Age, period and cohort analysis of age-specific maternal mortality trend in Ethiopia: A secondary analysis


Autoři: Biniam Getachew aff001;  Tippawan Liabsuetrakul aff001;  Shama Virani aff001;  Yirgu Gebrehiwot aff003
Působiště autorů: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand aff001;  Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, United States of America aff002;  Obstetrics and Gynecology Department, Addis Ababa University, Addis Ababa, Ethiopia aff003
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224220

Souhrn

Background

Maternal mortality (MM) was persistently high for several decades in Ethiopia though it has declined in recent years. The roles of time-varying elements in this decrease are unknown. Analyzing MM with age-period-cohort analysis will provide evidence to policymakers to re-direct resources towards vulnerable age groups. The aim of this analysis was to determine the role of age effect, period effect and birth cohort effect on the trend of age-specific maternal mortality in Ethiopia.

Methods

Age-period-cohort (APC) analysis was applied to examine the effect of age, period and birth cohort on MM in Ethiopia using data from the Ethiopian Demographic and Health Survey (EDHS) from years 2000, 2005, 2011 and 2016. Age-specific maternal mortality rates were calculated using standardized maternal death compared to age-specific population per 100,000 woman-years of exposure and the trend was analyzed.

Result

In most age groups, the MM rate decreased in 2015 compared with the previous years except for older women. According to the APC analysis, the age-cohort effect explains the MM rate better than age-period effect. The period effect shows the risk ratio of MM after 2005 decreased compared with before. The cohort effect illustrates women born after 1980 has lower risk ratio compared with the older one.

Conclusion

Maternal mortality in Ethiopia declined overall in recent years. However, certain age groups still face high maternal mortality rates. A national policy on MM reduction interventions for the identified high-risk age groups is required.

Klíčová slova:

Age groups – Antigen-presenting cells – Cohort studies – Death rates – Ethiopia – Global health – Health surveys – Health systems strengthening


Zdroje

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Článek vyšel v časopise

PLOS One


2020 Číslo 1