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Title 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)

Full text http://dx.doi.org/10.1186/1742-4755-12-S1-S7; http://hdl.handle.net/1885/100581

Date 2015

Author(s) Houle, Brian; Clark, Samuel J; Kahn, Kathleen; Tollman, Stephen; Yamin, Alicia E

Abstract 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.

Language en

Publisher BioMed Central

Type of publication Journal article

Source Reproductive Health

Rights © Houle et al; licensee BioMed Central Ltd. 2015 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://​creativecommons.​org/​licenses/​by/​4.​0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://​creativecommons.​org/​publicdomain/​zero/​1.​0/​) applies to the data made available in this article, unless otherwise stated.; Houle et al; licensee BioMed Central Ltd.

Repository Canberra - Australian National University

Added to C-A: 2016-04-25;09:38:52

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