Farid Midhet|Stan Becker|Heinz W. Berendes
Contextual determinants of maternal mortality in rural Pakistan
Eunice Kennedy Shriver National Institute of Child Health and Human Development|Johns Hopkins University|Eunice Kennedy Shriver National Institute of Child Health and Human Development
maternal mortality high pakistan particularly rural areas poor access health services investigated risk factors associated maternal mortality sixteen rural districts balochistan northwest frontier nwfp provinces pakistan designed nested casecontrol study comprising 261 cases maternal deaths reported last five years 9135 controls women survived pregnancy last five years using contextual analysis estimated interactions biological risk factors maternal mortality districtlevel indicators health services women 19 39 yr age first birth previous history fetal loss greater risk maternal death staffing patterns peripheral health facilities district accessibility essential obstetric care eoc significantly associated maternal mortality indicators also modified effects biological risk factors maternal mortality example nulliparous women living underserved districts greater risk living betterserved districts results consistent several studies pointed role health services causation maternal mortality many studies implicated distance hospital indicator access eoc lack prenatal care major determinants maternal mortality conclude better staffing peripheral health facilities improved access eoc could reduce risk maternal mortality among women rural balochistan nwfp