Variation in maternal mortality in Sidama Regional State, southern Ethiopia: A population based cross sectional household survey

Kea, Aschenaki Zerihun; Lindtjørn, Bernt; Gebretsadik, Achamyelesh; Hinderaker, Sven Gudmund

doi:10.1101/2022.07.14.22277635

Cited by 4 publications

(13 citation statements)

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“…We carried out a cross sectional study employing the sisterhood method (main focus of this paper) as part of larger maternal mortality household survey that used a retrospective 5-year recall of pregnancy and birth outcomes [8]. The study was conducted in Sidama Regional State, Southern Ethiopia.…”

Section: Methodsmentioning

confidence: 99%

“…The detailed sampling techniques of the study has been described elsewhere [8]. Below, we summarize the sampling technique of the sisterhood method conducted as part of a larger maternal mortality household survey.…”

Section: Methodsmentioning

confidence: 99%

“…We carried out an interview with 17444 participants and analysed the data of 17374 participants; 8884 (51.1%) men and 8490 (48.9%) women 15-49 years age. The participants were residents of the 8880 households of the survey [8]. The data was collected by diploma level teachers recruited from each kebele who were familiar with the culture and language of the study area.…”

Section: Methodsmentioning

confidence: 99%

“…A recent population based household survey conducted in Sidama Regional State identified a high MMR with district level variations. The overall MMR of the region, reported by this study was 419 (95% CI: 260-577) per 100,000 LB, but Aroresa district (the remote district) had a MMR 1142 (95% CI: 693-1591) deaths per 100,000 LB [8].…”

Section: Introductionmentioning

confidence: 99%

“…We carried out a population based household survey employing the indirect sisterhood method to measure maternal mortality in Sidama Regional State, southern Ethiopia. The indirect sisterhood method was part of larger maternal mortality survey aimed at measuring maternal mortality in Sidama Regional State using a retrospective 5-year recall period of pregnancy [8]. The larger study also included measuring physical access to skilled delivery using Geographic Information System.…”

Section: Introductionmentioning

confidence: 99%

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Reduction in maternal mortality ratio varies by district in Sidama Regional State, southern Ethiopia: Estimates by cross-sectional studies using the sisterhood method and a household survey of pregnancy and birth outcomes

Kea

Lindtjørn

Gebretsadik

et al. 2022

Preprint

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Maternal mortality studies conducted at national level do not provide subnational and local estimates useful for program planning and monitoring maternal mortality at lower administrative level. The aim of this study was to estimate lifetime risk (LTR) of maternal death and maternal mortality ratio (MMR), assess variations and reduction in MMR in Sidama Regional State, southern Ethiopia. This is cross-sectional study employed the sisterhood method as part of larger household maternal mortality survey that used a 5-year recall of pregnancy and birth outcomes. We visited 8880 households and interviewed 17444 respondents 15-49 years age. We assessed reduction in MMR using the sisterhood method (main focus of this paper) and a household survey of pregnancy and birth outcomes. We analyzed 17374 (99.6%) respondents; 8884 (51.1%) men and 8490 (48.9%) women. The 17,374 respondents reported 64,387 maternal sisters who had reached reproductive age. Among these, 2,402 (3.7%) sisters had died; 776 (32.3%) were pregnancy related deaths. The LTR of maternal death was 3.2% and MMR was 623 (95% CI: 573-658) per 100000 live births (LB), with reference to year 2010. The remote district (Aroresa) had a MMR of 1210 (95% CI: 1027-1318) per 100,000 LB. Assessment of MMR reduction using the two maternal mortality estimation methods showed that the MMR in Sidama Regional State declined over the past years. Significant reduction in MMR was observed in districts located near the regional center. However, no reduction was observed in districts located distant to the regional center. The high MMR with district level variations and lack of mortality reduction in districts located distant to the center highlights the need for instituting interventions tailored to the local context to save mothers and accelerate reduction in MMR.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Reduction in maternal mortality ratio varies by district in Sidama Regional State, southern Ethiopia: Estimates by cross-sectional studies using the sisterhood method and a household survey of pregnancy and birth outcomes

Kea

Lindtjørn

Gebretsadik

et al. 2022

Preprint

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Prevalence of maternal mortality causes based on ICD-MM: a systematic review and meta-analysis

