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The impacts of maternal mortality and cause of death on children's risk of dying in rural South Africa: evidence from a population based surveillance study (1992-2013)
Australian Demographic and Social Research Institute, The Australian National University; Institute of Behavioral Science, University of Colorado at Boulder; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand.
Institute Behavioral Science, University of Colorado at Boulder; MRC/Wits Rural Public Health and Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand; Department of Sociology, University of Washington; INDEPTH Network.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Institute of Behavioral Science, University of Colorado at Boulder; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand; NDEPTH Network.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Institute of Behavioral Science, University of Colorado at Boulder; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand; INDEPTH Network.
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2015 (English)In: Reproductive Health, ISSN 1742-4755, E-ISSN 1742-4755, Vol. 12, no Suppl 1, S7Article in journal (Refereed) Published
Abstract [en]

Background: Maternal mortality, the HIV/AIDS pandemic, and child survival are closely linked. This study contributes evidence on the impact of maternal death on children's risk of dying in an HIV-endemic population in rural South Africa. Methods: We used data for children younger than 10 years from the Agincourt health and socio-demographic surveillance system (1992-2013). We used discrete time event history analysis to estimate children's risk of dying when they experienced a maternal death compared to children whose mother survived (N=3,740,992 child months). We also examined variation in risk due to cause of maternal death. We defined mother's survival status as early maternal death (during pregnancy, childbirth, or within 42 days of most recent childbirth or identified cause of death), late maternal death (within 43-365 days of most recent childbirth), any other death, and mothers who survived. Results: Children who experienced an early maternal death were at 15 times the risk of dying (RRR 15.2; 95% CI 8.3-27.9) compared to children whose mother survived. Children under 1 month whose mother died an early (p=0.002) maternal death were at increased risk of dying compared to older children. Children whose mothers died of an HIV/AIDS or TB-related early maternal death were at 29 times the risk of dying compared to children with surviving mothers (RRR 29.2; 95% CI 11.7-73.1). The risk of these children dying was significantly higher than those children whose mother died of a HIV/AIDS or TB-related non-maternal death (p=0.017). Conclusions: This study contributes further evidence on the impact of a mother's death on child survival in a poor, rural setting with high HIV prevalence. The intersecting epidemics of maternal mortality and HIV/AIDS especially in sub-Saharan Africa - have profound implications for maternal and child health and well-being. Such evidence can help guide public and primary health care practice and interventions.

Place, publisher, year, edition, pages
BioMed Central, 2015. Vol. 12, no Suppl 1, S7
Keyword [en]
Maternal mortality, HIV, Child mortality, Infant mortality, South Africa, rural, health and demographic surveillance system
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-106272DOI: 10.1186/1742-4755-12-S1-S7ISI: 000353983500007PubMedID: 26000547OAI: oai:DiVA.org:umu-106272DiVA: diva2:841107
Available from: 2015-07-10 Created: 2015-07-09 Last updated: 2017-12-04Bibliographically approved

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