Department of Epidemiology, UCLA Fielding School of Public Health, , Los Angeles, California, USA.
J Epidemiol Community Health. 2013 Dec 1;67(12):992-8. doi: 10.1136/jech-2013-202565. Epub 2013 Jul 13.
Most global maternal deaths occur in Africa and Asia. In response, the Millennium Development Goal (MDG-5) calls for a 75% reduction in maternal mortality from 1990 to 2015. To assess the potential for progress in MDG-5 in Africa, we examined the cross-sectional and longitudinal associations of socioeconomic, demographic and population-health factors with maternal mortality rates in Africa.
We used data from global agencies and the published literature to identify socioeconomic, demographic and population-health explanatory factors that could be correlated with maternal mortality in 49 countries of Africa for the years 1990, 1995, 2000 and 2005. We used correlation, negative binomial and mixed Poisson regression models to investigate whether there exist associations between potential explanatory factors and maternal mortality.
Some African countries have made substantial progress towards achieving MDG-5 while others have fallen behind. Lower gross domestic product (GDP) and female enrolment in primary schools, but higher HIV prevalence, neonatal mortality rate and total fertility rate, were associated with higher maternal mortality.
Maternal mortality rates in African countries appear to be declining. The mean maternal mortality ratios in Africa decreased from 695.82 in 1990 to 562.18 in 2005. Yet some countries are more likely than others to achieve MDG-5. Better socioeconomic, demographic and population health development appear to be conducive to better maternal health in Africa. Sustained efforts on all these fronts will be needed to close the gap in maternal survival and achieve MDG-5 in Africa.
大多数全球产妇死亡发生在非洲和亚洲。为此，千年发展目标（MDG-5）呼吁将产妇死亡率从 1990 年到 2015 年降低 75%。为评估非洲在实现 MDG-5 方面的进展潜力，我们研究了社会经济、人口和人口健康因素与非洲产妇死亡率之间的横断面和纵向关联。
我们使用来自全球机构和已发表文献的数据，确定了社会经济、人口和人口健康的解释因素，这些因素可能与 1990 年、1995 年、2000 年和 2005 年非洲 49 个国家的产妇死亡率相关。我们使用相关、负二项式和混合泊松回归模型来研究潜在解释因素与产妇死亡率之间是否存在关联。
一些非洲国家在实现 MDG-5 方面取得了重大进展，而其他国家则落后了。国内生产总值（GDP）和小学女生入学率较低，但艾滋病毒流行率、新生儿死亡率和总生育率较高，与产妇死亡率较高相关。
非洲国家的产妇死亡率似乎在下降。非洲的平均产妇死亡率从 1990 年的 695.82 降至 2005 年的 562.18。然而，一些国家比其他国家更有可能实现 MDG-5。更好的社会经济、人口和人口健康发展似乎有利于改善非洲的产妇健康。需要在所有这些方面持续努力，以缩小产妇生存差距，实现非洲的 MDG-5。
