Trends and Associated Factors of Maternal Mortality in Zambia: Analysis of Routinely Collected Data (2015-April 2019)

Nedah Chikonde Musonda; Mumbi Chola; Patrick Kaonga; Samson Shumba; Choolwe Jacobs

doi:doi:10.11648/j.jgo.20210905.14

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Trends and Associated Factors of Maternal Mortality in Zambia: Analysis of Routinely Collected Data (2015-April 2019)

Nedah Chikonde Musonda, Mumbi Chola, Patrick Kaonga, Samson Shumba, Choolwe Jacobs

Published in Journal of Gynecology and Obstetrics (Volume 9, Issue 5)

Received: 30 July 2021 Accepted: 19 August 2021 Published: 30 September 2021

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Abstract

Introduction: Reduction of maternal mortality is a global priority. Based on one of Sustainable Development Goal target, Zambia aims to improve maternal health and one of the top priorities is to reduce maternal mortality ratio (MMR) to less 70 per 100,000 live births by 2030. Tracking progress towards set targets remains critical to guide policy and program implementation. This study aimed at assessing the trends and associated factors of maternal mortality in Zambia from April 2015 to April 2019. Methods: Data on maternal deaths was collected from the maternal surveillance database from April 2015-April 2019 from the 9 provinces of Zambia. Data was aggregated and coded in excel then merged. Incident rate ratios were reported using Zero Truncated Poisson (ZTP) regression. All analysis was done in 2021 using STATA version 14.2. Results: A total of 1,461 maternal deaths were reviewed. The trends of maternal deaths in the four-year period have not been consistently high or low but steadily following an upward trend with no significant downward trend. A multivariable ZTP model showed that women in Luapula (IRR 0.21 95% CI; 0.07-0.58), Western (IRR 0.44 95% CI; 0.24-0.81) and Lusaka (IRR 0.07 95% CI; 0.001-0.51) provinces had a reduced IRR of maternal deaths compared to women in Central province (P<0.05). The findings also showed that the age group 20-29 and 30 – 39 years had an increased IRR of maternal death compared to the age group less than 20 years (p<0.05). Sepsis, (aIRR 0.14 95% CI; 0.3-0.57), Hypertensive disorders (aIRR 0.20 95% CI; 0.07-0.61) and indirect causes (aIRR 0.22 95% CI; 0.08-0.63) in the study had a reduced IRR compared to women who had abortions (P<0.05). However, women who had live births controlling for other variables had an increased IRR (aIRR 4.75 95% CI; 1.56-14.43) compared to those who had abortions (P<0.05). There was no sufficient evidence to suggest HIV was associated with maternal deaths (P=0.24). Conclusion: The findings in this study shows that, in Zambia, maternal deaths over the years have not had a significant decline, thus provides evidence for re-strategizing, planning, policy formulation and implementation for reproductive health programmes to reduce maternal deaths in Zambia.

Published in	Journal of Gynecology and Obstetrics (Volume 9, Issue 5)
DOI	10.11648/j.jgo.20210905.14
Page(s)	155-161
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Maternal Mortality, Maternal Death, Sepsis, Hypertensive Disorders

References

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Nedah Chikonde Musonda, Mumbi Chola, Patrick Kaonga, Samson Shumba, Choolwe Jacobs. (2021). Trends and Associated Factors of Maternal Mortality in Zambia: Analysis of Routinely Collected Data (2015-April 2019). Journal of Gynecology and Obstetrics, 9(5), 155-161. https://doi.org/10.11648/j.jgo.20210905.14

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ACS Style

Nedah Chikonde Musonda; Mumbi Chola; Patrick Kaonga; Samson Shumba; Choolwe Jacobs. Trends and Associated Factors of Maternal Mortality in Zambia: Analysis of Routinely Collected Data (2015-April 2019). J. Gynecol. Obstet. 2021, 9(5), 155-161. doi: 10.11648/j.jgo.20210905.14

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AMA Style

Nedah Chikonde Musonda, Mumbi Chola, Patrick Kaonga, Samson Shumba, Choolwe Jacobs. Trends and Associated Factors of Maternal Mortality in Zambia: Analysis of Routinely Collected Data (2015-April 2019). J Gynecol Obstet. 2021;9(5):155-161. doi: 10.11648/j.jgo.20210905.14

