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Maternal Mortality in Colombia in 2011: A Two Level Ecological Study

Author

Listed:
  • Luz Mery Cárdenas-Cárdenas
  • Karol Cotes-Cantillo
  • Pablo Enrique Chaparro-Narváez
  • Julián Alfredo Fernández-Niño
  • Angel Paternina-Caicedo
  • Carlos Castañeda-Orjuela
  • Fernando De la Hoz-Restrepo

Abstract

Objective: Maternal mortality reduction is a Millennium Development Goal. In Colombia, there is a large disparity in the maternal mortality ratio (MMR) between and into departments (states) and also between municipalities. We examined socioeconomics variables at the municipal and departmental levels which could be associated to the municipal maternal mortality in Colombia. Methods: A multilevel ecology study was carried out using different national data sources in Colombia. The outcome variable was the MMR at municipal level in 2011 with multidimensional poverty at municipal and department level as the principal independent variables and other measures of the social and economic characteristics at municipal and departmental level were also considered explicative variables (overall fertility municipal rate, percentage of local rural population, health insurance coverage, per capita territorial participation allocated to the health sector, transparency index and Gini coefficient). The association between MMR and socioeconomic contextual conditions at municipal and departmental level was assessed using a multilevel Poisson regression model. Results: The MMR in the Colombian municipalities was associated significantly with the multidimensional poverty (relative ratio of MMR: 3.52; CI 95%: 1.09-11.38). This association was stronger in municipalities from departments with the highest poverty (relative ratio of MMR: 7.14; CI 95%: 2.01-25.35). Additionally, the MMR at municipal level was marginally associated with municipally health insurance coverage (relative ratio of MMR: 0.99; CI 95%: 0.98-1.00), and significantly with transparency index at departmental level (relative ratio of MMR: 0.98; CI 95%: 0.97-0.99). Conclusion: Poverty and transparency in a contextual level were associated with the increase of the municipal MMR in Colombia. The results of this study are useful evidence for informing the public policies discussion and formulation processes with a differential approach.

Suggested Citation

  • Luz Mery Cárdenas-Cárdenas & Karol Cotes-Cantillo & Pablo Enrique Chaparro-Narváez & Julián Alfredo Fernández-Niño & Angel Paternina-Caicedo & Carlos Castañeda-Orjuela & Fernando De la Hoz-Restrepo, 2015. "Maternal Mortality in Colombia in 2011: A Two Level Ecological Study," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-14, March.
    • Handle: RePEc:plo:pone00:0118944
    DOI: 10.1371/journal.pone.0118944
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    1. Hausman, Jerry, 2015. "Specification tests in econometrics," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 38(2), pages 112-134.
    2. Roumeen Islam, 2006. "Does More Transparency Go Along With Better Governance?," Economics and Politics, Wiley Blackwell, vol. 18(2), pages 121-167, July.
    3. Roberto Carlos Angulo Salazar & Yadira Díaz Cuervo & Renata Pardo, 2011. "Índice de Pobreza Multidimensional para Colombia," Archivos de Economía 9228, Departamento Nacional de Planeación.
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