Maternal mortality by socio-demographic characteristics and cause of death in South Africa: 2007\u20132015

Nolunkcwe J Bomela

doi:10.1186/s12889-020-8179-x

Abstract

BackgroundSouth Africa’s maternal mortality ratio remains high although it has substantially declined in the past few years. Numerous studies undertaken in South Africa on maternal mortality have not paid much attention to how the causes are distributed in different socio-demographic groups. This study assesses and analyses the causes of maternal mortality according to sociodemographic factors in South Africa.MethodsThe causes of maternal deaths were assessed with respect to age, province, place of death, occupation, education and marital status. Data were obtained from the vital registration database of Statistics South Africa. About 14,892 maternal deaths of women from 9 to 55 years of age were analysed using frequency tables, cross-tabulations and logistic regression. Maternal mortality ratio (MMR), by year, age group, and province for the years 2007–2015 was calculated.ResultsThe 2007–2015 MMR was 139.3 deaths per 100,000 live births (10,687,687 total live births). The year 2009 had the highest MMR during this period. Specific province MMR for three triennia (2007–2009; 2010–2012; 2013–2015) shows that the Free State province had the highest MMR (297.9/100000 live births; 214.6/100000 live births; 159/100000 live births) throughout this period. MMR increased with age. Although the contribution of the direct causes of death (10603) was more than double the contribution of indirect causes (4289) maternal mortality showed a steady decline during this period.ConclusionsThe study shows evidence of variations in the causes of death among different socio-demographic subgroups. These variations indicate that more attention has to be given to the role played by socio-demographic factors in maternal mortality.

Highlights

South Africa’s maternal mortality ratio remains high it has substantially declined in the past few years
Notwithstanding the high levels, South Africa has reported a decline in the number of maternal deaths1 and institutional Maternal Mortality Ratio since 2009 [2]
An inventory of progress made on the Sustainable Development Goals (SDGs) in South Africa revealed significant advances made in development, including health, over the past 25 years, as well as the considerable challenges that remain

Summary

Introduction

South Africa’s maternal mortality ratio remains high it has substantially declined in the past few years. Notwithstanding the high levels, South Africa has reported a decline in the number of maternal deaths and institutional Maternal Mortality Ratio (iMMR) since 2009 [2]. The reduction in deaths from non-pregnancy related infections and the success of the Human Immunodeficiency Virus (HIV) antiviral treatment programme in pregnancy and beyond have been hailed as the main reason for the decline in iMMR in South Africa during the past few years [2]. An inventory of progress made on the Sustainable Development Goals (SDGs) in South Africa revealed significant advances made in development, including health, over the past 25 years, as well as the considerable challenges that remain. This report, in reference to Goal 3 of the SDGs which is to ensure healthy lives for all and promote well-being for all at all ages, states that improvements in health services in the country have reduced maternal and child mortality rates and the incidence of some communicable diseases [1, 5]

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