title: Time series analysis of maternal mortality in Africa from 1990 to 2005.
abstract: OBJECTIVE
  Most global maternal deaths occur in Africa and Asia. In response, the Millennium Development Goal (MDG-5) calls for a 75% reduction in maternal mortality from 1990 to 2015. To assess the potential for progress in MDG-5 in Africa, we examined the cross-sectional and longitudinal associations of socioeconomic, demographic and population-health factors with maternal mortality rates in Africa.
  
  
  METHODS
  We used data from global agencies and the published literature to identify socioeconomic, demographic and population-health explanatory factors that could be correlated with maternal mortality in 49 countries of Africa for the years 1990, 1995, 2000 and 2005. We used correlation, negative binomial and mixed Poisson regression models to investigate whether there exist associations between potential explanatory factors and maternal mortality.
  
  
  RESULTS
  Some African countries have made substantial progress towards achieving MDG-5 while others have fallen behind. Lower gross domestic product (GDP) and female enrolment in primary schools, but higher HIV prevalence, neonatal mortality rate and total fertility rate, were associated with higher maternal mortality.
  
  
  CONCLUSIONS
  Maternal mortality rates in African countries appear to be declining. The mean maternal mortality ratios in Africa decreased from 695.82 in 1990 to 562.18 in 2005. Yet some countries are more likely than others to achieve MDG-5. Better socioeconomic, demographic and population health development appear to be conducive to better maternal health in Africa. Sustained efforts on all these fronts will be needed to close the gap in maternal survival and achieve MDG-5 in Africa.
authors.affiliation: Department of Epidemiology, UCLA Fielding School of Public Health, , Los Angeles, California, USA.
authors.forename: Maral
authors.initials: M
authors.lastname: DerSarkissian
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Thompson
authors.forename: Onyebuchi A
authors.initials: OA
authors.lastname: Arah
mesh_terms: D000328:Adult; D000349:Africa / Q000453:epidemiology; D001723:Birth Rate / Q000639:trends*; D046688:Child Mortality / Q000639:trends*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D014943:Global Health; D006040:Goals; D059066:Gross Domestic Product; D015658:HIV Infections / Q000453:epidemiology; D006291:Health Policy; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008428:Maternal Mortality / Q000639:trends*; D008429:Maternal Welfare; D016017:Odds Ratio; D011158:Population Growth; D015995:Prevalence; D012959:Socioeconomic Factors
keywords: INTERNATIONAL HLTH; MATERNAL HEALTH; MORTALITY; TIME-SERIES