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International Journal of Public Health

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Open Access 01-05-2018 | Original Article

Maternal mortality and morbidity burden in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study

Author: GBD 2015 Eastern Mediterranean Region Maternal Mortality Collaborators

Published in: International Journal of Public Health | Special Issue 1/2018

Abstract

Objectives

Assessing the burden of maternal mortality is important for tracking progress and identifying public health gaps. This paper provides an overview of the burden of maternal mortality in the Eastern Mediterranean Region (EMR) by underlying cause and age from 1990 to 2015.

Methods

We used the results of the Global Burden of Disease 2015 study to explore maternal mortality in the EMR countries.

Results

The maternal mortality ratio in the EMR decreased 16.3% from 283 (241–328) maternal deaths per 100,000 live births in 1990 to 237 (188–293) in 2015. Maternal mortality ratio was strongly correlated with socio-demographic status, where the lowest-income countries contributed the most to the burden of maternal mortality in the region.

Conclusion

Progress in reducing maternal mortality in the EMR has accelerated in the past 15 years, but the burden remains high. Coordinated and rigorous efforts are needed to make sure that adequate and timely services and interventions are available for women at each stage of reproductive life.

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Abouzahir C, Wardlaw T (2001) Maternal mortality at the end of a decade: signs of progress? Bull World Health Org 79:561–573

Alvarez JL, Gil R, Hernández V, Gil A (2009) Factors associated with maternal mortality in Sub-Saharan Africa: an ecological study. BMC Public Health 9:462. doi:10.1186/1471-2458-9-462 CrossRefPubMedPubMedCentral

Bayati M, Akbarian R, Kavosi Z (2013) Determinants of life expectancy in eastern mediterranean region: a health production function. Int J Health Policy Manag 1:57–61. doi:10.15171/ijhpm.2013.09 CrossRefPubMedPubMedCentral

Buor D, Bream K (2004) An analysis of the determinants of maternal mortality in sub-Saharan Africa. J Womens Health 13:926–938. doi:10.1089/jwh.2004.13.926 CrossRef

Campbell OMR, Graham WJ, Lancet Maternal Survival Series steering group (2006) Strategies for reducing maternal mortality: getting on with what works. Lancet Lond Engl 368:1284–1299. doi:10.1016/S0140-6736(06)69381-1 CrossRef

Hertz E, Hebert JR, Landon J (1994) Social and environmental factors and life expectancy, infant mortality, and maternal mortality rates: results of a cross-national comparison. Soc Sci Med 39:105–114. doi:10.1016/0277-9536(94)90170-8 CrossRefPubMed

Homaie Rad E, Vahedi S, Teimourizad A et al (2013) Comparison of the effects of public and private health expenditures on the health status: a panel data analysis in eastern mediterranean countries. Int J Health Policy Manag 1:163–167. doi:10.15171/ijhpm.2013.29 CrossRefPubMedPubMedCentral

Institute for Health Metrics and Evaluation (2016) Global health data exchange | GHDx. http://ghdx.healthdata.org/. Accessed 1 June 2017

Institute for Health Metrics and Evaluation (2017) Global burden of disease data visualization. https://vizhub.healthdata.org/gbd-compare/. Accessed 13 July 2017

Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS et al (2014) Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 384:980–1004. doi:10.1016/S0140-6736(14)60696-6 CrossRefPubMedPubMedCentral

Kassebaum NJ, Arora M, Barber RM et al (2016a) Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 388:1603–1658. doi:10.1016/S0140-6736(16)31460-X CrossRef

Kassebaum NJ, Barber RM, Bhutta ZA et al (2016b) Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 388:1775–1812. doi:10.1016/S0140-6736(16)31470-2 CrossRef

Liang J, Zhu J, Dai L et al (2010) Maternal mortality in China, 1996–2005. Int J Gynecol Obstet 110:93–96. doi:10.1016/j.ijgo.2010.03.013 CrossRef

Lim SS, Dandona L, Hoisington JA et al (2010) India’s Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: an impact evaluation. Lancet 375:2009–2023. doi:10.1016/S0140-6736(10)60744-1 CrossRefPubMed

