The relationship between maternal education and mortality among women giving birth in health care institutions: Analysis of the cross sectional WHO Global Survey on Maternal and Perinatal Health
Background Approximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered avoidable. Millennium Development Goal five calls for a reduction in maternal mortality and the establishment of universal access to high quality repro...
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| Veröffentlicht in: | BMC public health Jg. 11; H. 1; S. 606 |
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| Hauptverfasser: | , , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
London
BioMed Central
29.07.2011
BioMed Central Ltd BMC |
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| ISSN: | 1471-2458, 1471-2458 |
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| Abstract | Background
Approximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered avoidable. Millennium Development Goal five calls for a reduction in maternal mortality and the establishment of universal access to high quality reproductive health care. There is evidence of a relationship between lower levels of maternal education and higher maternal mortality. This study examines the relationship between maternal education and maternal mortality among women giving birth in health care institutions and investigates the association of maternal age, marital status, parity, institutional capacity and state-level investment in health care with these relationships.
Methods
Cross-sectional information was collected on 287,035 inpatients giving birth in 373 health care institutions in 24 countries in Africa, Asia and Latin America, between 2004-2005 (in Africa and Latin America) and 2007-2008 (in Asia) as part of the WHO Global Survey on Maternal and Perinatal Health. Analyses investigated associations between indicators measured at the individual, institutional and country level and maternal mortality during the intrapartum period: from admission to, until discharge from, the institution where women gave birth. There were 363 maternal deaths.
Results
In the adjusted models, women with no education had 2.7 times and those with between one and six years of education had twice the risk of maternal mortality of women with more than 12 years of education. Institutional capacity was not associated with maternal mortality in the adjusted model. Those not married or cohabiting had almost twice the risk of death of those who were. There was a significantly higher risk of death among those aged over 35 (compared with those aged between 20 and 25 years), those with higher numbers of previous births and lower levels of state investment in health care. There were also additional effects relating to country of residence which were not explained in the model.
Conclusions
Lower levels of maternal education were associated with higher maternal mortality even amongst women able to access facilities providing intrapartum care. More attention should be given to the wider social determinants of health when devising strategies to reduce maternal mortality and to achieve the increasingly elusive MDG for maternal mortality. |
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| AbstractList | Background Approximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered avoidable. Millennium Development Goal five calls for a reduction in maternal mortality and the establishment of universal access to high quality reproductive health care. There is evidence of a relationship between lower levels of maternal education and higher maternal mortality. This study examines the relationship between maternal education and maternal mortality among women giving birth in health care institutions and investigates the association of maternal age, marital status, parity, institutional capacity and state-level investment in health care with these relationships. Methods Cross-sectional information was collected on 287,035 inpatients giving birth in 373 health care institutions in 24 countries in Africa, Asia and Latin America, between 2004-2005 (in Africa and Latin America) and 2007-2008 (in Asia) as part of the WHO Global Survey on Maternal and Perinatal Health. Analyses investigated associations between indicators measured at the individual, institutional and country level and maternal mortality during the intrapartum period: from admission to, until discharge from, the institution where women gave birth. There were 363 maternal deaths. Results In the adjusted models, women with no education had 2.7 times and those with between one and six years of education had twice the risk of maternal mortality of women with more than 12 years of education. Institutional capacity