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1. Can a simulation-based training program impact the use of evidence based routine practices at birth? Results of a hospital-based cluster randomized trial in Mexico.

Author: Fritz, Jimena, Fritz, Jimena, Walker, Dilys M, Cohen, Susanna, Angeles, Gustavo, Lamadrid-Figueroa, Hector, Fritz, Jimena, Fritz, Jimena, Walker, Dilys M, Cohen, Susanna, Angeles, Gustavo, and Lamadrid-Figueroa, Hector
Abstract: BackgroundIn Mexico, although the majority of births are attended in hospitals, reports have emerged of obstetric violence, use of unsafe practices, and failure to employ evidence-based practices (EBP). Recent attention has refocused global efforts towards provision of quality care that is both patient-centered and evidence-based. Scaling up of local interventions should rely on strong evidence of effectiveness.ObjectiveTo perform a secondary analysis to evaluate the impact of a simulation and team-training program (PRONTO) on the performance of EBP in normal births.MethodsA pair-matched cluster randomized controlled trial of the intervention was designed to measure the impact of the program (PRONTO intervention) on a sample of 24 hospitals (12 hospitals received the PRONTO training and 12 served as controls) in the states of Chiapas, Guerrero, and Mexico. We estimated the impact of receiving the intervention on the probability of birth practices performance in a sample of 641 observed births of which 318 occurred in the treated hospitals and 323 occurred in control hospitals. Data was collected at 4 time points (baseline, 4th, 8th and 12th months after the training). Women were blinded to treatment allocation but observers and providers were not. Estimates were obtained by fitting difference-in-differences logistic regression models considering confounding variables. The trial is registered at clinicaltrials.gov: # NCT01477554.ResultsSignificant changes were found following the intervention. At 4 months post-intervention an increase of 20 percentage points (p.p.) for complete Active Management of Third Stage of Labor (AMTSL) (p = 0.044), and 16 p.p. increase for Skin-to-Skin Contact (p = 0.067); at 12 months a 25 p.p. increase of the 1st step of AMTSL (p = 0.026) and a 42 p.p. increase of Delayed Cord Clamping (p = 0.004); at 4 months a 30 (p = 0.001) and at 8 months a 22 (p = 0.010) p.p. decrease for Uterine Sweeping.ConclusionsThe intervention has an impact on ad
Published: 2017

2. Can a simulation-based training program impact the use of evidence based routine practices at birth? Results of a hospital-based cluster randomized trial in Mexico.

Author: Fritz, Jimena, van Wouwe, Jacobus P1, Fritz, Jimena, Walker, Dilys M, Cohen, Susanna, Angeles, Gustavo, Lamadrid-Figueroa, Hector, Fritz, Jimena, van Wouwe, Jacobus P1, Fritz, Jimena, Walker, Dilys M, Cohen, Susanna, Angeles, Gustavo, and Lamadrid-Figueroa, Hector
Abstract: BackgroundIn Mexico, although the majority of births are attended in hospitals, reports have emerged of obstetric violence, use of unsafe practices, and failure to employ evidence-based practices (EBP). Recent attention has refocused global efforts towards provision of quality care that is both patient-centered and evidence-based. Scaling up of local interventions should rely on strong evidence of effectiveness.ObjectiveTo perform a secondary analysis to evaluate the impact of a simulation and team-training program (PRONTO) on the performance of EBP in normal births.MethodsA pair-matched cluster randomized controlled trial of the intervention was designed to measure the impact of the program (PRONTO intervention) on a sample of 24 hospitals (12 hospitals received the PRONTO training and 12 served as controls) in the states of Chiapas, Guerrero, and Mexico. We estimated the impact of receiving the intervention on the probability of birth practices performance in a sample of 641 observed births of which 318 occurred in the treated hospitals and 323 occurred in control hospitals. Data was collected at 4 time points (baseline, 4th, 8th and 12th months after the training). Women were blinded to treatment allocation but observers and providers were not. Estimates were obtained by fitting difference-in-differences logistic regression models considering confounding variables. The trial is registered at clinicaltrials.gov: # NCT01477554.ResultsSignificant changes were found following the intervention. At 4 months post-intervention an increase of 20 percentage points (p.p.) for complete Active Management of Third Stage of Labor (AMTSL) (p = 0.044), and 16 p.p. increase for Skin-to-Skin Contact (p = 0.067); at 12 months a 25 p.p. increase of the 1st step of AMTSL (p = 0.026) and a 42 p.p. increase of Delayed Cord Clamping (p = 0.004); at 4 months a 30 (p = 0.001) and at 8 months a 22 (p = 0.010) p.p. decrease for Uterine Sweeping.ConclusionsThe intervention has an impact on ad
Published: 2017