Midhet F, Becker S, Berendes HW (1998) Contextual determinants of maternal mortality in rural Pakistan. Soc Sci Med 46:1587–1598CrossRefPubMed

Mokdad AH, Forouzanfar MH, Daoud F et al (2016) Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet Glob Health 4:e704–713. doi:10.1016/S2214-109X(16)30168-1 CrossRefPubMedPubMedCentral

Muldoon KA, Galway LP, Nakajima M et al (2011) Health system determinants of infant, child and maternal mortality: a cross-sectional study of UN member countries. Glob Health 7:42. doi:10.1186/1744-8603-7-42 CrossRef

Peterson HB, Haidar J, Merialdi M et al (2012) Preventing maternal and newborn deaths globally: using innovation and science to address challenges in implementing life-saving interventions. Obstet Gynecol 120:636–642. doi:10.1097/AOG.0b013e3182632cc1 CrossRefPubMed

Randive B, San Sebastian M, De Costa A, Lindholm L (2014) Inequalities in institutional delivery uptake and maternal mortality reduction in the context of cash incentive program, Janani Suraksha Yojana: results from nine states in India. Soc Sci Med 123:1–6. doi:10.1016/j.socscimed.2014.10.042 CrossRefPubMed

Ribeiro PS, Jacobsen KH, Mathers CD, Garcia-Moreno C (2008) Priorities for women’s health from the Global Burden of Disease study. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet 102:82–90. doi:10.1016/j.ijgo.2008.01.025 CrossRef

Ronsmans C, Graham WJ (2006) Maternal mortality: who, when, where, and why. Lancet 368:1189–1200. doi:10.1016/S0140-6736(06)69380-X CrossRefPubMed

Rowe AK, de Savigny D, Lanata CF, Victora CG (2005) How can we achieve and maintain high-quality performance of health workers in low-resource settings? Lancet Lond Engl 366:1026–1035. doi:10.1016/S0140-6736(05)67028-6 CrossRef

Thaddeus S, Maine D (1994) Too far to walk: maternal mortality in context. Soc Sci Med 38:1091–1110CrossRefPubMed

UNICEF (2016) Female genital mutilation/cutting: a global concern. https://www.unicef.org/media/files/FGMC_2016_brochure_final_UNICEF_SPREAD.pdf. Accessed 13 July 2017

United Nations (2015) Transforming our world: the 2030 agenda for sustainable development. https://sustainabledevelopment.un.org/post2015/transformingourworld. Accessed 12 July 2017

Vos T, Allen C, Arora M et al (2016) Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 388:1545–1602. doi:10.1016/S0140-6736(16)31678-6 CrossRef

Wang H, Naghavi M, Allen C et al (2016) Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 388:1459–1544. doi:10.1016/S0140-6736(16)31012-1 CrossRef

Warren E, Post N, Hossain M et al (2015) Systematic review of the evidence on the effectiveness of sexual and reproductive health interventions in humanitarian crises. BMJ Open. doi:10.1136/bmjopen-2015-008226 CrossRefPubMedPubMedCentral

WHO (2017) High-quality healthcare needed for girls and women who have experienced female genital mutilation. http://www.who.int/reproductivehealth/topics/fgm/en/

WHO, UNICEF, UNFPA, World Bank (2007) Maternal mortality in 2005. http://www.who.int/whosis/mme_2005.pdf. Accessed 13 July 2017

World Health Organization (1992) International Statistical classification of diseases and related health problems. Tenth Revision

Title: Maternal mortality and morbidity burden in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study
Author: GBD 2015 Eastern Mediterranean Region Maternal Mortality Collaborators
Publication date: 01-05-2018
Publisher: Springer International Publishing
Published in: International Journal of Public Health / Issue Special Issue 1/2018
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI: https://doi.org/10.1007/s00038-017-1004-3

At a glance: The STEP trials

Springer Medicine

Maternal mortality and morbidity burden in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study

Abstract

Objectives

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

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