Abstract
BackgroundMaternal deaths occur mostly in developing countries and the majority of them are preventable. This study analyzes changes in maternal mortality and related causes in Henan Province, China, between 1996 and 2009, in an attempt to provide a reliable basis for introducing effective interventions to reduce the maternal mortality ratio (MMR), part of the fifth Millennium Development Goal.Methods and FindingsThis population-based maternal mortality survey in Henan Province was carried out from 1996 to 2009. Basic information was obtained from the health care network for women and children and the vital statistics system, from specially trained monitoring personnel in 25 selected monitoring sites and by household survey in each case of maternal death. This data was subsequently reported to the Henan Provincial Maternal and Child Healthcare Hospital. The total MMR in Henan Province declined by 78.4%, from 80.1 per 100 000 live births in 1996 to 17.3 per 100 000 live births in 2009. The decline was more pronounced in rural than in urban areas. The most common causes of maternal death during this period were obstetric hemorrhage (43.8%), pregnancy-induced hypertension (15.8%), amniotic fluid embolism (13.9%) and heart disease (8.0%). The MMR was higher in rural areas with lower income, less education and poorer health care.ConclusionThere was a remarkable decrease in the MMR in Henan Province between 1996 and 2009 mainly in the rural areas and MMR due to direct obstetric causes such as obstetric hemorrhage. This study indicates that improving the health care network for women, training of obstetric staff at basic-level units, promoting maternal education, and increasing household income are important interventional strategies to reduce the MMR further.
Highlights
Maternal health and wellbeing continues to be one of the major worldwide health challenges in the 21st century
This study indicates that improving the health care network for women, training of obstetric staff at basic-level units, promoting maternal education, and increasing household income are important interventional strategies to reduce the maternal mortality ratio (MMR) further
The MMR in Henan Province Between 1996 and 2009, a total of 2 483 327 live births occurred in the 25 survey areas in Henan Province, of which 1 906 003 occurred in rural areas and 577 324 occurred in urban areas
Summary
Maternal health and wellbeing continues to be one of the major worldwide health challenges in the 21st century. Reducing the MMR came into focus when it became one of the eight Millennium Development Goals (MDGs). The fifth MDG (MDG 5) includes 2 sub-goals: first, reducing the MMR by threequarters from 1990 to 2015 and, second, achieving universal access to reproductive health by 2015 [5]. Reliable information about the rates, trends, causes and factors associated with maternal mortality is essential for resource mobilization, and for planning and assessment of progress towards achieving MDG 5 [6]. Maternal deaths occur mostly in developing countries and the majority of them are preventable. This study analyzes changes in maternal mortality and related causes in Henan Province, China, between 1996 and 2009, in an attempt to provide a reliable basis for introducing effective interventions to reduce the maternal mortality ratio (MMR), part of the fifth Millennium Development Goal
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