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. 2018 Sep 13;13(9):e0203830.
doi: 10.1371/journal.pone.0203830. eCollection 2018.

Underlying determinants of maternal mortality in a rural South African population with high HIV prevalence (2000-2014): A population-based cohort analysis

B Tlou  1
Affiliations

Underlying determinants of maternal mortality in a rural South African population with high HIV prevalence (2000-2014): A population-based cohort analysis

B Tlou. PLoS One. .

Abstract

Introduction: Maternal mortality is one of the significant health indicators of any country and it's a frequent subject in many global heath discussions. Even though the global trends have shown a decrease on maternal mortality, many countries in sub-Saharan Africa failed to achieve the MDG 5 target in 2015.There is no specific single solution for reducing maternal mortality but there is unanimity that a reliable health system with skilled personal is vital for addressing maternal mortality. This study therefore seeks to identify the risk factors for maternal mortality in typical rural sub-Saharan African countries.

Method: A longitudinal population based cohort study was conducted using data from 2000-2014 in Africa Health Research Institute (AHRI).The Cox regression method was used to assess the influence of selected risk factors using the Mosley-Chen model on maternal mortality. A total of 20701 women aged 15-49 years were included in the study.

Results: The study found 212 maternal deaths from 32,620 live births with a maternal mortality ratio (MMR) of 650 per 100,000 live births. The main causes of death were Communicable diseases (38.2%), Aids and TB (31%) and Unknown causes (11.8%). An increased risk of death was identified on, poor wealth index (HR 3.92[1.01, 15.3]), period of death 2000-2006(HR32.1 [3.79, 71.5]) and number of deliveries (6.76[2.70, 16.9]) were associated with a high risk of maternal mortality after adjusting for other independent variables included in the study.

Conclusion: Socio-economic status, number of deliveries and period of death were found to be associated with maternal death in rural South Africa.

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Conflict of interest statement

The authors have declared that no competing interests exist

Figures

Fig 1
Fig 1. Location of the Africa Health Research Institute (AHRI) study area in KwaZulu-Natal Province, South Africa.
See this image and copyright information in PMC

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