#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

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: https://doi.org/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

1. Alkema L, Chou D, Hogan D, Zhang S, Moller A-B, Gemmill A, et al. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. The Lancet. 2016;387(10017):462–74.

2. Lozano R, Wang HD, Foreman KJ, Rajaratnam JK, Naghavi M, Marcus JR, et al. Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. Lancet. 2011;378(9797):1139–65. doi: 10.1016/S0140-6736(11)61337-8 21937100

3. WHO. Trends in maternal mortality: 1990 to 2015: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. 2015.

4. Nations United. The Millennium Development Goals Report 2015. New York: United Nations; 2015.

5. Berhan Y, Berhan A. Review of maternal mortality in Ethiopia: a story of the past 30 years. Ethiop J Health Sci. 2014;24 Suppl:3–14.

6. Central Statistical Agency (CSA)[Ethiopia] and ICF. Ethiopia Demographic and Health Survey 2000. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Authority and ORC Macro; 2001.

7. Central Statistical Agency (CSA)[Ethiopia] and ICF. Ethiopia Demographic and Health Survey 2005. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ORC Macro; 2006.

8. Central Statistical Agency [Ethiopia] and ICF. Ethiopia Demographic and Health Survey 2011. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International; 2012.

9. Berhan Y, Berhan A. Causes of maternal mortality in Ethiopia: a significant decline in abortion related death. Ethiop J Health Sci. 2014;24 Suppl:15–28.

10. Central Statistical Agency (CSA)[Ethiopia] and ICF. Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF; 2016.

11. Berhan Y, Berhan A. Reasons for persistently high maternal and perinatal mortalities in Ethiopia: Part I-Health system factors. Ethiop J Health Sci. 2014;24 Suppl:105–18.

12. Berhan Y, Berhan A. Reasons for persistently high maternal and perinatal mortalities in Ethiopia: Part II-Socio-economic and cultural factors. Ethiop J Health Sci. 2014;24 Suppl:119–36.

13. Berhan Y, Berhan A. Commentary: Reasons for persistently high maternal and perinatal mortalities in Ethiopia: Part III-Perspective of the "three delays" model. Ethiop J Health Sci. 2014;24 Suppl:137–48.

14. Holford TR. Analysing the temporal effects of age, period and cohort. Stat Methods Med Res. 1992;1(3):317–37. doi: 10.1177/096228029200100306 1341663

15. Graham W, Airey P. Measuring maternal mortality: sense and sensitivity. Health Policy Plan. 1987;2(4):323–33.

16. Wilmoth J. The lifetime risk of maternal mortality: concept and measurement. Bull World Health Organ. 2009;87(4):256–62. doi: 10.2471/BLT.07.048280 19551233

17. Tessema GA, Laurence CO, Melaku YA, Misganaw A, Woldie SA, Hiruye A, et al. Trends and causes of maternal mortality in Ethiopia during 1990–2013: findings from the Global Burden of Diseases study 2013. BMC Public Health. 2017;17(1):160. doi: 10.1186/s12889-017-4071-8 28152987

18. Holford TR. Approaches to fitting age-period-cohort models with unequal intervals. Stat Med. 2006;25(6):977–93. doi: 10.1002/sim.2253 16143994

19. Holford TR. Understanding the effects of age, period, and cohort on incidence and mortality rates. Annu Rev Public Health. 1991;12:425–57. doi: 10.1146/annurev.pu.12.050191.002233 2049144

20. R Development Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. 2017.

21. Collaborators GBDMM. Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1775–812. doi: 10.1016/S0140-6736(16)31470-2 27733286

22. Blanc AK, Winfrey W, Ross J. New Findings for Maternal Mortality Age Pattern Aggregated Results for 38 Countries. PLoS ONE. 2013;6(4):e59864.

23. Mgawadere F, Unkels R, Adegoke A, van den Broek N. Measuring maternal mortality using a Reproductive Age Mortality Study (RAMOS). BMC Pregnancy and Childbirth. 2016;16(291).

24. Jain AK. Measuring the effect of fertility decline on the maternal mortality ratio. Stud Fam Plann. 2011;42(4):247–60. doi: 10.1111/j.1728-4465.2011.00288.x 22292244

25. Workie NW, Ramana GN. The Health Extension Program in Ethiopia. Washington DC: The World Bank; 2013.

26. Federal Ministry of Health. Implementation manual for healthcare financing reports; Addis Ababa, Ethiopia. 2010.

27. Godefay H, Kinsman J, Admasu K, Byass P. Can innovative ambulance transport avert pregnancy-related deaths? One-year operational assessment in Ethiopia. J Glob Health. 2016;6(1):010410. doi: 10.7189/jogh.06.010410 27231545


Článek vyšel v časopise

PLOS One


2020 Číslo 1
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

KOST
Koncepce osteologické péče pro gynekology a praktické lékaře
nový kurz
Autoři: MUDr. František Šenk

Sekvenční léčba schizofrenie
Autoři: MUDr. Jana Hořínková

Hypertenze a hypercholesterolémie – synergický efekt léčby
Autoři: prof. MUDr. Hana Rosolová, DrSc.

Svět praktické medicíny 5/2023 (znalostní test z časopisu)

Imunopatologie? … a co my s tím???
Autoři: doc. MUDr. Helena Lahoda Brodská, Ph.D.

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#