Maternal Mortality in Colombia in 2011: A Two Level Ecological Study

Cárdenas-Cárdenas, Luz Mery; Cotes-Cantillo, Karol; Chaparro-Narváez, Pablo; Fernández-Niño, Julián Alfredo; Paternina-Caicedo, Ángel; Castañeda-Orjuela, Carlos; Hoz-Restrepo, Fernando De la

doi:10.1371/journal.pone.0118944

Cited by 20 publications

(20 citation statements)

References 18 publications

(28 reference statements)

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“…Ideally, analysis should follow an experimental design at the individual level, introducing maternal near‐miss determinants (ie, clinical indicators such as complications before, during, or after childbirth); however, this would lead to ethical debates beyond the scope of this study. Although previous ecological approaches to the understanding of mortality and its determinants exist, we believe that our results should be considered an initial approximation of the impact of GE on MM.…”

Section: Discusion and Conclusionmentioning

confidence: 96%

Government expenditure on health and maternal mortality in México: A spatial‐econometric analysis

Pérez-Pérez

Serván‐Mori²,

Nigenda

et al. 2019

Health Planning & Management

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Summary Objective To assess the relationship between government expenditure on maternal health (GE) and maternal mortality (MM) in Mexican poor population between 2000 and 2015 in the 2457 Mexican municipalities. Methods Using administrative data, we performed the analysis in three stages: First, we tested the presence of selection bias in MM. Next, we assessed the presence of spatial dependence in the incidence and severity of MM. Finally, we estimated a spatial error model considering the correction of estimates for the spatial dependence and selection bias assessed before. Results MM and GE were not randomly distributed throughout the Mexican territory; the most socially vulnerable municipalities exhibited the highest levels of MM severity but the lowest levels of GE and available human and physical resources for maternal health; the incidence of MM was independent of GE; elasticity of GE‐severity in MM was −4% (P < 0.01). Conclusions Resource allocation for maternal health must move towards a more comprehensive vision, and efforts to achieve an effective delivery of universal health services must improve, particularly regarding the most vulnerable municipalities.

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Section: Discusion and Conclusionmentioning

confidence: 96%

Government expenditure on health and maternal mortality in México: A spatial‐econometric analysis

Pérez-Pérez

Serván‐Mori²,

Nigenda

et al. 2019

Health Planning & Management

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“…Factors such as high fertility rate, low family planning coverage, short interpregnancy intervals, and out-ofhospital deliveries (especially at home) have been mentioned as the risk factors for pregnancy and delivery complications and higher maternal and under-five mortality rates (16)(17)(18)(19). In our study, these risk factors were significantly higher among rural women; therefore, these women and children under 5 years are more vulnerable than urban women.…”

Section: Discussionmentioning

confidence: 47%

Determinants of Fertility Patterns in Zahedan, Southeast Iran, 2015

et al. 2016

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Background: Fertility pattern is influenced by economic, social, cultural, and environmental factors. Sistan and Balouchestan province has the highest household size and total fertility rate in Iran. In this study, we aimed to evaluate the fertility pattern and determinants of the desired number of children among rural and urban women in Zahedan, Sistan and Balouchestan province, Iran in 2015. Methods: In this cross sectional study, 160 urban and rural couples were evaluated in Zahedan. The data collection tool was a questionnaire, including demographic information, fertility pattern, and family planning details. Chi square, independent t test, and Mann-Whitney U test were used to analyze the data. Binary logistic regression test was used to determine the association of different variables with the desired number of children. Results: Coverage of family planning programs was significantly lower for rural women, compared to their urban counterparts. In addition, the percentage of unsafe delivery was higher in rural women. The mean desired number of children was 3.18 ± 1.7 for urban and rural women and 3.56 ± 1.19 for their partners. As the binary logistic regression analysis showed, preference for a male child and Balouch ethnicity were significant predictors of the desired number of children for women and their partners (P < 0.05). Conclusions: Fertility pattern and determinants of reproductive performance can vary in different populations. Sistan and Balouchestan province has the lowest coverage of reproductive health programs and a high unsafe delivery rate. Therefore, reproductive and pregnancy health programs should be supplemented, parallel to policies concerning population growth.

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“…Es prioritario que Colombia optimice la salud de estas poblaciones y para ello debe generar estrategias que mejoren el acceso a servicios de salud de calidad integrales [30,31], así como mejorar la calidad de vida de la población [20].…”

Section: Discussionunclassified

“…La dificultad para lograr los avances esperados en smi se ha relacionado con factores como: fallas en el aseguramiento [18], presupuesto insuficiente para los servicios de salud [19], barreras geográficas, económicas y culturales para el acceso a dichos servicios, y la calidad misma de la atención que reciben gestantes, niñas y niños [20]. Con respecto al último punto, un estudio sobre la calidad del control prenatal (cpn) realizado en 23 entidades territoriales mostró que, si bien una norma emitida en el año 2000 (Resolución 412 de Minsalud) estableció como obligatorias un número de acciones durante el cpn, su cumplimiento solo se evidenció en el 1,1% de 2.651 historias clínicas (hc) revisadas [21].…”

Section: Introductionunclassified