Linda Bartlett|Amnesty LeFevre|Linnea Zimmerman|Sayed Ataullah Saeedzai|Sabera Turkmani|Weeda Zabih|Hannah Tappis|Stan Becker|Peter J. Winch|Marge Koblinsky|Ahmed Javed Rahmanzai
Progress and inequities in maternal mortality in Afghanistan (RAMOS-II): a retrospective observational study
Johns Hopkins University|Johns Hopkins University|Johns Hopkins University|Ministry of Public Health|Johns Hopkins University|University of Technology Sydney|Johns Hopkins University|Johns Hopkins University|Institute for Clinical Evaluative Sciences|Hospital for Sick Children|SickKids Foundation|Johns Hopkins University|Johns Hopkins University|United States Agency for International Development|Johns Hopkins University
risk maternal death afghanistan among highest world however risks within country poorly understood subnational maternal mortality estimates needed along broader understanding determinants guide future maternal health programmes aimed study maternal mortality risk causes careseeking patterns costs within countrywe household survey ramosii urban area kabul city rural area ragh badakshan questionnaires administered senior female household members data collected team female interviewers secondary school education information collected deaths livebirths stillbirths healthcare access costs household income assets births documented using pregnancy history investigated deaths women reproductive age 1249 years since january 2008 using verbal autopsy community members service providers district provincial national officials district interviewed elicit perceptions changes maternal mortality risk health service provision along programme policy documentation maternal care coveragedata collected march 2 2011 oct 16 2011 130 688 participants 63 329 kabul 67 359 ragh maternal mortality ratio ragh quadruple kabul 713 per 100 000 livebirths 95 ci 553873 ragh vs 166 63270 kabul recorded similar patterns maternal death indicators including maternal mortality rate 17 per 1000 women reproductive age 95 ci 1321 ragh vs 02 0103 kabul infant mortality also differed significantly two areas 1155 per 1000 livebirths 95 ci 10861223 ragh vs 248 205290 kabul kabul 5594 82 6789 women reported skilled attendant recent deliveries compared 381 3 11 366 women ragh estimated 85 women kabul 47 ragh incurred delivery costs mean us6620 iqr 6130 kabul 989 1187 ragh maternal complications third leading cause death women reproductive age kabul leading cause ragh mainly due hypertensive diseases pregnancy maternal mortality rate decreased significantly 2002 2011 kabul 71 ragh 84 plus maternal mortality indicators raghremarkable maternal mortality reductions occurred afghanistan disparity urban rural sites alarming maternal mortality indicators significantly higher ragh kabul customised service delivery needed ensure parity different geographic security settingsunited states agency international development usaid