title: Impacts of maternal mortality on living children and families: A qualitative study from Butajira, Ethiopia.
abstract: BACKGROUND
  The consequences of maternal mortality on orphaned children and the family members who support them are dramatic, especially in countries that have high maternal mortality like Ethiopia. As part of a four country, mixed-methods study (Ethiopia, Malawi, South Africa, and Tanzania) qualitative data were collected in Butajira, Ethiopia with the aim of exploring the far reaching consequences of maternal deaths on families and children.
  
  
  METHODS
  We conducted interviews with 28 adult family members of women who died from maternal causes, as well as 13 stakeholders (government officials, civil society, and a UN agency); and held 10 focus group discussions with 87 community members. Data were analyzed using NVivo10 software for qualitative analysis.
  
  
  RESULTS
  We found that newborns and children whose mothers died from maternal causes face nutrition deficits, and are less likely to access needed health care than children with living mothers. Older children drop out of school to care for younger siblings and contribute to household and farm labor which may be beyond their capacity and age, and often choose migration in search of better opportunities. Family fragmentation is common following maternal death, leading to tenuous relationships within a household with the births and prioritization of additional children further stretching limited financial resources. Currently, there is no formal standardized support system for families caring for vulnerable children in Ethiopia.
  
  
  CONCLUSIONS
  Impacts of maternal mortality on children are far-reaching and have the potential to last into adulthood. Coordinated, multi-sectorial efforts towards mitigating the impacts on children and families following a maternal death are lacking. In order to prevent impacts on children and families, efforts targeting maternal mortality must address inequalities in access to care at the community, facility, and policy levels.
authors.forename: Mitike
authors.initials: M
authors.lastname: Molla
authors.forename: Israel
authors.initials: I
authors.lastname: Mitiku
authors.forename: Alemayehu
authors.initials: A
authors.lastname: Worku
authors.forename: Alicia
authors.initials: A
authors.lastname: Yamin
mesh_terms: D000293:Adolescent; D000328:Adult; D017028:Caregivers / Q000191:economics / Q000706:statistics & numerical data; D002648:Child; D002669:Child Welfare / Q000191:economics / Q000706:statistics & numerical data; D054540:Child, Orphaned / Q000523:psychology / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003906:Developing Countries; D005002:Ethiopia / Q000453:epidemiology; D005192:Family Health / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D063130:Maternal Death / Q000191:economics / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D054238:Perinatal Mortality; D011159:Population Surveillance; D011203:Poverty; D036301:Qualitative Research; D012423:Rural Health / Q000706:statistics & numerical data; D012944:Social Support; D012959:Socioeconomic Factors; D055815:Young Adult