title: Maternal mortality regionalization and trend in Mexico (1937-1995)
abstract: BACKGROUND
  The objectives were to establish regions by level of maternal mortality in order to evaluate its trend from 1937-1995 and to analyze characteristics of cases which occurred from 1990-1995.
  
  
  METHODS
  Regionalization of the country by maternal mortality level was carried out using Poisson regression. Level and mortality trends were analyzed globally and compared by regions using Poisson and linear regression. Characteristics of cases were analyzed from 1990-1995 using proportions and X2 test.
  
  
  RESULTS
  Four well-differentiated and independent regions were established. Low and medium maternal mortality rate regions were found in northern and northwestern Mexico. High and very high maternal mortality regions were found in the South and the Southeast of the country. Even when maternal mortality had descended, the speed of the descent has decreased and in the last few years, maternal mortality has increased. The quality of health care is a challenge for regions with low mortality rates, while the problem of accessibility is present in those with very high mortality rates.
  
  
  CONCLUSIONS
  The employment of this regionalization approach in maternal mortality analysis would be useful to determine specific problems for each region. The establishment of programs according to this analysis could contribute to decrease in maternal mortality cases in Mexico.
authors.affiliation: División de Investigación Epidemiológica y en Servicios de Salud, Coordinación de Investigación Médica, Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, México, D.F. sandrar@cim.spin.com.mx
authors.forename: S
authors.initials: S
authors.lastname: Reyes Frausto
authors.forename: M A
authors.initials: MA
authors.lastname: Lezana Fernández
authors.forename: M D
authors.initials: MD
authors.lastname: García Peña
authors.forename: J L
authors.initials: JL
authors.lastname: Bobadilla Fernández
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008428:Maternal Mortality / Q000639:trends*; D008800:Mexico / Q000453:epidemiology; D012189:Retrospective Studies