Maternal Mortality and the Consequences on Infant and Child Survival in Rural Haiti

OBJECTIVE: To determine the odds of death of children when a woman of reproductive age dies from maternal or non maternal causes in rural Haiti. METHODS: Deaths among reproductive aged women between 1997 and 1999 in and around Jeremie, Haiti were classified as maternal or non maternal and matched to female, non-deceasesd controls based on village, age, and parity. Information regarding the health and survival of all of the offspring under 12 years old of the identified women was extracted from the Haitian Health Foundation (HHF) Health Information System (HIS). Additional demographic information was obtained through interviews with the mothers for controls and with family members for cases. Two analyses on child death were conducted; 1) the odds of death for each individual child after a mother's death and 2) the odds of one of the children in a family dying after the mother's death. FINDINGS: If a family experiences a maternal death, that family has a 55.0% increased odds of experiencing the loss of a child less than 12, whereas when a non maternal death occurs, no increased odds exists. When children of cases were compared to children of controls, mean weight z-scores were the same for the periods corresponding to before and after the maternal deaths. After a maternal death, dosage of BCG (Bacillus Calmette-Guerin) TB (tuberculosis) immunization for the surviving child is significantly lower, as are dosage of measles immunization and the first dose of vitamin A. CONCLUSIONS: This study shows that a maternal death significantly effects the survival of children in a family in a greater way than a non maternal death.