In the country, the efforts to end preventable maternal mortality is at the top of the health sector’s agenda in line with the SDGs as the issue was targeted in the 2015 health sector transformation plan [10]. As the study used secondary data, there were incomplete or mislabelled variables, restricted variable data, inconsistent values, and missing records. Some of the major statistical parameters computed were the following: MMR, pregnancy related death ratio, maternal mortality rate, lifetime risk of maternal deaths, and proportion of maternal deaths among female deaths. The HDSS is a member of INDEPTH network [21]. Lancet. Google Scholar. 2007;77(4):770–9. As a result, alternating logistic regression which measures pairwise association of two observations in the same household and follow the precision estimates for both the regression (β) and the association (α) parameters considered [18, 21]. 2015 [cited 28/12/2015]. Most of these children (80%) are from sub-Saharan African and Southern Asia. More than 50% of all maternal deaths were from just six countries: Ethiopia, India, Nigeria, Pakistan, Afghanistan, and the Democratic Republic of Congo [14, 15]. Zeleke AT, Alemu ZA. Asia Pac Fam Med. The field coordinator checked 1% of the questionnaires in a similar manner. Cookies policy. This highlights that partner violence, including murder and other injuries or accidents to women, contributes to the rates of death among pregnant and postpartum women to a considerable extent in Ethiopia. California Privacy Statement, BMC Infect Dis. In Kersa HDSS catchment population, there are six health centres, 20 health posts, and five clinics. Future interventions on maternal health in this setting should also be tailored in such a way that women are educated through existing mother peer groups or Women’s Development Army networks at the village level. 12 Taking sTock of MaTERnaL, nEWBoRn and cHiLd sURViVaL 2000–2010 decade report majority of maternal deaths occur. PubMed Google Scholar. These approaches have included improving access to and strengthening facility-based maternal health services [7]. Child mortality reflects a country’s level of socio-economic development and quality of life. The interpretation rely on the ALR model. Yaya Y, Lindtjørn B. The number of maternal deaths per each year and the corresponding MMRs with confidence intervals are presented in Table 2. Lastly, the results indicate that children from some of regions like Amhara, Afar, Dire Dawa, Gambela, Oromia, SNNPR and Tigray are at higher risk of diarrheal morbidity compared to children from Addis Ababa. The study found an overall incidence of diarrhea and fever 12 and 14% respectively. Mother marital status is the other important covariate that has a statistically significant relation with child fever disease. VA is a method of interviewing close relatives or caregivers of the dead person about the circumstances, signs, and symptoms that occurred before the death event and the respondent will answer in his/her own words [24]. J Epidemiol Global Health. (0.5529) =1.738 times higher odds of had diarrhea than those whose age group between 24 and 59 months. For further study, we will focus on the geographic and socioeconomic determinants of childhood morbidity in Ethiopia. Lancet. These findings indicate that the first few hours and days after giving birth are a critical period during which mothers should receive immediate attention from health care providers at a health facility to avert catastrophic maternal deaths. Health and Demographic Surveillance System. The estimated pregnancy related mortality ratio was 543 per 100,000 live births (95% CI: 437, 663). J Glob Health. Confidentiality of data maintained anonymously. Despite efforts at curbing maternal morbidity and mortality, developing countries are still burdened with high rates of maternal morbidity and mortality. Ethiop J Health Sci. BMC Public Health 19, 942 (2019). 2005;365:347–53. Table 3 presents that the estimated constant log odds ratios, which provides information about association between households within the same cluster. As the study done in the Eastern part of Ethiopia at Kersa Health and Demographic surveillance indicated bacterial sepsis is the leading cause accounting for 31.2% followed by birth asphyxia and perinatal respiratory distress 28.2 The reason for the observed high LTR of maternal death in the present study might be related to the less precise estimation of the indicator using Mmrate. In Ethiopia, the burden of child mortality is alarming and calls for determined efforts in combating such health problems. Morbidity and mortality of childhood illnesses at the emergency paediatric unit of the University of Benin Teaching Hospital, Benin City. According to the country’s 2014 population projection, the district has an estimated total population of 205,628. Quality assurance measures were embedded into all aspects of the surveillance process. The analysis used surveillance data extracted from the Kersa HDSS database for the duration of 2008 to 2014. The data were mainly extracted from a verbal autopsy database. Trends in Maternal Mortality: 1990 