was not associated with maternal mortality in the adjusted model. Those not married or cohabiting had almost twice the risk of death of those who were. There was a significantly higher risk of death among those aged over 35 (compared with those aged between 20 and 25 years), those with higher numbers of previous births and lower levels of state investment in health care. There were also additional effects relating to country of residence which were not explained in the model. Conclusions Lower levels of maternal education were associated with higher maternal mortality even amongst women able to access facilities providing intrapartum care. More attention should be given to the wider social determinants of health when devising strategies to reduce maternal mortality and to achieve the increasingly elusive MDG for maternal mortality. Approximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered avoidable. Millennium Development Goal five calls for a reduction in maternal mortality and the establishment of universal access to high quality reproductive health care. There is evidence of a relationship between lower levels of maternal education and higher maternal mortality. This study examines the relationship between maternal education and maternal mortality among women giving birth in health care institutions and investigates the association of maternal age, marital status, parity, institutional capacity and state-level investment in health care with these relationships. Cross-sectional information was collected on 287,035 inpatients giving birth in 373 health care institutions in 24 countries in Africa, Asia and Latin America, between 2004-2005 (in Africa and Latin America) and 2007-2008 (in Asia) as part of the WHO Global Survey on Maternal and Perinatal Health. Analyses investigated associations between indicators measured at the individual, institutional and country level and maternal mortality during the intrapartum period: from admission to, until discharge from, the institution where women gave birth. There were 363 maternal deaths. In the adjusted models, women with no education had 2.7 times and those with between one and six years of education had twice the risk of maternal mortality of women with more than 12 years of education. Institutional capacity was not associated with maternal mortality in the adjusted model. Those not married or cohabiting had almost twice the risk of death of those who were. There was a significantly higher risk of death among those aged over 35 (compared with those aged between 20 and 25 years), those with higher numbers of previous births and lower levels of state investment in health care. There were also additional effects relating to country of residence which were not explained in the model. Lower levels of maternal education were associated with higher maternal mortality even amongst women able to access facilities providing intrapartum care. More attention should be given to the wider social determinants of health when devising strategies to reduce maternal mortality and to achieve the increasingly elusive MDG for maternal mortality. Abstract Background Approximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered avoidable. Millennium Development Goal five calls for a reduction in maternal mortality and the establishment of universal access to high quality reproductive health care. There is evidence of a relationship between lower levels of maternal education and higher maternal mortality. This study examines the relationship between maternal education and maternal mortality among women giving birth in health care institutions and investigates the association of maternal age, marital status, parity, institutional capacity and state-level investment in health care with these relationships. Methods Cross-sectional information was collected on 287,035 inpatients giving birth in 373 health care institutions in 24 countries in Africa, Asia and Latin America, between 2004-2005 (in Africa and Latin America) and 2007-2008 (in Asia) as part of the WHO Global Survey on Maternal and Perinatal Health. Analyses investigated associations between indicators measured at the individual, institutional and country level and maternal mortality during the intrapartum period: from admission to, until discharge from, the institution where women gave birth. There were 363 maternal deaths. Results In the adjusted models, women with no education had 2.7 times and those with between one and six years of education had twice the risk of maternal mortality of women with more than 12 years of education. Institutional capacity was not associated with maternal mortality in the adjusted model. Those not married or cohabiting had almost twice the risk of death of those