A woman's lifetime risk disparities in maternal mortality in Ethiopia

Abstract

Background In Ethiopia, a woman's lifetime risk (chance) of dying from maternal causes over a woman's reproductive lifespan continues to be a public health challenge. However, detailed evidence is scarce. This study aimed to assess woman's lifetime risk disparities in maternal mortality. Methods National data from the Ethiopian Demographic and Health Survey from 2000 to 2016 were used. To determine a woman's lifetime risk of dying, first, the maternal mortality ratio was calculated. Then, a woman's lifetime risk of dying was calculated. Four policy‐relevant socio‐economic factors were assessed: residence, education, regional states and economic status. To assess a woman's lifetime risk disparities in maternal mortality, the rate ratio (R) was used as per the World Health Organization's Health Equity Assessment Toolkit and software. Results From 61,610 respondents, 795 deaths were reported. A woman's lifetime risk of dying nearly halved from 4.6% in 2000 (1 in 22 women) to 1.9% in 2016 (1 in 52 women). In 2016, the highest woman's lifetime risk of dying was observed among rural women (1 in 111 women), in Oromiya regional state (1 in 71 women), women with secondary education (1 in 82 women) and women with middle income (1 in 77 women). The socioeconomic factors that drive a woman's lifetime risk disparities in maternal mortality include residence (1.3‐times higher among rural women), regional state (2‐times higher among women in Oromiya regional state), education (6‐times higher among women with lower educational status), and economic status (1.3‐times higher among the poorest women). Conclusion Ethiopian women experienced a high lifetime risk of maternal mortality which varies across socioeconomic groups. Therefore, equity‐oriented maternal healthcare is recommended to reduce the effects of structural inequities, such as poverty, and the inequitable distribution of the socioeconomic factors of maternal health that sustain a woman's lifetime risk disparities in maternal mortality.

Unequal uptake of skilled maternal health care services in Ethiopia: cross-sectional data analyses informed by the intersectionality theory

“…It is not just that Ethiopia is home to one of the highest burdens of maternal mortality globally 10 —roughly 4% of all maternal deaths—but that there is also large within-country variation to the disadvantage of underserved populations. 11 Literature showed that the lifetime risk of maternal death dropped from 4.6% in 2000 to 1.9% in 2016 in Ethiopia, 11 reflecting a ‘maternal mortality transition’ over time. However, theory-driven equity studies are needed on maternal health care services to inform the development of targeted interventions for underserved populations, thereby reducing gaps in maternal mortality to the point of no concern.…”