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Rural-urban differentials in pregnancy-related mortality in Zambia: estimates using data collected in a census.

Banda R, Fylkesnes K, Sandøy IF - Popul Health Metr (2015)

Bottom Line: The 2010 round of population and housing censuses recorded a significant increase in the number of countries collecting maternal mortality data.Adjusted adult female mortality was high; an adolescent aged 15 years had a one-in-three chance of dying before her 50th birthday in rural areas and one-in-four chance in urban areas.Future censuses should pay greater attention to strategies for improving data quality.

View Article: PubMed Central - PubMed

Affiliation: Central Statistical Office, Lusaka, Zambia ; Centre for International Health, University of Bergen, Bergen, Norway.

ABSTRACT

Background: The use of census data to measure maternal mortality is a recent phenomenon, implemented in settings with non-functional vital registration systems and driven by needs for trend data. The 2010 round of population and housing censuses recorded a significant increase in the number of countries collecting maternal mortality data. The objective of this study was to estimate rural-urban differentials in pregnancy-related mortality in Zambia using census data.

Methods: We used data from the Zambia 2000 and 2010 censuses. Both censuses recorded the female population by age, the number of children ever born, and live births 12 months prior to the census. The 2010 census further recorded, by age, household, and pregnancy-related deaths 12 months prior to the census. We evaluated and adjusted recorded live births using the cohort Parity Fertility ratio method, and household deaths using deaths distribution methods (General Growth Balance and Synthetic Extinct Generation). Adult female mortality and pregnancy-related mortality for rural and urban areas were estimated for the period October 2009 to October 2010.

Results: Data evaluation showed errors in recorded population age, age-at-death, live births, and deaths, and appropriate adjustments were made. Adjusted adult female mortality was high; an adolescent aged 15 years had a one-in-three chance of dying before her 50th birthday in rural areas and one-in-four chance in urban areas. Pregnancy-related deaths comprised 15.3 % of all deaths among reproductive-age women overall; 17.9 % in rural areas and 9.8 % in urban areas. The pregnancy-related mortality ratio for the period was 789 deaths/100,000 live births overall: 960/100,000 live births in rural areas and 470/100,000 live births in urban areas.

Conclusions: Census-based estimates show very high adult female mortality and particularly high pregnancy-related mortality in both rural and urban areas of Zambia 12 months prior to the 2010 census. Future censuses should pay greater attention to strategies for improving data quality.

No MeSH data available.


Related in: MedlinePlus

Percent of total pregnancy-related deaths for each 5-year age group within rural and urban areas
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Fig3: Percent of total pregnancy-related deaths for each 5-year age group within rural and urban areas

Mentions: About half of all recorded pregnancy-related deaths were reported to have occurred in the antepartum period (while the woman was pregnant); 48 % in rural areas and 50 % in urban areas, while postpartum deaths constituted 28 % in rural areas and 17 % in urban areas. A total of 2445 pregnancy-related deaths of women aged 15–49 were recorded in rural areas, representing a PMDF of 17.9 %, while in urban areas, 1252 pregnancy-related deaths were recorded, representing a PMDF of 9.8 % (Table 4). Pregnancy-related deaths as a proportion of total deaths of women was highest among young women aged 15–19, particularly in rural areas where the PMDF in this age group was 44 % compared to 17 % in urban areas. However, women in the age group 25–29 had the highest proportion of total pregnancy-related deaths recorded in both rural and urban areas (Fig. 3). The crude PRMRatio was marginally higher in urban areas; 846/100,000 live births compared to 831/100,000 live births in rural areas (Table 4). The age-specific crude PRMRatios were higher among urban women aged 15–19 and older than 35 years compared to their rural peers (Fig. 4). Adjustment of both deaths and live births (full adjustment) resulted in a PRMRatio of 789/100,000 live births overall; 960/100,000 live births in rural areas and 470/100,000 in urban areas.Table 4


Rural-urban differentials in pregnancy-related mortality in Zambia: estimates using data collected in a census.