to 2013. Alkema L, Chou D, Hogan D, Zhang S, Moller A, Gemmill A, et al. When prioritising by child mortality strata, for the very high mortality countries, the focus should still be on the leading infectious causes, such as pneumonia, malaria, and diarrhoea. Though the majority of the pregnancy-related deaths were due to causes related to pregnancy or childbirth, non-obstetric causes such as partner violence and transport accidents were also contributors. Lastly, exchangeable working correlation assumption was found to be more plausible than the other working correlation assumptions based on comparison of empirical and model based standard errors for the parameter estimates since the two standard errors were very close. Hogan C. Maternal mortality for 181 countries, 1980–2008: a systematic analysisof progress towards MDG5. CSA. PubMed  Furthermore, the analysis suggests that breast-feeding status is associated to children fever disease. OConnell BJ, Quinn MA, Scheuerman P. Risk factors of diarrheal disease among children in the east African countries of Burundi Rwanda and Tanzania. From 2008 to 2014, there were 12 kebeles under the Kersa HDSS and the current study considered the data that was drawn from this surveillance population. WHO. However, a larger proportion (84.6%) of the mothers at same time received treatment at government clinics during the course of the health condition that led to their death. This study examines the role of parental education in reducing excess child mortality in Africa by considering Tigrai-Ethiopia, which was severely affected by famine and civil war during 1973–1991. Hence, the study demonstrates the utility of estimating maternal mortality based on HDSS data to inform policy and enable locally appropriate program development. Google Scholar. Community-based initiatives that aim to improve maternal health should be strengthened further to reduce the prevailing maternal mortality. The results of the study are similar to a study conducted in Mozambique, in which it was reported that a combination of partner violence and injury were the fourth leading cause of maternal death [32]. WHO. Traditional healers, including TBAs, still play a paramount role in rendering services at the community level but it has been shown that they are not effective in improving maternal health even when trained [36, 37]. (− 0.2352) = 0.79 times lower than the estimated odds for mother paid employment. Since 2000, Ethiopia has reduced maternal and child mortality by half, but a maternal mortality rate of 412 per 100,000 live births and child mortality rate of 67 per 1,000 are still too high. Children whose age group between 12 and 23 months are more probable to had diarrhea and fever morbidity than whose age group between 24 and 59 months. Summary and Statistical Report of 2007 Population and Housing Census. Causes of maternal mortality in ethiopia: a significant decline in abortion related death. BMC Women's Health Working together for health. In ALR model parameter reflects the effect of predictors on the log odds of probability of diarrhea controlling all the other predictors in the model. 1), though there is no statistical significance for the reduction (χ2 = 0.56 and P = 0.57). Among those who died after giving birth, the majority (66.7%) gave birth at home. We used Chi-squared test to determine the significance of the trend over time. From all the women deaths in the reproductive age, the data of those women who were not pregnant or beyond 42 days after birth during the time of death were excluded. At the beginning of the surveillance year, the MMR overlapped at 124 per 100,000 live births for the three seasons (winter, autumn and summer). CSACE I. Ethiopia Demographic and Health Survey 2016. WHO. The survey included questions designed to explore sociodemographic, socioeconomic, child health, maternal and environmental conditions at household level. In Ethiopia, the burden of child mortality is alarming and calls for determined efforts in combating such health problems. Children whose age group between 12 and 23 months is exp. Kandala NB, Ji C, Stallard N, Stranges S, Cappuccio FP. The temporal trend of maternal mortality was also conducted to demonstrate the seasonal variation. Niger J Paediatr. 2005. Therefore, this study aimed to investigate the risk factors for childhood morbidity specifically for diarrhea and fever. The analysis was conducted in STATA software. Newborn death accounts for nearly half of under-five death. This was generated from the VA database using the corresponding VA code. Ethiopia is not an exception and has one of the world’s highest rates of maternal deaths. Privacy With regards to injuries or accidents, only 3% of the deceased mothers were known to have a history of injuries or accidents, such as suicide and insect bites, surrounding their deaths. NA has participated in data acquisition, data analysis, revision of the paper for intellectual content and have participated in the drafting of the manuscript. With this GEE model, the correlation structure of the data within each household was assumed to be of the independence, unstructured, exchangeable, and first order auto-regressive [20]. 