Desigualdades sociales en la mortalidad materna, República Dominicana, 2016

Abstract

Esta investigación pretende cuantificar las diferencias en la razón de mortalidad materna en las provincias de la República Dominicana, considerando las distintas condiciones sociales a la que estas mujeres están expuestas. Se utilizó la información proveniente de registro de estadísticas vitales. Se calculó la asociación entre la razón de mortalidad materna y ciertos indicadores socioeconómicos seleccionados. Se calcularon las métricas de desigualdad tomando en cuenta los indicadores socioeconómicos que se hallaron significativamente asociados con la razón de mortalidad materna, resultando esta dos veces mayor en los territorios más desfavorecidos socialmente, comparados con los territorios que se encontraron en mejores condiciones sociales.

Characterization of maternal mortality and severe maternal morbidity before and during covid-19: an analysis for the Dominican Republic

“…Some of these provinces are located in the border area with Haiti, with high levels of poverty and limited coverage of some basic services. The results also show that the provinces of María Trinidad Sánchez and San Pedro de Macorís are in the group with the highest mortality ratio (8).…”

“…There is evidence that in the Dominican Republic, maternal mortality is higher in territories with higher levels of multidimensional poverty or in localities with lower levels of human development. Furthermore, the probability of a woman dying from causes related to pregnancy, childbirth, or the postpartum period in the most socially disadvantaged territories was about twice as high compared to the most socially advantaged territories (8).…”

“…Although the interventions have contributed to sustained reductions in maternal and child mortality, the program goals have not yet been achieved (2,10,22), such as the goal set in the MDG 5 to reduce by 75% the maternal mortality rate that existed in the early 1990s. (8) argue that the national average tends to conceal the heterogeneity of the health situation within the country, as mortality assumes a differential behavior according to the geographical regions of each country. At the provincial level, the areas with the highest maternal mortality ratio for 2016 correspond, to a greater extent, to small provinces in terms of population, such as Independencia, Santiago Rodríguez, Bahoruco, Pedernales, and Elías Piña.…”

“…In 2013, the Dominican Republic showed a maternal mortality ratio of approximately 102 deaths per 100,000 live births, and by the year 2016, it had decreased to a ratio of 92.1 deaths per 100,000 live births. This indicator hides the heterogeneity of the country's health situation, as there are health regions that had a higher maternal mortality ratio than the national average and others below it, such as the case of the Northwest Cibao Region (Indicator well above the average) and the Central Cibao Region (Indicator below the average) (8,9). These data exceed the average for the Latin American and Caribbean region (9).…”

“…Despite governmental efforts in the matter, the Dominican Republic has not been able to experience a significant reduction in maternal mortality, which distances the country from achieving the 2030 Agenda and the Sustainable Development Goals (10,11). It is imperative to highlight that the Dominican Republic, being a country with a high middle income (8,476.75 USD per capita (12,13) that has a high coverage of prenatal care (98.9%) and institutional delivery (97.5%).…”