Effect of Adolescent Female Fertility and Healthcare Spending on Maternal and Neonatal Mortality in South Asia: A Retrospective Study Finding From 1990–2017

Abstract

Background: Maternal and neonatal mortality is high in south Asia. Adolescent female fertility and healthcare spending are an important factor to reduce maternal and neonatal mortality. Objectives: The main objective of this study was used to examine the effect of adolescent female fertility and healthcare spending on maternal and neonatal mortality in south Asian countries. Methods: Using a retrospective panel study design, a total of 8 south Asian countries data from world development indicator 1990-2017 were analyzed. Descriptive statistics is used for summary measure and fixed and random effect regression using multiple imputations estimated with relevant variables of adolescent female fertility, healthcare spending, physician, and adult female literacy rate. Findings: Increasing adolescent female fertility significantly positive effect on neonatal and maternal mortality. We found neonatal and maternal mortality are more likely to decrease depends on healthcare spending. A change in the healthcare spending has a significantly negative effect on neonatal mortality (-0.125, 95% CI: [-0.208 to -.042; P-value < 0.001), that is one percent increases in healthcare spending should decrease by 0.125 neonatal mortality and maternal mortality by 0.163 (95% CI: [-0.301 to -0.026]; P-value < 0.001). Conclusions: Maternal and neonatal mortality could reduce through increase of healthcare spending and decreasing of adolescent female fertility in south Asian countries. Expansion of maternal and new-born health programs should consider that decreasing female fertility and increasing healthcare spending has potential to improve maternal and neonatal health.