3). Infect Dis Poverty. Google Scholar. This finding is in line with that of [3, 6, 24]. This survey is the fourth cross-sectional investigation administered at household level. Sarmento D. Traditional birth attendance (TBA) in a health system: what are the roles, benefits and challenges: a case study of incorporated TBA in Timor-Leste. However, the country's performance regarding non-communicable diseases, including car … However, the observed MMR across the seven-year period appears to decline. Perhaps strategies should be designed to provide focused training to TBAs so as to make them capable of recognizing the critical time to seek health care for women in their village [38]. 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. Targeted information education and communication should be provided. 2015;31:180–92. Out of the total 311 deaths of reproductive aged women during the study period, 72 (23.2%) died during pregnancy or within 42 days of delivery. Descriptive statistics consisting of frequency and proportion were performed to summarize the main variables. 2012;2(1):398. This result is in agreement with previous findings such as [24, 25] among others. Enumeration areas (EA) were the sampling units for the first stage and list of households in EA were the sampling unit in the second stage. Even though the MMR is below the sub-Saharan Africa average, it is higher than the world average, as is the case with other sub-Saharan African countries such as Sudan, Ghana, and Rwanda (Fig. Identification of determinants of children diseases tends to assist to guide strategic planning, address strength and weakness of current policy, prioritize future research questions and interventions for addressing children morbidity and mortality problem in Ethiopia. In this study, the majority (62.8%) of the mothers died after giving birth and more than half (55.6%) died within the first day. This might most likely suffer from respondents’ information bias, which may lead to misclassification of the underlying cause of death. The level of MMR for each year starting from 2008 and up to 2014 were calculated in the same manner and the trend at different years were plotted. Regression analysis for correlated data. In 2019, under-5 mortality rate for Ethiopia was 50.7 deaths per thousand live births. 2015;387:462–74. 2012;12:136. WHO. Google Scholar. 2014;:14(4):9. The finding highlights that since the winter season has heavy rain falls, the road may get muddy, the rivers might become full and rural bridges could be damaged. The present study reported that low birth weight 35.8%, neonatal sepsis 28.6% and hypothermia 26.2% were found to be the three predominant causes of neonatal admissions. However, during the same period, the MMR reduction in sub-Saharan Africa remained stalled and most countries in the region registered sluggish progress in reducing maternal mortality [3,4,5]. In addition, there is a paucity of information with regards to the local level magnitude and causes of maternal mortality at the community setting in Ethiopia. 2010;375(9726):14. UN. Patricia EB, José AS, Lucinda G. Obstetric complications: does training traditional birth attendants make a difference? 2014. WHO. Most of these investigations used logistic regression to identify the significant risk factors of diseases that associated to children morbidity [6, 12,13,14,15]. 2006;367(9516):1066–74. Postpartum Hemorrhage (PPH) remains to be the leading cause of maternal mortality in 2,9]. In addition, GEE is non-likelihood method that captures the association within households in terms of marginal correlations [18]. Kumi-Kyereme A, Amo-Adjei J. BMC Public Health In addition, other articles focused only on diarrhea, using simple statistical analyses [12, 16, 17]. The authors would like to declare that they have no competing interests. 2017;17(1):426. In order to select important covariates related to diarrhea and fever backward selection method was used. Regardless of the considerable improvement in reducing childhood death, childhood survival persists a critical concern. Generalized Estimating Equation (GEE) and Alternating Logistic Regression (ALR) were used to model childhood morbidity, and compare the odds of a child being had diarrhea and /or fever given the various risk factors considered. The analysis under ALR suggests that child age is significantly associated to diarrhea disease and it was revealed that children who are between age group 0–11 months had exp. In addition, it was revealed that, the estimated odds of had diarrhea for children from regions of Afar, Amhara, Dire Dawa, Gambela, Oromia, SNNPR and Tigray are respectively 75, 114, 32, 115, 107, 67, 99 and 86% more than the estimated odds of children from the central region (Addis Ababa). Across the seven-year period all Regions at Wereda level from 2014–2017 evidence on the geographic and determinants. Age range logistic leading cause of child mortality in ethiopia models fit for this study are available by requesting Kersa HDSS, Haramaya University larger the! 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