Spatial Distribution of Maternal Mortality in Ethiopia: Further Analysis of Ethiopian Demo¬graphic and Health Survey

Weldesenbet Adisu Birhanu; Tusa Biruk Shalmen; Adem Ali Mekonen; Aychiluhm Setognal Birara; Endeshaw Amare Muchie; Sisay Malede Mequanent; Regassa  Lemma Demissie; Gemeda Assefa Tola

Weldesenbet Adisu Birhanu
Tusa Biruk Shalmen
Adem Ali Mekonen
Aychiluhm Setognal Birara
Endeshaw Amare Muchie
Sisay Malede Mequanent
Regassa Lemma Demissie
Gemeda Assefa Tola

Abstract

Background: Maternal mortality is one of the major public health problems challenging the medical community, especially in developing countries. In Ethiopia, despite great emphasis to reduce maternal mortality, it is still high indicating progress in improving maternal health is inadequate. Identifying hotspot areas with a high prevalence of maternal mortality is important to design evidence-based interventions and reduce maternal mortality. Despite this fact, the geographical distribution of maternal mortality in Ethiopia remains unclear. Therefore, this study aimed to explore the spatial distribution of maternal mortality in Ethiopia.

Methods: Community-based cross-sectional study design was employed in the 2016 Ethiopian Demographic and Health Survey. A total of 12790 women were included in this analysis. The distribution of maternal mortality across the country was observed by ArcGIS software. Getis-Ord Gi* statistics were used to identify the hot and cold spot areas for maternal mortality.

Results: The spatial distribution of maternal mortality in Ethiopia was found to be clustered with Global Moran’s I = 0.031 [p value < 0.0001]. Hotspot areas with high clustering of maternal mortality were identified in five administrative zones of Tigray regional states, four zones of Afar regional state, one South Nations Nationalities and Peoples zone of Amhara regional state, two zones of Oromia regional state, one zone of the Somali region, and one zone of SNNP. Cold spot areas with low significant clustering of maternal mortality were identified in Addis Ababa, three zones of the Amhara region, five zones of the Oromia regional state, five zones of SNNP, and two zones of the Gambella region.

Conclusion: Spatial distribution of maternal mortality in Ethiopia is non-random and varies from region to region. The clustered hot spot areas with high clustering were identified in Tigray, Afar, Amhara, Somali, SNNP, and Oromia regions whereas cold spot areas with low clustering of maternal mortality rates were detected in Oromia, SNNP, Gambella, and Amhara regions. Therefore, this study recommended strengthening maternal health programs by targeting Tigray, Afar, Amhara Somali, SNNP, and Oromia regions.

Keywords: Maternal mortality; Spatial Analysis; Ethiopian demographic and health survey; Ethiopia

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