who were. There was a significantly higher risk of death among those aged over 35 (compared with those aged between 20 and 25 years), those with higher numbers of previous births and lower levels of state investment in health care. There were also additional effects relating to country of residence which were not explained in the model. Conclusions Lower levels of maternal education were associated with higher maternal mortality even amongst women able to access facilities providing intrapartum care. More attention should be given to the wider social determinants of health when devising strategies to reduce maternal mortality and to achieve the increasingly elusive MDG for maternal mortality. Background Approximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered avoidable. Millennium Development Goal five calls for a reduction in maternal mortality and the establishment of universal access to high quality reproductive health care. There is evidence of a relationship between lower levels of maternal education and higher maternal mortality. This study examines the relationship between maternal education and maternal mortality among women giving birth in health care institutions and investigates the association of maternal age, marital status, parity, institutional capacity and state-level investment in health care with these relationships. Methods Cross-sectional information was collected on 287,035 inpatients giving birth in 373 health care institutions in 24 countries in Africa, Asia and Latin America, between 2004-2005 (in Africa and Latin America) and 2007-2008 (in Asia) as part of the WHO Global Survey on Maternal and Perinatal Health. Analyses investigated associations between indicators measured at the individual, institutional and country level and maternal mortality during the intrapartum period: from admission to, until discharge from, the institution where women gave birth. There were 363 maternal deaths. Results In the adjusted models, women with no education had 2.7 times and those with between one and six years of education had twice the risk of maternal mortality of women with more than 12 years of education. Institutional capacity was not associated with maternal mortality in the adjusted model. Those not married or cohabiting had almost twice the risk of death of those who were. There was a significantly higher risk of death among those aged over 35 (compared with those aged between 20 and 25 years), those with higher numbers of previous births and lower levels of state investment in health care. There were also additional effects relating to country of residence which were not explained in the model. Conclusions Lower levels of maternal education were associated with higher maternal mortality even amongst women able to access facilities providing intrapartum care. More attention should be given to the wider social determinants of health when devising strategies to reduce maternal mortality and to achieve the increasingly elusive MDG for maternal mortality. Approximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered avoidable. Millennium Development Goal five calls for a reduction in maternal mortality and the establishment of universal access to high quality reproductive health care. There is evidence of a relationship between lower levels of maternal education and higher maternal mortality. This study examines the relationship between maternal education and maternal mortality among women giving birth in health care institutions and investigates the association of maternal age, marital status, parity, institutional capacity and state-level investment in health care with these relationships.BACKGROUNDApproximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered avoidable. Millennium Development Goal five calls for a reduction in maternal mortality and the establishment of universal access to high quality reproductive health care. There is evidence of a relationship between lower levels of maternal education and higher maternal mortality. This study examines the relationship between maternal education and maternal mortality among women giving birth in health care institutions and investigates the association of maternal age, marital status, parity, institutional capacity and state-level investment in health care with these relationships.Cross-sectional information was collected on 287,035 inpatients giving birth in 373 health care institutions in 24 countries in Africa, Asia and Latin America, between 2004-2005 (in Africa and Latin America) and 2007-2008 (in Asia) as part of the WHO Global Survey on Maternal and Perinatal Health. Analyses investigated associations between indicators measured at the individual, institutional and country level and maternal