Yirdley G Sandoval-Vargas1, Javier H Eslava-Schmalbach1. 1. Grupo de Equidad en Salud, Instituto de Investigaciones Clínicas, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, ygsandovalv@unal.edu.co.
Abstract
OBJECTIVE: Describing inequality regarding maternal mortality in Colombia for 2000-2001, 2005-2006 and 2008-2009. METHODS: This was an ecological study. The maternal mortality rate (MMR) was estimated, adjusted for maternal age, Colombian department and causes of maternal mortality. The main causes of mortality were described for 2000-2001, 2005-2006 and 2008-2009. The excess of risk of maternal death in Colombia was calculated regarding the best external referent using the attributable fraction (AF). The AF was correlated with the indicator of unsatisfied basic needs (UBN) by department. RESULTS: The highest MMR in Colombia was between 81 and 161 per 100,000 live births and the lowest between 3 and 5; the lowest MMR in the world was between 2 and 4 per 100,000 live births for the same periods. The main causes of maternal mortality in Colombia were hypertension during pregnancy, unclassified obstetric conditions and complications when giving birth. An excess of risk of maternal mortality in Colombia was found (on average 86 %) when compared to an external referent. A correlation was found between AF and UBN. CONCLUSIONS: Great inequality was found regarding maternal mortality in Colombia and when comparing Colombia to developed countries. Inequality regarding maternal mortality persists in spite of advances having been made regarding reform of the healthcare system, thereby suggesting that this has not been effective in reducing maternal mortality and its inequalities.
OBJECTIVE: Describing inequality regarding maternal mortality in Colombia for 2000-2001, 2005-2006 and 2008-2009. METHODS: This was an ecological study. The maternal mortality rate (MMR) was estimated, adjusted for maternal age, Colombian department and causes of maternal mortality. The main causes of mortality were described for 2000-2001, 2005-2006 and 2008-2009. The excess of risk of maternal death in Colombia was calculated regarding the best external referent using the attributable fraction (AF). The AF was correlated with the indicator of unsatisfied basic needs (UBN) by department. RESULTS: The highest MMR in Colombia was between 81 and 161 per 100,000 live births and the lowest between 3 and 5; the lowest MMR in the world was between 2 and 4 per 100,000 live births for the same periods. The main causes of maternal mortality in Colombia were hypertension during pregnancy, unclassified obstetric conditions and complications when giving birth. An excess of risk of maternal mortality in Colombia was found (on average 86 %) when compared to an external referent. A correlation was found between AF and UBN. CONCLUSIONS: Great inequality was found regarding maternal mortality in Colombia and when comparing Colombia to developed countries. Inequality regarding maternal mortality persists in spite of advances having been made regarding reform of the healthcare system, thereby suggesting that this has not been effective in reducing maternal mortality and its inequalities.
Authors: Luz Mery Cárdenas-Cárdenas; Karol Cotes-Cantillo; Pablo Enrique Chaparro-Narváez; Julián Alfredo Fernández-Niño; Angel Paternina-Caicedo; Carlos Castañeda-Orjuela; Fernando De la Hoz-Restrepo Journal: PLoS One Date: 2015-03-18 Impact factor: 3.240