Linking high parity and maternal and child mortality: what is the impact of lower health services coverage among higher order births?

BMC Public Health

Review

Emily Sonneveldt¹  John Stover¹  Willyanne DeCormier Plosky¹ 

[1] Futures Institute, Glastonbury, CT, USA;

关键词: Child Mortality;    High Parity;    Maternal Mortality Ratio;    Institutional Delivery;    Skilled Birth Attendance;   

DOI  :  10.1186/1471-2458-13-S3-S7

来源: Springer

【 摘 要 】

BackgroundA number of data sets show that high parity births are associated with higher child mortality than low parity births. The reasons for this relationship are not clear. In this paper we investigate whether high parity is associated with lower coverage of key health interventions that might lead to increased mortality.MethodsWe used DHS data from 10 high fertility countries to examine the relationship between parity and coverage for 8 child health intervention and 9 maternal health interventions. We also used the LiST model to estimate the effect on maternal and child mortality of the lower coverage associated with high parity births.ResultsOur results show a significant relationship between coverage of maternal and child health services and birth order, even when controlling for poverty. The association between coverage and parity for maternal health interventions was more consistently significant across countries all countries, while for child health interventions there were fewer overall significant relationships and more variation both between and within countries. The differences in coverage between children of parity 3 and those of parity 6 are large enough to account for a 12% difference in the under-five mortality rate and a 22% difference in maternal mortality ratio in the countries studied.ConclusionsThis study shows that coverage of key health interventions is lower for high parity children and the pattern is consistent across countries. This could be a partial explanation for the higher mortality rates associated with high parity. Actions to address this gap could help reduce the higher mortality experienced by high parity birth.

【 授权许可】

CC BY   
© Sonneveldt et al; licensee BioMed Central Ltd. 2013