mortality during the intrapartum period: from admission to, until discharge from, the institution where women gave birth. There were 363 maternal deaths.METHODSCross-sectional information was collected on 287,035 inpatients giving birth in 373 health care institutions in 24 countries in Africa, Asia and Latin America, between 2004-2005 (in Africa and Latin America) and 2007-2008 (in Asia) as part of the WHO Global Survey on Maternal and Perinatal Health. Analyses investigated associations between indicators measured at the individual, institutional and country level and maternal mortality during the intrapartum period: from admission to, until discharge from, the institution where women gave birth. There were 363 maternal deaths.In the adjusted models, women with no education had 2.7 times and those with between one and six years of education had twice the risk of maternal mortality of women with more than 12 years of education. Institutional capacity was not associated with maternal mortality in the adjusted model. Those not married or cohabiting had almost twice the risk of death of those who were. There was a significantly higher risk of death among those aged over 35 (compared with those aged between 20 and 25 years), those with higher numbers of previous births and lower levels of state investment in health care. There were also additional effects relating to country of residence which were not explained in the model.RESULTSIn the adjusted models, women with no education had 2.7 times and those with between one and six years of education had twice the risk of maternal mortality of women with more than 12 years of education. Institutional capacity was not associated with maternal mortality in the adjusted model. Those not married or cohabiting had almost twice the risk of death of those who were. There was a significantly higher risk of death among those aged over 35 (compared with those aged between 20 and 25 years), those with higher numbers of previous births and lower levels of state investment in health care. There were also additional effects relating to country of residence which were not explained in the model.Lower levels of maternal education were associated with higher maternal mortality even amongst women able to access facilities providing intrapartum care. More attention should be given to the wider social determinants of health when devising strategies to reduce maternal mortality and to achieve the increasingly elusive MDG for maternal mortality.CONCLUSIONSLower levels of maternal education were associated with higher maternal mortality even amongst women able to access facilities providing intrapartum care. More attention should be given to the wider social determinants of health when devising strategies to reduce maternal mortality and to achieve the increasingly elusive MDG for maternal mortality. Approximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered avoidable. Millennium Development Goal five calls for a reduction in maternal mortality and the establishment of universal access to high quality reproductive health care. There is evidence of a relationship between lower levels of maternal education and higher maternal mortality. This study examines the relationship between maternal education and maternal mortality among women giving birth in health care institutions and investigates the association of maternal age, marital status, parity, institutional capacity and state-level investment in health care with these relationships. Cross-sectional information was collected on 287,035 inpatients giving birth in 373 health care institutions in 24 countries in Africa, Asia and Latin America, between 2004-2005 (in Africa and Latin America) and 2007-2008 (in Asia) as part of the WHO Global Survey on Maternal and Perinatal Health. Analyses investigated associations between indicators measured at the individual, institutional and country level and maternal mortality during the intrapartum period: from admission to, until discharge from, the institution where women gave birth. There were 363 maternal deaths. In the adjusted models, women with no education had 2.7 times and those with between one and six years of education had twice the risk of maternal mortality of women with more than 12 years of education. Institutional capacity was not associated with maternal mortality in the adjusted model. Those not married or cohabiting had almost twice the risk of death of those who were. There was a significantly higher risk of death among those aged over 35 (compared with those aged between 20 and 25 years), those with higher numbers of previous births and lower levels of state investment in health care. There were also additional effects relating to country of residence which were not explained in the model. Lower levels of maternal education were associated with higher maternal mortality even amongst women able to access facilities providing intrapartum care. More attention should be given to the wider social determinants of health when devising strategies to reduce maternal mortality and to achieve the increasingly elusive MDG for maternal mortality. |
