Changes in causes of pregnancy-related and maternal mortality in Zimbabwe 2007-08 to 2018-19 : findings from two reproductive age mortality surveys

dc.contributor.authorMusarandega, Reuben
dc.contributor.authorNgwenya, Solwayo
dc.contributor.authorMurewanhema, Grant
dc.contributor.authorMachekano, Rhoderick
dc.contributor.authorMagwali, Thulani
dc.contributor.authorNystrom, Lennarth
dc.contributor.authorPattinson, Robert Clive
dc.contributor.authorMunjanja, Stephen
dc.date.accessioned2022-07-28T05:44:55Z
dc.date.available2022-07-28T05:44:55Z
dc.date.issued2022-05
dc.description.abstractBACKGROUND: Reducing maternal mortality is a priority of Sustainable Development Goal 3.1 which requires frequent epidemiological analysis of trends and patterns of the causes of maternal deaths. We conducted two reproductive age mortality surveys to analyse the epidemiology of maternal mortality in Zimbabwe and analysed the changes in the causes of deaths between 2007-08 and 2018-19. METHODS: We performed a before and after analysis of the causes of death among women of reproductive ages (WRAs) (12-49 years), and pregnant women from the two surveys implemented in 11 districts, selected using multi-stage cluster sampling from each province of Zimbabwe (n=10); an additional district selected from Harare. We calculated mortality incidence rates and incidence rate ratios per 10000 WRAs and pregnant women (with 95% confidence intervals), in international classification of disease groups, using negative binomial models, and compared them between the two surveys. We also calculated maternal mortality ratios, per 100 000 live births, for selected causes of pregnancy-related deaths. RESULTS: We identified 6188 deaths among WRAs and 325 PRDs in 2007-08, and 1856 and 137 respectively in 2018-19. Mortality in the WRAs decreased by 82% in diseases of the respiratory system and 81% in certain infectious or parasitic diseases' groups, which include HIV/AIDS and malaria. Pregnancy-related deaths decreased by 84% in the indirect causes group and by 61% in the direct causes group, and HIV/AIDS-related deaths decreased by 91% in pregnant women. Direct causes of death still had a three-fold MMR than indirect causes (151 vs. 51 deaths per 100 000) in 2018-19. CONCLUSION: Zimbabwe experienced a decline in both direct and indirect causes of pregnancy-related deaths. Deaths from indirect causes declined mainly due to a reduction in HIV/AIDS-related and malaria mortality, while deaths from direct causes declined because of a reduction in obstetric haemorrhage and pregnancy-related infections. Ongoing interventions ought to improve the coverage and quality of maternal care in Zimbabwe, to further reduce deaths from direct causes.en_US
dc.description.departmentSchool of Health Systems and Public Health (SHSPH)en_US
dc.description.sponsorshipThe United Kingdom’s Foreign, Commonwealth and Development Office, Department for International Development, UNFPA, UNICEF and WHO Zimbabwe offices, University of Zimbabwe and Ministry of Health.en_US
dc.description.urihttp://www.biomedcentral.com/bmcpublichealthen_US
dc.identifier.citationMusarandega R., Ngwenya S., Murewanhema G., Machekano R., Magwali T., Nystrom L., Pattinson R. & Munjanja S.; Zimbabwe Maternal and Perinatal Mortality Study Group. Changes in causes of pregnancy-related and maternal mortality in Zimbabwe 2007-08 to 2018-19: findings from two reproductive age mortality surveys. BMC Public Health. 2022 May 10;22(1):923. doi: 10.1186/s12889-022-13321-7.en_US
dc.identifier.issn1471-2458 (online)
dc.identifier.other10.1186/s12889-022-13321-7
dc.identifier.urihttps://repository.up.ac.za/handle/2263/86517
dc.language.isoenen_US
dc.publisherBMCen_US
dc.rights© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License.en_US
dc.subjectMaternal deathen_US
dc.subjectCauses of deathen_US
dc.subjectICD-MMen_US
dc.subjectICD-10en_US
dc.subjectZimbabween_US
dc.subjectPregnancy-related deathsen_US
dc.subjectMaternal mortalityen_US
dc.subjectInternational classifcation of diseasesen_US
dc.subjectCivil registration and vital statisticsen_US
dc.subjectSDG-03: Good health and well-beingen_US
dc.subjectSustainable development goals (SDGs)en_US
dc.subjectWomen of reproductive ages (WRAs)en_US
dc.subjectCivil registration and vital statistics (CRVS)en_US
dc.titleChanges in causes of pregnancy-related and maternal mortality in Zimbabwe 2007-08 to 2018-19 : findings from two reproductive age mortality surveysen_US
dc.typeArticleen_US

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