Borde Moges Tadesse
School of Public Health, College of Health Sciences and Medicine Dilla University Dilla Ethiopia.
Public Health Chall. 2023 Jan 13;2(1):e56. doi: 10.1002/puh2.56. eCollection 2023 Mar.
In Ethiopia, a woman's lifetime risk (chance) of dying from maternal causes over a woman's reproductive lifespan continues to be a public health challenge. However, detailed evidence is scarce. This study aimed to assess woman's lifetime risk disparities in maternal mortality.
National data from the Ethiopian Demographic and Health Survey from 2000 to 2016 were used. To determine a woman's lifetime risk of dying, first, the maternal mortality ratio was calculated. Then, a woman's lifetime risk of dying was calculated. Four policy-relevant socio-economic factors were assessed: residence, education, regional states and economic status. To assess a woman's lifetime risk disparities in maternal mortality, the rate ratio () was used as per the World Health Organization's Health Equity Assessment Toolkit and software.
From 61,610 respondents, 795 deaths were reported. A woman's lifetime risk of dying nearly halved from 4.6% in 2000 (1 in 22 women) to 1.9% in 2016 (1 in 52 women). In 2016, the highest woman's lifetime risk of dying was observed among rural women (1 in 111 women), in Oromiya regional state (1 in 71 women), women with secondary education (1 in 82 women) and women with middle income (1 in 77 women). The socioeconomic factors that drive a woman's lifetime risk disparities in maternal mortality include residence (1.3-times higher among rural women), regional state (2-times higher among women in Oromiya regional state), education (6-times higher among women with lower educational status), and economic status (1.3-times higher among the poorest women).
Ethiopian women experienced a high lifetime risk of maternal mortality which varies across socioeconomic groups. Therefore, equity-oriented maternal healthcare is recommended to reduce the effects of structural inequities, such as poverty, and the inequitable distribution of the socioeconomic factors of maternal health that sustain a woman's lifetime risk disparities in maternal mortality.
在埃塞俄比亚，女性在其整个生殖寿命期间死于孕产妇原因的终生风险仍然是一项公共卫生挑战。然而，详细证据匮乏。本研究旨在评估孕产妇死亡率方面女性的终生风险差异。
使用了埃塞俄比亚2000年至2016年人口与健康调查的全国数据。为确定女性的终生死亡风险，首先计算孕产妇死亡率。然后，计算女性的终生死亡风险。评估了四个与政策相关的社会经济因素：居住地、教育程度、地区州和经济状况。根据世界卫生组织的健康公平评估工具包和软件，使用率比（）来评估孕产妇死亡率方面女性的终生风险差异。
在61610名受访者中，报告了795例死亡。女性的终生死亡风险从2000年的4.6%（22名女性中有1名）降至2016年的1.9%（52名女性中有1名），几乎减半。2016年，农村女性（111名女性中有1名）、奥罗米亚地区州的女性（71名女性中有1名）、受过中等教育的女性（82名女性中有1名）和中等收入女性（77名女性中有1名）的终生死亡风险最高。导致孕产妇死亡率方面女性终生风险差异的社会经济因素包括居住地（农村女性高1.3倍）、地区州（奥罗米亚地区州的女性高2倍）、教育程度（教育程度较低的女性高6倍）和经济状况（最贫困女性高1.3倍）。
埃塞俄比亚女性经历的孕产妇死亡终生风险较高，且在社会经济群体中存在差异。因此，建议提供以公平为导向的孕产妇保健，以减少贫困等结构性不平等以及维持孕产妇死亡率方面女性终生风险差异的孕产妇健康社会经济因素不公平分配的影响。