| ArticleNumber | 606 |
| Audience | Academic |
| Author | Karlsen, Saffron Hogue, Carol J Calles, Dinorah L Raine, Rosalind Souza, João-Paulo Gülmezoglu, A Metin Say, Lale |
| AuthorAffiliation | 1 Department of Epidemiology & Public Health, UCL, 1-19 Torrington Place, London WC1E 6BT, UK 2 Department of Reproductive Health and Research, World Health Organisation, Avenue Appia 20, Geneva, CH-1211, Switzerland 3 Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA |
| AuthorAffiliation_xml | – name: 1 Department of Epidemiology & Public Health, UCL, 1-19 Torrington Place, London WC1E 6BT, UK – name: 2 Department of Reproductive Health and Research, World Health Organisation, Avenue Appia 20, Geneva, CH-1211, Switzerland – name: 3 Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA |
| Author_xml | – sequence: 1 givenname: Saffron surname: Karlsen fullname: Karlsen, Saffron email: s.karlsen@ucl.ac.uk organization: Department of Epidemiology & Public Health – sequence: 2 givenname: Lale surname: Say fullname: Say, Lale organization: Department of Reproductive Health and Research, World Health Organisation – sequence: 3 givenname: João-Paulo surname: Souza fullname: Souza, João-Paulo organization: Department of Reproductive Health and Research, World Health Organisation – sequence: 4 givenname: Carol J surname: Hogue fullname: Hogue, Carol J organization: Rollins School of Public Health, Emory University – sequence: 5 givenname: Dinorah L surname: Calles fullname: Calles, Dinorah L organization: Rollins School of Public Health, Emory University – sequence: 6 givenname: A Metin surname: Gülmezoglu fullname: Gülmezoglu, A Metin organization: Department of Reproductive Health and Research, World Health Organisation – sequence: 7 givenname: Rosalind surname: Raine fullname: Raine, Rosalind organization: Department of Epidemiology & Public Health |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/21801399$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | Karlsen et al; licensee BioMed Central Ltd. 2011 COPYRIGHT 2011 BioMed Central Ltd. Copyright ©2011 Karlsen et al; licensee BioMed Central Ltd. 2011 Karlsen et al; licensee BioMed Central Ltd. |
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| Keywords | Maternal Mortality Maternal Education Maternal Death Perinatal Health Health Care Institution |
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Public Health Paper No.771984GenevaWHO WagstaffAClaesonMThe Millennium Development Goals for health: rising to the challenges2004World Bank SinghSDarrochJEAshfordLSVlassoffMAdding it up: The costs and benefits of investing in family planning and maternal and newborn health2009New YorkGuttmacher Institute and United Nations Population Fundhttp://www.unfpa.org/webdav/site/global/shared/documents/publications/2009/adding_it_up_report.pdf ThaddeusSMaineDToo far to walk: maternal mortality in contextSocial Science and Medicine1994388109111101:STN:280:DyaK2czhslShsg%3D%3D10.1016/0277-9536(94)90226-78042057 KhanKSWojdylaDSayLGümezogluAMVan LookPFAWHO analysis of causes of maternal death: a systematic reviewLancet20063671066107410.1016/S0140-6736(06)68397-916581405 VillarjValladaresEWojdylaDZavaletaNCarroliGVelazcoAShahACampodónicoLBatagliaVFaundesALangerANarvárezADonnerARomeroMReynosoSSimônia de PáduaKGiordanoDKublickasMAcostaACaesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey of maternal and perinatal health in Latin AmericaLancet20063671819182910.1016/S0140-6736(06)68704-716753484 VillarJCarroliGZavaletaNDonnerAWojdylaDFaundesAVelazcoABatagliaVLangerANarváezAValladaresEShahACampodónicoLRomeroMReynosoSSimônia de PáduaKGiodanoDKublickasMAcostaAWHO 2005 Global Survey on Maternal and Perinatal Health Research GroupMaternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective studyBMJ2007335102510.1136/bmj.39363.706956.55179778192078636 GrownCGuptaGRPandeRTaking action to improve women's health through gender equality and women's empowermentLancet200536554154310.1016/S0140-6736(05)70278-615705464 HoganMCForemanKJNoghaviMAhnSYWangMMakelaSMLopezADLozanoRMurrayCJLMaternal Mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5Lancet20103751609162310.1016/S0140-6736(10)60518-120382417 McAlisterCBaskettTFFemale education and maternal mortality: a worldwide surveyJournal of Obstetrics Gynaecology Canada2006281198399010.1016/S1701-2163(16)32294-017169224 