Abstract
Introduction: Maternal mortality in our region observed a significative reduction, however, it continues to be a a public health problem. In Cali-Colombia was traditionally concentrated in the eastern and hillside areas and with high prevalence of afroamerican patients.
 Materials and methods: To analyze the behavior of maternal mortality during the last twenty years in the city, an ecological analytical study of spatial correlation was carried out including in the analysis, economic, sociocultural and health care factors. Univariate, bivariate and multivariate analyzes were performed.
 Results: The spatial analysis showed clusters of maternal mortality in the northern and central areas of the city. As a risk factor for maternal mortality, it was observed that in pregnant women belonging to the mixed ethnic backgrounds and spanic white ethnicity from low socioeconomic income (IRR: 1.13, 95% CI 1.03-1.24). Access to basic education (OR: 0.66, 95% CI 0.53-0.83), attendance at prenatal care (OR: 0.95 95% CI 0.93-0.98) and access to health institutions (OR: 0.96, 95% CI: 0.95-0-97) identified as protective factors for maternal mortality.
 Conclusion: The clusters for maternal-perinatal mortality in the city during the last two decades had a significant spatial change with a new pattern of risk factors associated to maternal mortality.
Highlights
Maternal mortality in our region observed a significative reduction, it continues to be a a public health problem
As a risk factor for maternal mortality, it was observed that in pregnant women belonging to the mixed ethnic backgrounds and spanic white ethnicity from low socioeconomic income (IRR: 1.13, 95% CI 1.03-1.24)
Official reports on the behavior of maternal mortality at the level of Cali and the Department of Valle del Cauca, report the behavior of the Maternal mortality (MM) georeferenced by commune without having described the pattern of geographic distribution associated with economic variables and social determinants [2]
Summary
Maternal mortality in our region observed a significative reduction, it continues to be a a public health problem. Maternal mortality (MM) is a public health problem that mainly affects developing countries with a family, social and economic impact [1]. Official reports on the behavior of maternal mortality at the level of Cali and the Department of Valle del Cauca, report the behavior of the MM georeferenced by commune without having described the pattern of geographic distribution associated with economic variables and social determinants [2]. The National Health Observatory has required more specific local analyzes on the behavior of maternal mortality. In response to this call, this research evaluated economic, sociocultural and health care factors that could be associated with MM describing the clusters for maternal deaths that had been analyzed by the Maternal Mortality Surveillance Committee (MMSC).
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