Banda R, Fylkesnes K, Sandøy IF - Popul Health Metr (2015)

Percent of total pregnancy-related deaths for each 5-year age group within rural and urban areas
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4666090&req=5

Fig3: Percent of total pregnancy-related deaths for each 5-year age group within rural and urban areas
Mentions: About half of all recorded pregnancy-related deaths were reported to have occurred in the antepartum period (while the woman was pregnant); 48 % in rural areas and 50 % in urban areas, while postpartum deaths constituted 28 % in rural areas and 17 % in urban areas. A total of 2445 pregnancy-related deaths of women aged 15–49 were recorded in rural areas, representing a PMDF of 17.9 %, while in urban areas, 1252 pregnancy-related deaths were recorded, representing a PMDF of 9.8 % (Table 4). Pregnancy-related deaths as a proportion of total deaths of women was highest among young women aged 15–19, particularly in rural areas where the PMDF in this age group was 44 % compared to 17 % in urban areas. However, women in the age group 25–29 had the highest proportion of total pregnancy-related deaths recorded in both rural and urban areas (Fig. 3). The crude PRMRatio was marginally higher in urban areas; 846/100,000 live births compared to 831/100,000 live births in rural areas (Table 4). The age-specific crude PRMRatios were higher among urban women aged 15–19 and older than 35 years compared to their rural peers (Fig. 4). Adjustment of both deaths and live births (full adjustment) resulted in a PRMRatio of 789/100,000 live births overall; 960/100,000 live births in rural areas and 470/100,000 in urban areas.Table 4

Bottom Line: The 2010 round of population and housing censuses recorded a significant increase in the number of countries collecting maternal mortality data.Adjusted adult female mortality was high; an adolescent aged 15 years had a one-in-three chance of dying before her 50th birthday in rural areas and one-in-four chance in urban areas.Future censuses should pay greater attention to strategies for improving data quality.

View Article: PubMed Central - PubMed

Affiliation: Central Statistical Office, Lusaka, Zambia ; Centre for International Health, University of Bergen, Bergen, Norway.

ABSTRACT

Background: The use of census data to measure maternal mortality is a recent phenomenon, implemented in settings with non-functional vital registration systems and driven by needs for trend data. The 2010 round of population and housing censuses recorded a significant increase in the number of countries collecting maternal mortality data. The objective of this study was to estimate rural-urban differentials in pregnancy-related mortality in Zambia using census data.

Methods: We used data from the Zambia 2000 and 2010 censuses. Both censuses recorded the female population by age, the number of children ever born, and live births 12 months prior to the census. The 2010 census further recorded, by age, household, and pregnancy-related deaths 12 months prior to the census. We evaluated and adjusted recorded live births using the cohort Parity Fertility ratio method, and household deaths using deaths distribution methods (General Growth Balance and Synthetic Extinct Generation). Adult female mortality and pregnancy-related mortality for rural and urban areas were estimated for the period October 2009 to October 2010.

Results: Data evaluation showed errors in recorded population age, age-at-death, live births, and deaths, and appropriate adjustments were made. Adjusted adult female mortality was high; an adolescent aged 15 years had a one-in-three chance of dying before her 50th birthday in rural areas and one-in-four chance in urban areas. Pregnancy-related deaths comprised 15.3 % of all deaths among reproductive-age women overall; 17.9 % in rural areas and 9.8 % in urban areas. The pregnancy-related mortality ratio for the period was 789 deaths/100,000 live births overall: 960/100,000 live births in rural areas and 470/100,000 live births in urban areas.

Conclusions: Census-based estimates show very high adult female mortality and particularly high pregnancy-related mortality in both rural and urban areas of Zambia 12 months prior to the 2010 census. Future censuses should pay greater attention to strategies for improving data quality.

No MeSH data available.


Related in: MedlinePlus