Social Determinants and Ethnic Factors Associated with a New Spatial Distribution of Maternal Mortality for a City of Colombia (2000-2019)

Abstract

Introduction: Maternal mortality in our region observed a significative reduction, however, it continues to be a a public health problem. In Cali-Colombia was traditionally concentrated in the eastern and hillside areas and with high prevalence of afroamerican patients.
 Materials and methods: To analyze the behavior of maternal mortality during the last twenty years in the city, an ecological analytical study of spatial correlation was carried out including in the analysis, economic, sociocultural and health care factors. Univariate, bivariate and multivariate analyzes were performed.
 Results: The spatial analysis showed clusters of maternal mortality in the northern and central areas of the city. As a risk factor for maternal mortality, it was observed that in pregnant women belonging to the mixed ethnic backgrounds and spanic white ethnicity from low socioeconomic income (IRR: 1.13, 95% CI 1.03-1.24). Access to basic education (OR: 0.66, 95% CI 0.53-0.83), attendance at prenatal care (OR: 0.95 95% CI 0.93-0.98) and access to health institutions (OR: 0.96, 95% CI: 0.95-0-97) identified as protective factors for maternal mortality.
 Conclusion: The clusters for maternal-perinatal mortality in the city during the last two decades had a significant spatial change with a new pattern of risk factors associated to maternal mortality.