facility delivery was 66%. This ranged from 23% in Chad to 94% in Gabon. More than half of the countries recorded a less than 70% prevalence of health facility delivery. The adjusted odds of health facility delivery were lowest in Chad. The probability of giving birth at a health facility also declined with increasing age but increased with the level of education and wealth status. Women from rural areas had a lower likelihood (AOR = 0.59, 95%CI = 0.57–0.61) of delivering at a health facility compared with urban women. Conclusions Our findings point to the inability of many SSA countries to meet the SDG targets concerning reductions in maternal mortality and improving the health of reproductive age women. The findings thus justify the need for peer learning among SSA countries for the adaption and integration into local contexts, of interventions that have proven to be successful in improving health facility delivery among reproductive age women.

Evaluation of civil registration and vital statistics system in the Maldives: Focus on mortality statistics

2020 ◽  
Vol 36 (4) ◽  
pp. 933-941
Author(s):  
Sofoora Kawsar Usman ◽  
Sheena Moosa
Keyword(s):  
Cause Of Death ◽  
Causes Of Death ◽  
Time Lag ◽  
International Classification Of Diseases ◽  
Vital Statistics ◽  
Mortality Data ◽  
Death Registration ◽  
Quality Of Data ◽  
Civil Registration

An efficient Civil Registration and Vital Statistics (CRVS) system is a development imperative. Data on death registration and causes of death are important for measuring health outcomes. This paper evaluates the completeness and quality of data on death registration and causes of death (CoD) based on analysis of the registration records on death and causes of death for the period 2009–2018. Using established methods and approaches, we observed that CRVS system performed well on death registration completeness, quality of age and sex reporting. However, the quality of cause of death data was poor with 50% of the International Classification of Diseases (ICD) codes classified as “major garbage codes” and significant time lag was observed in the transmission and production of vital statistics. The CRVS system in Maldives is complete with all deaths occurring within its territory registered and causes of death recorded. The two areas that require attention are the time taken for publication of vital statistics and quality of cause of death reporting. Appropriate re-engineering of the existing business process can build real-time mortality data, and regular quality assessment of death certificates with feedback to health facilities can bring sustained improvements in quality of vital statistics.

scholarly journals Traditional Beliefs and Learning about Maternal Risk in Zambia

2017 ◽  
Vol 107 (5) ◽  
pp. 511-515 ◽  
Author(s):  
Nava Ashraf ◽  
Erica Field ◽  
Giuditta Rusconi ◽  
Alessandra Voena ◽  
Roberta Ziparo
Keyword(s):  
Maternal Mortality ◽  
Sub Saharan Africa ◽  
Traditional Beliefs ◽  
Maternal Deaths ◽  
Maternal Risk ◽  
Risk Levels ◽  
Birth Complications ◽  
Female Perceptions ◽  
Sub Saharan ◽  
Very High

Maternal mortality remains very high in many parts of the developing world, especially in sub-Saharan Africa. While maternal deaths are observable, it may not be straightforward for individuals to learn about risk factors. This paper utilizes novel data on male and female perceptions of maternal risk in Zambia to document that superstitions about causes of maternal mortality are pervasive and to uncover evidence that such beliefs impede learning about maternal health risk levels and correlates. In our data, people who hold traditional beliefs disregard past birth complications completely in assessing future risk, unlike those who hold modern beliefs.

scholarly journals A Review of Energy Communities in Sub-Saharan Africa as a Transition Pathway to Energy Democracy

2021 ◽  
Vol 13 (4) ◽  
pp. 2128
Author(s):  
Amollo Ambole ◽  
Kweku Koranteng ◽  
Peris Njoroge ◽  
Douglas Logedi Luhangala
Keyword(s):  
Stakeholder Engagement ◽  
Energy Systems ◽  
Sub Saharan Africa ◽  
Energy Access ◽  
Energy Projects ◽  
Global North ◽  
Sub Saharan ◽  
Energy Justice ◽  
Design Proposal ◽  
Ssa Countries

Energy communities have received considerable attention in the Global North, especially in Europe, due to their potential for achieving sustainable energy transitions. In Sub-Saharan Africa (SSA), energy communities have received less attention partly due to the nascent energy systems in many emerging SSA states. In this paper, we argue that these nascent energy systems offer an opportunity to co-create energy communities that can tackle the energy access challenges faced by most SSA countries. To understand how such energy communities are realised in the sub-region, we undertake a systematic review of research on energy communities in 46 SSA countries. Our findings show that only a few energy projects exhibit the conventional characteristics of energy communities; In most of these projects, local communities are inadequately resourced to institute and manage their own projects. We thus look to stakeholder engagement approaches to propose co-design as a strategy for strengthening energy communities in SSA. We further embed our co-design proposal in energy democracy thinking to argue that energy communities can be a pathway towards equity and energy justice in SSA. We conclude that energy communities can indeed contribute to improving energy access in Africa, but they need an enabling policy environment to foster their growth and sustainability.

