An Analysis of Factors Linked to the Decline in Maternal Mortality in Nepal
Identifieur interne : 001F95 ( Main/Curation ); précédent : 001F94; suivant : 001F96An Analysis of Factors Linked to the Decline in Maternal Mortality in Nepal
Auteurs : Sanu Shrestha ; Jacqueline S. Bell ; Debbi MaraisSource :
- PLoS ONE [ 1932-6203 ] ; 2014.
Abstract
Nepal experienced a steep decline in maternal mortality between 1996 and 2006, which had again dropped by 2010. The aim of this study was to investigate any trends in factors that may be responsible for this decline. The study was based on a secondary data analysis of maternity care services and socio-demographic variables extracted from the Nepal Demographic Health Surveys (1996, 2001, 2006 and 2011). Complex sample analysis was performed to determine the trends in these variables across the four surveys. Univariate logistic regression was performed for selected maternity care service variables to calculate the average change in odds ratio for each survey. Multivariate logistic regression was performed to determine the trends in the health service uptake adjusting for socio-demographic variables. There were major demographic and socio-economic changes observed between 1996 and 2011: notably fewer women delivering at ‘high risk’ ages, decreased fertility, higher education levels and migration to urban areas. Significant trends were observed for improved uptake of all maternity care services. The largest increase was observed in health facility delivery (odds ratio = 2.21; 95% confidence interval = 1.92, 2.34) and women making four or more antenatal visits (odds ratio = 2.24; 95% confidence interval = 2.03, 2.47). After adjusting for all socio-demographic factors, the trends were still significant but disparities become more pronounced at the extremes of the socio-economic spectrum. The odds ratios for each maternity care service examined decreased slightly after adjusting for education, indicating that improved levels of education could partly explain these trends. The improved utilisation of maternity care services seems essential to the decline in maternal mortality in Nepal
Url:
DOI: 10.1371/journal.pone.0093029
PubMed: 24705366
PubMed Central: 3976277
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Bell</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Marais, Debbi" sort="Marais, Debbi" uniqKey="Marais D" first="Debbi" last="Marais">Debbi Marais</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24705366</idno><idno type="pmc">3976277</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3976277</idno><idno type="RBID">PMC:3976277</idno><idno type="doi">10.1371/journal.pone.0093029</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">002A93</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002A93</idno><idno type="wicri:Area/Pmc/Curation">002A92</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002A92</idno><idno type="wicri:Area/Pmc/Checkpoint">001558</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001558</idno><idno type="wicri:Area/Ncbi/Merge">002838</idno><idno type="wicri:Area/Ncbi/Curation">002838</idno><idno type="wicri:Area/Ncbi/Checkpoint">002838</idno><idno type="wicri:Area/Main/Merge">001F99</idno><idno type="wicri:Area/Main/Curation">001F95</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">An Analysis of Factors Linked to the Decline in Maternal Mortality in Nepal</title><author><name sortKey="Shrestha, Sanu" sort="Shrestha, Sanu" uniqKey="Shrestha S" first="Sanu" last="Shrestha">Sanu Shrestha</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Bell, Jacqueline S" sort="Bell, Jacqueline S" uniqKey="Bell J" first="Jacqueline S." last="Bell">Jacqueline S. Bell</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Marais, Debbi" sort="Marais, Debbi" uniqKey="Marais D" first="Debbi" last="Marais">Debbi Marais</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Nepal experienced a steep decline in maternal mortality between 1996 and 2006, which had again dropped by 2010. The aim of this study was to investigate any trends in factors that may be responsible for this decline. The study was based on a secondary data analysis of maternity care services and socio-demographic variables extracted from the Nepal Demographic Health Surveys (1996, 2001, 2006 and 2011). Complex sample analysis was performed to determine the trends in these variables across the four surveys. Univariate logistic regression was performed for selected maternity care service variables to calculate the average change in odds ratio for each survey. Multivariate logistic regression was performed to determine the trends in the health service uptake adjusting for socio-demographic variables. There were major demographic and socio-economic changes observed between 1996 and 2011: notably fewer women delivering at ‘high risk’ ages, decreased fertility, higher education levels and migration to urban areas. Significant trends were observed for improved uptake of all maternity care services. The largest increase was observed in health facility delivery (odds ratio = 2.21; 95% confidence interval = 1.92, 2.34) and women making four or more antenatal visits (odds ratio = 2.24; 95% confidence interval = 2.03, 2.47). After adjusting for all socio-demographic factors, the trends were still significant but disparities become more pronounced at the extremes of the socio-economic spectrum. The odds ratios for each maternity care service examined decreased slightly after adjusting for education, indicating that improved levels of education could partly explain these trends. The improved utilisation of maternity care services seems essential to the decline in maternal mortality in Nepal<monospace>. </monospace>These findings have implications for policy planning in terms of government resources for maternity care services and the education sector.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Alvarez, Jl" uniqKey="Alvarez J">JL Alvarez</name></author><author><name sortKey="Gil, R" uniqKey="Gil R">R Gil</name></author><author><name sortKey="Hernandez, V" uniqKey="Hernandez V">V Hernandez</name></author><author><name sortKey="Gil, A" uniqKey="Gil A">A Gil</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shen, C" uniqKey="Shen C">C Shen</name></author><author><name sortKey="Williamson, Jb" uniqKey="Williamson J">JB Williamson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Asamoah, Bo" uniqKey="Asamoah B">BO 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Mesko</name></author><author><name sortKey="Amery, J" uniqKey="Amery J">J Amery</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Bell, J" uniqKey="Bell J">J Bell</name></author><author><name sortKey="Hussein, J" uniqKey="Hussein J">J Hussein</name></author><author><name sortKey="Jentsch, B" uniqKey="Jentsch B">B Jentsch</name></author><author><name sortKey="Scotland, G" uniqKey="Scotland G">G Scotland</name></author><author><name sortKey="Bullough, C" uniqKey="Bullough C">C Bullough</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Van Eijk, Am" uniqKey="Van Eijk A">AM Van Eijk</name></author><author><name sortKey="Bles, Hm" uniqKey="Bles H">HM Bles</name></author><author><name sortKey="Odhiambo, F" uniqKey="Odhiambo F">F Odhiambo</name></author><author><name sortKey="Ayisi, Jg" uniqKey="Ayisi J">JG Ayisi</name></author><author><name sortKey="Blokland, Ie" 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