Pan American Health AssociationGender, Health and Development in the Americas-Basic Indicators 20052005http://www.paho.org/English/AD/GE/GenderBrochure05.pdf World Health OrganisationThe World Health Report 2005: Make every mother and child count2005GenevaWHO10.1596/978-0-8213-6133-7 The LancetEditorial: Gender equity is the key to maternal and child healthLancet2010375193910.1016/S0140-6736(10)60905-1 Marmot ReviewFair Society, Healthy Lives2010LondonThe Marmot Review AndersonTHow can child and maternal mortality be cut?BMJ2010340c43110.1136/bmj.c43120103527 GreenAGereinNExclusion, inequity and health system development: the critical emphases for maternal, neonatal and child healthBulletin of the World Health Organisation2005836402 NdyomugyenyiRMagnussenPMalaria morbidity, mortality and pregnancy outcome in areas with different levels of malaria transmission in Uganda: a hospital record-based studyTransactions of the Royal Society of Tropical Medicine and Hygiene20019554634681:STN:280:DC%2BD3MnlsVWisA%3D%3D10.1016/S0035-9203(01)90003-311706650 BuehlerJWKaunitzAMHogueCJRHughesJMSmithJCRochatRWMaternal Mortality in Women Aged 35 Years or Older: United StatesJournal of the American Medical Association1986255153571:STN:280:DyaL28%2FmtlShsA%3D%3D10.1001/jama.1986.033700100590253940305 CaldwellJCEducation as a factor in mortality decline. 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| References_xml | – reference: World Health OrganisationThe World Health Report 2005: Make every mother and child count2005GenevaWHO10.1596/978-0-8213-6133-7 – reference: GoldsteinHKendall's Library of Statistics 3: multi-level statistical models1995LondonArnold – reference: UNESCO International Standard Classification of Education. [http://www.unesco.org/education/information/nfsunesco/doc/isced_1997.htm] – reference: Pan American Health AssociationGender, Health and Development in the Americas-Basic Indicators 20052005http://www.paho.org/English/AD/GE/GenderBrochure05.pdf – reference: HortonRThe continued invisibility of women and childrenLancet20103751941194310.1016/S0140-6736(10)60902-620569823 – reference: GreenAGereinNExclusion, inequity and health system development: the critical emphases for maternal, neonatal and child healthBulletin of the World Health Organisation2005836402 – reference: ThaddeusSMaineDToo far to walk: maternal mortality in contextSocial Science and Medicine1994388109111101:STN:280:DyaK2czhslShsg%3D%3D10.1016/0277-9536(94)90226-78042057 – reference: HuntPReport of the UN Special Rapporteur on the right to the highest attainable standard of health to the United Nations General Assembly. UN Doc A/61/3382006New YorkUnited Nations – reference: VillarjValladaresEWojdylaDZavaletaNCarroliGVelazcoAShahACampodónicoLBatagliaVFaundesALangerANarvárezADonnerARomeroMReynosoSSimônia de PáduaKGiordanoDKublickasMAcostaACaesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey of maternal and perinatal health in Latin AmericaLancet20063671819182910.1016/S0140-6736(06)68704-716753484 – reference: CaldwellJCEducation as a factor in mortality decline. An examination of Nigerian dataPopulation Studies19793339541310.2307/2173888 – reference: RonsmansCGrahamWJThe Lancet Maternal Survival Series steering groupMaternal mortality: who, when, where, and whyLancet20063681189120010.1016/S0140-6736(06)69380-X17011946 – reference: McAlisterCBaskettTFFemale education and maternal mortality: a worldwide surveyJournal of Obstetrics Gynaecology Canada2006281198399010.1016/S1701-2163(16)32294-017169224 – reference: Confidential Enquiry into Maternal and Child HealthSaving Mothers Lives: Reviewing maternal deaths to make motherhood safer - 2003-20052007LondonCEMACH – reference: WagstaffAClaesonMThe Millennium Development Goals for health: rising to the challenges2004World Bank – reference: BuehlerJWKaunitzAMHogueCJRHughesJMSmithJCRochatRWMaternal Mortality in Women Aged 35 Years or Older: United StatesJournal of the American Medical Association1986255153571:STN:280:DyaL28%2FmtlShsA%3D%3D10.1001/jama.1986.033700100590253940305 – reference: ArrowsmithSHamlinECWallLLObstructed labor injury complex: Obstetric fistula formation and the multifaceted morbidity of maternal birth trauma in the developing worldObstetrical & Gynecological Survey1996515685741:STN:280:DyaK2s%2Fis12rug%3D%3D10.1097/00006254-199609000-00024 – reference: CampbellOMRGrahamWJThe Lancet Maternal Survival Series steering groupStrategies for reducing maternal mortality: getting on with what worksLancet200636895431284129910.1016/S0140-6736(06)69381-117027735 – reference: Marmot ReviewFair Society, Healthy Lives2010LondonThe Marmot Review – reference: NdyomugyenyiRMagnussenPMalaria morbidity, mortality and pregnancy outcome in areas with different