scholarly journals Garbage codes as causes of death and quality of mortality statistics in Belo Horizonte, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Ishitani ◽  
R Teixeira ◽  
D Abreu ◽  
L Paixão ◽  
E França
Keyword(s):  
Causes Of Death ◽  
Health Planning ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Mortality Statistics ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Hospital Deaths ◽  
Belo Horizonte

Abstract Background Quality of cause-of-death information is fundamental for health planning. Traditionally, this quality has been assessed by the analysis of ill-defined causes from chapter XVIII of the International Classification of Diseases - 10th revision (ICD-10). However, studies have considered other useless diagnoses for public health purposes, defined, in conjunction with ill-defined causes, as garbage codes (GC). In Brazil, despite the high completeness of the Mortality Information System, approximately 30% of deaths are attributable to GCs. This study aims to analyze the frequency of GCs in Belo Horizonte municipality, the capital of Minas Gerais state, Brazil. Methods Data of deaths from 2011 to 2013 in Belo Horizonte were analyzed. GCs were classified according to the GBD 2015 study list. These codes were classified in: a) GCs from chapter XVIII of ICD-10 (GC-R), and b) GC from other chapters of ICD-10 (GC-nonR). Proportions of GC were calculated by sex, age, and place of occurrence. Results In Belo Horizonte, from the total of 44,123 deaths, 5.5% were classified as GC-R. The majority of GCs were GC-nonR (25% of total deaths). We observed a higher proportion of GC in children (1 to 4 years) and in people aged over 60 years. GC proportion was also higher in females, except in the age-groups under 1 year and 30-59 years. Home deaths (n = 7,760) had higher proportions of GCs compared with hospital deaths (n = 30,182), 36.9% and 28.7%, respectively. The leading GCs were the GC-R other ill-defined and unspecified causes of death (ICD-10 code R99)), and the GCs-nonR unspecified pneumonia (J18.9), unspecified stroke (I64), and unspecified septicemia (A41.9). Conclusions Analysis of GCs is essential to evaluate the quality of mortality information. Key messages Analysis of ill-defined causes (GC-R) is not sufficient to evaluate the quality of information on causes of death. Causes of death analysis should consider the total GC, in order to advance the discussion and promote adequate intervention on the quality of mortality statistics.

scholarly journals Household structure, maternal characteristics and children’s stunting in sub-Saharan Africa: evidence from 35 countries

2020 ◽  
Author(s):  
Sanni Yaya ◽  
Olanrewaju Oladimeji ◽  
Emmanuel Kolawole Odusina ◽  
Ghose Bishwajit
Keyword(s):  
Birth Interval ◽  
Household Wealth ◽  
Household Structure ◽  
Sub Saharan Africa ◽  
Physical Growth ◽  
Multiple Birth ◽  
Rural Children ◽  
Sub Saharan ◽  
Ssa Countries ◽  
Childhood Stunting

Abstract Background Adequate nutrition in early childhood is a necessity to achieve healthy growth and development, as well as a strong immune system and good cognitive development. The period from conception to infancy is especially vital for optimal physical growth, health and development. In this study we examined the influence of household structure on stunting in children <5 yrs of age in sub-Saharan Africa (SSA) countries. Methods Demographic and Health Survey data from birth histories in 35 SSA countries were used in this study. The total sample of children born within the 5 yrs before the surveys (2008 and 2018) was 384 928. Children whose height-for-age z-score throughout was <−2 SDs from the median of the WHO reference population were considered stunted. Percentages and χ2 tests were used to explore prevalence and bivariate associations of stunting. In addition, a multivariable logistic regression model was fitted to stunted children. All statistical tests were conducted at a p<0.05 level of significance. Results More than one-third of children in SSA countries were reportedly stunted. The leading countries include Burundi (55.9%), Madagascar (50.1%), Niger (43.9%) and the Democratic Republic of the Congo (42.7%). The percentage of stunted children was higher among males than females and among rural children than their urban counterparts in SSA countries. Children from polygamous families and from mothers who had been in multiple unions had a 5% increase in stunting compared with children from monogamous families and mothers who had only one union (AOR 1.05 [95% CI 1.02 to 1.09]). Furthermore, rural children were 1.23 times as likely to be stunted compared with urban children (AOR 1.23 [95% CI 1.16 to 1.29]). Children having a <24-mo preceding birth interval were 1.32 times as likely to be stunted compared with first births (AOR 1.32 [95% CI 1.26 to 1.38]). In addition, there was a 2% increase in stunted children for every unit increase in the age (mo) of children (AOR 1.02 [95% CI 1.01 to 1.02]). Multiple-birth children were 2.09 times as likely to be stunted compared with a singleton (AOR 2.09 [95% CI 1.91 to 2.28]). Conclusions The study revealed that more than one-third of children were stunted in SSA countries. Risk factors for childhood stunting were also identified. Effective interventions targeting factors associated with childhood stunting, such as maternal education, advanced maternal age, male sex, child’s age, longer birth interval, multiple-birth polygamy, improved household wealth and history of mothers’ involvement in multiple unions, are required to reduce childhood stunting in the region.

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