Changes in causes of pregnancy‑related and maternal mortality in Zimbabwe 2007‑08 to 2018‑19: findings from two reproductive age mortality surveys
| dc.contributor.author | Musarandega, R. | |
| dc.contributor.author | Ngwenya, S. | |
| dc.contributor.author | Murewanhema, G. | |
| dc.contributor.author | Machekano, R. | |
| dc.contributor.author | Magwali, T. | |
| dc.contributor.author | Nystrom, L. | |
| dc.contributor.author | Pattinson, R. | |
| dc.contributor.author | Munjanja, S. | |
| dc.date.accessioned | 2025-09-15T12:52:44Z | |
| dc.date.available | 2025-09-15T12:52:44Z | |
| dc.date.issued | 2022 | |
| dc.description.abstract | Background Reducing maternal mortality is a priority of Sustainable Development Goal 3.1 which requires frequent epidemiological analysis of trends and patterns of the causes of maternal deaths. We conducted two reproductive age mortality surveys to analyse the epidemiology of maternal mortality in Zimbabwe and analysed the changes in the causes of deaths between 2007-08 and 2018-19. Methods We performed a before and after analysis of the causes of death among women of reproductive ages (WRAs) (12-49 years), and pregnant women from the two surveys implemented in 11 districts, selected using multi-stage cluster sampling from each province of Zimbabwe (n=10); an additional district selected from Harare. We calculated mortality incidence rates and incidence rate ratios per 10000 WRAs and pregnant women (with 95% confidence intervals), in international classification of disease groups, using negative binomial models, and compared them between the two surveys. We also calculated maternal mortality ratios, per 100 000 live births, for selected causes of pregnancy-related deaths. Results We identified 6188 deaths among WRAs and 325 PRDs in 2007-08, and 1856 and 137 respectively in 2018-19. Mortality in the WRAs decreased by 82% in diseases of the respiratory system and 81% in certain infectious or parasitic diseases' groups, which include HIV/AIDS and malaria. Pregnancy-related deaths decreased by 84% in the indirect causes group and by 61% in the direct causes group, and HIV/AIDS-related deaths decreased by 91% in pregnant women. Direct causes of death still had a three-fold MMR than indirect causes (151 vs. 51 deaths per 100 000) in 2018-19. Conclusion Zimbabwe experienced a decline in both direct and indirect causes of pregnancy-related deaths. Deaths from indirect causes declined mainly due to a reduction in HIV/AIDS-related and malaria mortality, while deaths from direct causes declined because of a reduction in obstetric haemorrhage and pregnancy-related infections. Ongoing interventions ought to improve the coverage and quality of maternal care in Zimbabwe, to further reduce deaths from direct causes. | |
| dc.description.sponsorship | The United Kingdom’s Foreign, Commonwealth and Development Office (FCDO), formerly Department for International Development (DfID), funded the 2007-08 survey. UNFPA, UNICEF and WHO Zimbabwe offices, University of Zimbabwe and Ministry of Health provided technical and financial support to both the 2007-08 and the 2018-19 surveys. WHO-Geneva (through a grant from the Improving Maternal Health Measurement (IMHM) Project at the Women & Health Initiative of the Harvard T.H. Chan School of Public Health, funded by the Bill & Melinda Gates Foundation and Development and Research Training in Human Reproduction (HRP) [Grant Number OPP1169546] and WHO-Zimbabwe funded the 2007-08 and 2018-19 data validation. | |
| dc.identifier.citation | Musarandega, R., Ngwenya, S., Murewanhema, G., Machekano, R., Magwali, T., Nystrom, L., Pattinson, R. and Munjanja, S., 2022. Changes in causes of pregnancy-related and maternal mortality in Zimbabwe 2007-08 to 2018-19: findings from two reproductive age mortality surveys. BMC Public Health, 22(1), p.923. | |
| dc.identifier.uri | http://196.220.97.103:4000/handle/123456789/1055 | |
| dc.language.iso | en | |
| dc.publisher | BMC Public Health | |
| dc.title | Changes in causes of pregnancy‑related and maternal mortality in Zimbabwe 2007‑08 to 2018‑19: findings from two reproductive age mortality surveys | |
| dc.type | Article |