levels of malaria transmission in Uganda: a hospital record-based studyTransactions of the Royal Society of Tropical Medicine and Hygiene20019554634681:STN:280:DC%2BD3MnlsVWisA%3D%3D10.1016/S0035-9203(01)90003-311706650 – reference: FilippiVRonsmansCCampbellOMRGrahamWJMillsABorghiJKoblinskyMOsrinDMaternal health in poor countries: the broader context and a call for actionLancet20063681535154110.1016/S0140-6736(06)69384-717071287 – reference: MenendezCRomagosaCIsmailMRCarrilloCSauteFOsmanNMachungoFBardajiAQuintóLMayorACanicheDDobañoCAlonsoPLOrdiJAn autopsy study of maternal mortality in Mozabique: the contribution of infectious diseasesPLoS Medicine200852e4410.1371/journal.pmed.0050044182888872245982 – reference: BackmanGHuntPKhoslaRJaramillo-StraussCFikreBMRumbleCPevalinDPáezDAPinedaMAFrisanchoATarcoDMotlaghMFarcasanuDVladescuCHealth systems and the right to health: an assessment of 194 countriesLancet20083722047208510.1016/S0140-6736(08)61781-X19097280 – reference: MorrissonCJüttingJPWomen's discrimination in developing countries: a new data set for better policiesWorld Development20053371065108110.1016/j.worlddev.2005.04.002 – reference: HoganMCForemanKJNoghaviMAhnSYWangMMakelaSMLopezADLozanoRMurrayCJLMaternal Mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5Lancet20103751609162310.1016/S0140-6736(10)60518-120382417 – reference: RonsmansCKhlatMAdolescence and risk of violent death during pregnancy in Matlab, BangladeshLancet199935414481:STN:280:DC%2BD3c%2FgvFShtw%3D%3D10.1016/S0140-6736(99)03222-510543680 – reference: NussbaumMCWomen's education: A Global ChallengeSigns200429232535510.1086/378571 – reference: Luque FernándezMÁBuena CavanillasADramaix-WilmetMSoriaFSde Mata Donado CamposJGuilbertDHIncrease in maternal mortality associated with change in the reproductive pattern in Spain: 1996-2005Journal of Epidemiology and Community Health20096343343810.1136/jech.2008.08273519221111 – reference: SinghSDarrochJEAshfordLSVlassoffMAdding it up: The costs and benefits of investing in family planning and maternal and newborn health2009New YorkGuttmacher Institute and United Nations Population Fundhttp://www.unfpa.org/webdav/site/global/shared/documents/publications/2009/adding_it_up_report.pdf – reference: LumbiganonPLaopaiboonMGülmezogluAMSouzaJPTaneepanichskulSRuyanPAttygalleDEShresthaNMoriRNguyenDHHoangTBRathavyTChuyunKCheangKFestinMUdomprasertgulVGermarMJYanqiuGRoyMCarroliGBa-ThikeKFilatovaEVillarJWorld Health Organization Global Survey on Maternal and Perinatal Health Research Group. Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08Lancet2010375971349049910.1016/S0140-6736(09)61870-520071021 – reference: GrownCGuptaGRPandeRTaking action to improve women's health through gender equality and women's empowermentLancet200536554154310.1016/S0140-6736(05)70278-615705464 – reference: RiceNLeylandAMultilevel models: applications to health dataJournal of Health Services Research and Policy1996131541641:STN:280:DyaK1czitFertg%3D%3D10180862 – reference: KhanKSWojdylaDSayLGümezogluAMVan LookPFAWHO analysis of causes of maternal death: a systematic reviewLancet20063671066107410.1016/S0140-6736(06)68397-916581405 – reference: ShenCWilliamsonJBMaternal mortality, women's status, and economic dependency in less developed countries: a cross-national analysisSocial Science & Medicine19994921972141:STN:280:DyaK1MzktFOqtw%3D%3D10.1016/S0277-9536(99)00112-4 – reference: KleczkowskiBMRoemerMIVan der WerffANational health systems and their reorientation towards health for all guidlines for policy-making. Public Health Paper No.771984GenevaWHO – reference: VillarJCarroliGZavaletaNDonnerAWojdylaDFaundesAVelazcoABatagliaVLangerANarváezAValladaresEShahACampodónicoLRomeroMReynosoSSimônia de PáduaKGiodanoDKublickasMAcostaAWHO 2005 Global Survey on Maternal and Perinatal Health Research GroupMaternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective studyBMJ2007335102510.1136/bmj.39363.706956.55179778192078636 – reference: World Health OrganisationTrends in maternal mortality: 1990 to 2008. 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Approximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered avoidable.... Approximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered avoidable. Millennium... Background Approximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered avoidable.... Abstract Background Approximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered... |
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| Title | The relationship between maternal education and mortality among women giving birth in health care institutions: Analysis of the cross sectional WHO Global Survey on Maternal and Perinatal Health |
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