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The Effects of Maternal Mortality on Infant and Child Survival in Rural Tanzania: A Cohort Study

Abstract

Objectives

The full impact of a maternal death includes consequences faced by orphaned children. This analysis adds evidence to a literature on the magnitude of the association between a woman’s death during or shortly after childbirth, and survival outcomes for her children.

Methods

The Ifakara and Rufiji Health and Demographic Surveillance Sites in rural Tanzania conduct longitudinal, frequent data collection of key demographic events at the household level. Using a subset of the data from these sites (1996–2012), this survival analysis compared outcomes for children who experienced a maternal death (42 and 365 days definitions) during or near birth to those children whose mothers survived.

Results

There were 111 maternal deaths (or 229 late maternal deaths) during the study period, and 46.28 % of the index children also subsequently died (40.73 % of children in the late maternal death group) before their tenth birthday—a much higher prevalence of child mortality than in the population of children whose mothers survived (7.88 %, p value <0.001). Children orphaned by early maternal deaths had a 51.54 % chance of surviving to their first birthday, compared to a 94.42 % probability for children of surviving mothers. A significant, but lesser, child survival effect was also found for paternal deaths in this study period.

Conclusions

The death of a mother compromises the survival of index children. Reducing maternal mortality through improved health care—especially provision of high-quality skilled birth attendance, emergency obstetric services and neonatal care—will also help save children’s lives.

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Acknowledgments

We thank our collaborators at the Ifakara Health Institute (IHI) for providing us with the data for this study. We thank Vanessa Boulanger for coordinating between IHI and Harvard. This Project has been conducted with support from The John and Katie Hansen Family Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Correspondence to Jocelyn E. Finlay.

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Finlay, J.E., Moucheraud, C., Goshev, S. et al. The Effects of Maternal Mortality on Infant and Child Survival in Rural Tanzania: A Cohort Study. Matern Child Health J 19, 2393–2402 (2015). https://doi.org/10.1007/s10995-015-1758-2

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  • DOI: https://doi.org/10.1007/s10995-015-1758-2

Keywords

  • Maternal mortality
  • Infant mortality
  • Survival analysis
  • Orphanhood
  • Tanzania
  • Cohort study