Alipour,

Payandeh,

Karimi

2023

BMC Pregnancy Childbirth

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Background Maternal mortality is a universal public health challenge. ICD-Maternal Mortality (ICD-MM) was introduced in 2012 to facilitate the gathering, analysis, and interpretation of data on maternal deaths worldwide. The present study aimed to estimate the global prevalence of maternal death causes through a systematic review and meta-analysis. Methods A systematic literature search was conducted using various databases, including Web of Science, PubMed, Scopus, ScienceDirect, Cochrane Library, as well as Persian databases such as MagIran and Scientific Information Database (SID). The search encompassed articles published until August 21, 2022. Thirty-four eligible articles were included in the final analysis. Analysis was performed using a meta-analysis approach. The exact Clopper-Pearson confidence intervals, heterogeneity assessment, and random effects models with Mantel-Haenszel methods were employed using the STATA software version 14.2. Results The most prevalent causes of maternal deaths, listed in descending order from highest to lowest prevalence, were non-obstetric complications (48.32%), obstetric hemorrhage (17.63%), hypertensive disorders of pregnancy, childbirth, and the puerperium (14.01%), other obstetric complications (7.11%), pregnancy with abortive outcome (5.41%), pregnancy-related infection (5.26%), unanticipated complications of management (2.25%), unknown/undetermined causes (2.01%), and coincidental causes (1.59%), respectively. Conclusion Non-obstetric complications, obstetric hemorrhage, and hypertensive disorders of pregnancy, childbirth, and puerperium were the most common causes of maternal deaths. To reduce the burden of maternal mortality causes, increasing awareness and promoting self-care management among women of reproductive age, and implementing effective screening mechanisms for high-risk mothers during pregnancy, childbirth, and the puerperium can play a significant role. ICD-MM enables the uniform collection and comparison of maternal death information at different levels (local, national, and international) by facilitating the consistent collection, analysis, and interpretation of data on maternal deaths. Our findings can be utilized by policymakers and managers at various levels to facilitate necessary planning aimed at reducing the burden of maternal mortality causes.

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Perceptions, Barriers, and Facilitators of Maternal Health Service Utilization in Southern Ethiopia: A Qualitative Exploration of Community Members’ and Health Care Providers’ Views<strong> </strong>

Yoseph,

Teklesilasie,

Guillen-Grima

et al. 2023

Preprint

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Background: Maternal health service (MHS) use is a key strategy to reduce maternal mortality. However, the existing evidence is scarce to design efficient intervention strategies in Ethiopia. Thus, we aimed to explore community members and health care providers' perceptions of MHS, and barriers, and facilitators of MHS use in southern Ethiopia. Methods: A phenomenological qualitative study was conducted from November 14-30, 2022, in the northern zone of the Sidama region. Sixteen in-depth interviews, nine focus group discussions, and 15 key informant interviews were done with 112 study participants. A maximum variance sampling method was used to select study participants. Data coding and analysis were done using MAXQAD 2020 software and presented in narratives. Results: Communities have positive perceptions and good practices of skilled antenatal care (ANC) and health facility delivery (HFD), but lack awareness of postnatal care (PNC) services and schedules. Some have experienced negative interactions with health care providers, health facilities, and ambulance drivers. The main identified barriers to ANC use were lack of awareness of ANC benefits, distance from a health facility, costs associated with ANC use, long waiting time, lack of access to road, and women being busy with different household chores. Distance from health facility, costs associated with HFD use, unpredicted labour, lack of an ANC visit, lack of a birth preparedness plan, and non-dignified care were the main barriers to HFD. The major identified barriers to PNC use were home delivery, lack of awareness of PNC service and schedule, and socio-cultural beliefs. The main identified facilitators of MHS use were previous experience and fear of obstetric complications, health extension workers and women’s development teams, and pregnant women's forum.Conclusions: Rural women still encounter several challenges when using MHS, even though communities have positive perceptions and good practices of skilled MHS. Bad experiences mothers faced in health facilities, challenges associated with the costs of MHS use, poor awareness of service, and unpredictable labour continued to be basic barriers to MHS use. Intervention approaches should consider inter-sectoral collaboration to address barriers at the community and health facility levels. The programs must emphasize the transportation arrangements during unpredictable labour, the needs of poor mothers, and women who have poor awareness of MHS at the community level.

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Variation in maternal mortality in Sidama Regional State, southern Ethiopia: A population based cross sectional household survey

Cited by 4 publications

References 50 publications

Reduction in maternal mortality ratio varies by district in Sidama Regional State, southern Ethiopia: Estimates by cross-sectional studies using the sisterhood method and a household survey of pregnancy and birth outcomes

Reduction in maternal mortality ratio varies by district in Sidama Regional State, southern Ethiopia: Estimates by cross-sectional studies using the sisterhood method and a household survey of pregnancy and birth outcomes

Prevalence of maternal mortality causes based on ICD-MM: a systematic review and meta-analysis

Perceptions, Barriers, and Facilitators of Maternal Health Service Utilization in Southern Ethiopia: A Qualitative Exploration of Community Members’ and Health Care Providers’ Views<strong> </strong>

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