Maternal mortality estimation at the subnational level: a model-based method with an application to Bangladesh |
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Authors: | Ahmed Saifuddin Hill Kenneth |
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Institution: | aJohns Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street (E4642), Baltimore, MD, 21205, United States of America (USA).;bHarvard Center for Population and Development Studies, Boston, USA. |
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Abstract: | ObjectiveTo provide a model-based method of estimating maternal mortality at the subnational level and illustrate its use in estimating maternal mortality rates (MMrates) and maternal mortality ratios (MMRs) in all 64 districts of Bangladesh.MethodsKnowing that mortality is more pronounced among the poorer segments of a population, in rural areas and in areas with poor availability and utilization of maternal care, we used an empirical Bayesian prediction method to estimate maternal mortality at the subnational level from the spatial distribution of such factors.FindingsMMRs varied significantly by district in Bangladesh, from 158 maternal deaths per 100?000 live births at Dhaka district to 782 in the northern coastal regions. Maternal mortality was consistently higher in the eastern and northern regions, which are known to be culturally conservative and to have poor transportation systems.ConclusionBangladesh has made noteworthy strides in reducing maternal mortality since 1990, even though the utilization of skilled birth attendants has increased very little. However, several areas still show alarmingly high maternal mortality figures and need to be prioritized and targeted by health administrators and policy-makers. |
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