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@article{10.11648/j.jgo.20210905.14,
  author = {Nedah Chikonde Musonda and Mumbi Chola and Patrick Kaonga and Samson Shumba and Choolwe Jacobs},
  title = {Trends and Associated Factors of Maternal Mortality in Zambia: Analysis of Routinely Collected Data (2015-April 2019)},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {9},
  number = {5},
  pages = {155-161},
  doi = {10.11648/j.jgo.20210905.14},
  url = {https://doi.org/10.11648/j.jgo.20210905.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20210905.14},
  abstract = {Introduction: Reduction of maternal mortality is a global priority. Based on one of Sustainable Development Goal target, Zambia aims to improve maternal health and one of the top priorities is to reduce maternal mortality ratio (MMR) to less 70 per 100,000 live births by 2030. Tracking progress towards set targets remains critical to guide policy and program implementation. This study aimed at assessing the trends and associated factors of maternal mortality in Zambia from April 2015 to April 2019. Methods: Data on maternal deaths was collected from the maternal surveillance database from April 2015-April 2019 from the 9 provinces of Zambia. Data was aggregated and coded in excel then merged. Incident rate ratios were reported using Zero Truncated Poisson (ZTP) regression. All analysis was done in 2021 using STATA version 14.2. Results: A total of 1,461 maternal deaths were reviewed. The trends of maternal deaths in the four-year period have not been consistently high or low but steadily following an upward trend with no significant downward trend. A multivariable ZTP model showed that women in Luapula (IRR 0.21 95% CI; 0.07-0.58), Western (IRR 0.44 95% CI; 0.24-0.81) and Lusaka (IRR 0.07 95% CI; 0.001-0.51) provinces had a reduced IRR of maternal deaths compared to women in Central province (P<0.05). The findings also showed that the age group 20-29 and 30 – 39 years had an increased IRR of maternal death compared to the age group less than 20 years (p<0.05). Sepsis, (aIRR 0.14 95% CI; 0.3-0.57), Hypertensive disorders (aIRR 0.20 95% CI; 0.07-0.61) and indirect causes (aIRR 0.22 95% CI; 0.08-0.63) in the study had a reduced IRR compared to women who had abortions (P<0.05). However, women who had live births controlling for other variables had an increased IRR (aIRR 4.75 95% CI; 1.56-14.43) compared to those who had abortions (P<0.05). There was no sufficient evidence to suggest HIV was associated with maternal deaths (P=0.24). Conclusion: The findings in this study shows that, in Zambia, maternal deaths over the years have not had a significant decline, thus provides evidence for re-strategizing, planning, policy formulation and implementation for reproductive health programmes to reduce maternal deaths in Zambia.},
 year = {2021}
}

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TY - JOUR
T1 - Trends and Associated Factors of Maternal Mortality in Zambia: Analysis of Routinely Collected Data (2015-April 2019)
AU - Nedah Chikonde Musonda
AU - Mumbi Chola
AU - Patrick Kaonga
AU - Samson Shumba
AU - Choolwe Jacobs
Y1 - 2021/09/30
PY - 2021
N1 - https://doi.org/10.11648/j.jgo.20210905.14
DO - 10.11648/j.jgo.20210905.14
T2 - Journal of Gynecology and Obstetrics
JF - Journal of Gynecology and Obstetrics
JO - Journal of Gynecology and Obstetrics
SP - 155
EP - 161
PB - Science Publishing Group
SN - 2376-7820
UR - https://doi.org/10.11648/j.jgo.20210905.14
AB - Introduction: Reduction of maternal mortality is a global priority. Based on one of Sustainable Development Goal target, Zambia aims to improve maternal health and one of the top priorities is to reduce maternal mortality ratio (MMR) to less 70 per 100,000 live births by 2030. Tracking progress towards set targets remains critical to guide policy and program implementation. This study aimed at assessing the trends and associated factors of maternal mortality in Zambia from April 2015 to April 2019. Methods: Data on maternal deaths was collected from the maternal surveillance database from April 2015-April 2019 from the 9 provinces of Zambia. Data was aggregated and coded in excel then merged. Incident rate ratios were reported using Zero Truncated Poisson (ZTP) regression. All analysis was done in 2021 using STATA version 14.2. Results: A total of 1,461 maternal deaths were reviewed. The trends of maternal deaths in the four-year period have not been consistently high or low but steadily following an upward trend with no significant downward trend. A multivariable ZTP model showed that women in Luapula (IRR 0.21 95% CI; 0.07-0.58), Western (IRR 0.44 95% CI; 0.24-0.81) and Lusaka (IRR 0.07 95% CI; 0.001-0.51) provinces had a reduced IRR of maternal deaths compared to women in Central province (P<0.05). The findings also showed that the age group 20-29 and 30 – 39 years had an increased IRR of maternal death compared to the age group less than 20 years (p<0.05). Sepsis, (aIRR 0.14 95% CI; 0.3-0.57), Hypertensive disorders (aIRR 0.20 95% CI; 0.07-0.61) and indirect causes (aIRR 0.22 95% CI; 0.08-0.63) in the study had a reduced IRR compared to women who had abortions (P<0.05). However, women who had live births controlling for other variables had an increased IRR (aIRR 4.75 95% CI; 1.56-14.43) compared to those who had abortions (P<0.05). There was no sufficient evidence to suggest HIV was associated with maternal deaths (P=0.24). Conclusion: The findings in this study shows that, in Zambia, maternal deaths over the years have not had a significant decline, thus provides evidence for re-strategizing, planning, policy formulation and implementation for reproductive health programmes to reduce maternal deaths in Zambia.
VL - 9
IS - 5
ER -

