title: Maternal mortality and its correlates: practical implications of data analysis across multiple countries.
abstract: OBJECTIVE
  Studies of maternal mortality that use data from multiple countries often identify statistically significant correlates and interpret them as factors relevant to policy. This study was designed to address the fragility of a statistical association between the maternal mortality rate and its main correlates, and to assess the relevance of multi-country data analysis for policy making.
  
  
  METHODS
  Patterns of variation in the maternal mortality rate associated with the fertility rate, income per capita, primary and secondary school enrollment, institutional quality, women's participation in politics, and health systems indicators across 111 countries in 2000 and 128 countries in 2005 were investigated using a linear multilevel modelling approach.
  
  
  RESULTS
  The fertility rate and income per capita were the only robust predictors of the maternal mortality rate. Health systems indicators and school enrollment, after controlling for the effect of the fertility rate, income per capita, and region-specific contextual factors, were found to be unstable direct predictors of the maternal mortality rate.
  
  
  CONCLUSIONS
  Although multi-country comparative studies can identify key correlates of the maternal mortality rate, policy recommendations to reduce maternal mortality should be based on causal models that take contextual factors into account.
authors.affiliation: Department of Economics, University of Regina, Regina SK.
authors.forename: Ken Imanak
authors.initials: KI
authors.lastname: Sagynbekov
mesh_terms: D001723:Birth Rate; D004522:Educational Status; D005260:Female; D014943:Global Health / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008428:Maternal Mortality / Q000639:trends*; D015233:Models, Statistical; D055361:Multilevel Analysis; D018743:Perinatal Care / Q000592:standards; D011247:Pregnancy; D013223:Statistics as Topic; D014944:World Health Organization
keywords: birth rate; income; maternal mortality; maternal welfare