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Author Information

Nedah Chikonde Musonda

Department of Epidemiology & Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia
Mumbi Chola

Field Implementation Unit, ZAMPHIA Survey, Maryland Global Initiatives Corporation (MGIC), Lusaka, Zambia
Patrick Kaonga

Department of Epidemiology & Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia
Samson Shumba

Department of Epidemiology & Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia
Choolwe Jacobs

Department of Epidemiology & Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia

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Nedah Chikonde Musonda, Mumbi Chola, Patrick Kaonga, Samson Shumba, Choolwe Jacobs. (2021). Trends and Associated Factors of Maternal Mortality in Zambia: Analysis of Routinely Collected Data (2015-April 2019). Journal of Gynecology and Obstetrics, 9(5), 155-161. https://doi.org/10.11648/j.jgo.20210905.14

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Nedah Chikonde Musonda; Mumbi Chola; Patrick Kaonga; Samson Shumba; Choolwe Jacobs. Trends and Associated Factors of Maternal Mortality in Zambia: Analysis of Routinely Collected Data (2015-April 2019). J. Gynecol. Obstet. 2021, 9(5), 155-161. doi: 10.11648/j.jgo.20210905.14

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AMA Style

Nedah Chikonde Musonda, Mumbi Chola, Patrick Kaonga, Samson Shumba, Choolwe Jacobs. Trends and Associated Factors of Maternal Mortality in Zambia: Analysis of Routinely Collected Data (2015-April 2019). J Gynecol Obstet. 2021;9(5):155-161. doi: 10.11648/j.jgo.20210905.14

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@article{10.11648/j.jgo.20210905.14,
  author = {Nedah Chikonde Musonda and Mumbi Chola and Patrick Kaonga and Samson Shumba and Choolwe Jacobs},
  title = {Trends and Associated Factors of Maternal Mortality in Zambia: Analysis of Routinely Collected Data (2015-April 2019)},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {9},
  number = {5},
  pages = {155-161},
  doi = {10.11648/j.jgo.20210905.14},
  url = {https://doi.org/10.11648/j.jgo.20210905.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20210905.14},
  abstract = {Introduction: Reduction of maternal mortality is a global priority. Based on one of Sustainable Development Goal target, Zambia aims to improve maternal health and one of the top priorities is to reduce maternal mortality ratio (MMR) to less 70 per 100,000 live births by 2030. Tracking progress towards set targets remains critical to guide policy and program implementation. This study aimed at assessing the trends and associated factors of maternal mortality in Zambia from April 2015 to April 2019. Methods: Data on maternal deaths was collected from the maternal surveillance database from April 2015-April 2019 from the 9 provinces of Zambia. Data was aggregated and coded in excel then merged. Incident rate ratios were reported using Zero Truncated Poisson (ZTP) regression. All analysis was done in 2021 using STATA version 14.2. Results: A total of 1,461 maternal deaths were reviewed. The trends of maternal deaths in the four-year period have not been consistently high or low but steadily following an upward trend with no significant downward trend. A multivariable ZTP model showed that women in Luapula (IRR 0.21 95% CI; 0.07-0.58), Western (IRR 0.44 95% CI; 0.24-0.81) and Lusaka (IRR 0.07 95% CI; 0.001-0.51) provinces had a reduced IRR of maternal deaths compared to women in Central province (P<0.05). The findings also showed that the age group 20-29 and 30 – 39 years had an increased IRR of maternal death compared to the age group less than 20 years (p<0.05). Sepsis, (aIRR 0.14 95% CI; 0.3-0.57), Hypertensive disorders (aIRR 0.20 95% CI; 0.07-0.61) and indirect causes (aIRR 0.22 95% CI; 0.08-0.63) in the study had a reduced IRR compared to women who had abortions (P<0.05). However, women who had live births controlling for other variables had an increased IRR (aIRR 4.75 95% CI; 1.56-14.43) compared to those who had abortions (P<0.05). There was no sufficient evidence to suggest HIV was associated with maternal deaths (P=0.24). Conclusion: The findings in this study shows that, in Zambia, maternal deaths over the years have not had a significant decline, thus provides evidence for re-strategizing, planning, policy formulation and implementation for reproductive health programmes to reduce maternal deaths in Zambia.},
 year = {2021}
}

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