3. Global, regional, and national levels of maternal mortality, 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Author: Kassebaum, Nicholas J., Barber, Ryan M., Bhutta, Zulfiqar A., Dandona, Lalit, Gething, Peter W., Hay, Simon I., Kinfu, Yohannes, Larson, Heidi J., Liang, Xiaofeng, Lim, Stephen S., Lopez, Alan D., Lozano, Rafael, Mensah, George A., Mokdad, Ali H., Naghavi, Mohsen, Pinho, Christine, Salomon, Joshua A., Steiner, Caitlyn, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M., Abd-Allah, Foad, Abdallat, Mahmud A., Abdulle, Abdishakur M., Abera, Semaw Ferede, Aboyans, Victor, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M. E., Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Adelekan, Ademola Lukman, Adou, Arsene Kouablan, Afanvi, Kossivi Agbelenko, Agarwal, Arnav, Kiadaliri, Aliasghar Ahmad, Ajala, Oluremi N., Akinyemiju, Tomi F., Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore K. M., Alasfoor, Deena, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alhabib, Samia, Ali, Raghib, Alkerwi, Ala'a, Alla, Francois, Al-Raddadi, Rajaa, Alsharif, Ubai, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T., Amberbir, Alemayehu, Amegah, Adeladza Kofi, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H., Anderson, Gregory M., Antoine, Rose Mayerline, Antonio, Carl Abelardo T., Aregay, Atsede Fantahun, Ärnlöv, Johan, Arora, Megha, Arsenijevic, Valentina S. Arsic, Artaman, Al, Asayesh, Hamid, Atique, Suleman, Avokpaho, Euripide Frinel G. Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Bahit, Maria C., Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barker-Collo, Suzanne L., Barnighausen, Till, Basu, Sanjay, Bayou, Tigist Assefa, Bayou, Yibeltal Tebekaw, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, NeerajHaidong Wang, Bekele, Tolesa, Bell, Michelle L., Bennett, Derrick A., Bensenor, Isabela M., Berhane, Adugnaw, Bernabe, Eduardo, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Biadgilign, Sibhatu, Bikbov, Boris, Bin Abdulhak, Aref A., Biroscak, Brian J., Biryukov, Stan, Bisanzio, Donal, Bjertness, Espen, Blore, Jed D., Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J. K., Brugha, Traolach S., Butt, Zahid A., Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Cardenas, Rosario, Carrero, Juan Jesus, Carter, Austin, Casey, Daniel C., Castaneda-Oquela, Carlos A., Castro, Ruben Estanislao, Catala-Lopez, Ferran, Cavalleri, Fiorella, Chang, Hsing-Yi, Chang, Jung -Chen, Chavan, Laxmikant, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Cirillo, Massimo, Coates, Matthew M., Coggeshall, Megan, Colistro, Valentina, Colquhoun, Samantha M., Cooper, Cyrus, Cooper, Leslie Trumbull, Cortinovis, Monica, Dahiru, Tukur, Damasceno, Albertino, Danawi, Hadi, Dandona, Rakhi, Das Neves, Jose, De Leo, Diego, Dellavalle, Robert P., Deribe, Kebede, Deribew, Amare, Jarlais, Don C. Des, Dharmaratne, Samath D., Dicker, Daniel J., Ding, Eric L., Dossou, Edem, Dubey, Manisha, Ebel, Beth E., Ellingsen, Christian Lycke, Elyazar, Iqbal, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Esteghamati, Alireza, Faraon, Emerito Jose Aquino, Farid, Talha A., Farinha, Carla Sofia E. Sa, Faro, Andre, Farvid, Maryam S., Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C., Fischer, Florian, Fitchett, Joseph R. A., Fleming, Tom, Gt, Nataliya Fo, Franca, Elisabeth Barboza, Franklin, Richard C., Fraser, Maya S., Friedman, Joseph, Pullman, Nancy, Furst, Thomas, Futran, Neal D., Gambashidze, Ketevan, Gamkrelidze, Amiran, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebremedhin, Mengistu, Gebru, Alemseged Aregay, Geleijnse, Johanna M., Gibney, Katherine B., Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Glaser, Elizabeth, Goenka, Shifalika, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Goto, Atsushi, Graetz, Nicholas, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hancock, Jamie, Handal, Alexis J., Hankey, Graeme J., Harb, Hilda L., Harikrishnan, Sivadasanpillai, Harun, Kimani M., Havmoeller, Rasmus, Hoek, Hans W., Horino, Masako, Horita, Nobuyuki, Hosgood, H. Dean, Hoy, Damian G., Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Huang, John J., Huybrechts, Inge, Huynh, Chantal, Iannarone, Marissa, Iburg, Kim Moesgaard, Idrisov, Bulat T., Iyer, Veena J., Jacobsen, Kathryn H., Jahanmehr, Nader, Jakovljevic, Mihajlo B., Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jibat, Tariku, Jonas, Jost B., Kabir, Zubair, Kamal, Ritul, Kan, Haidong, Karch, Andre, Karletsos, Dimitris, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Francoise, Kazanjan, Konstantin, Kazi, Dhruv S., Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khonelidze, Irma, Khosravi, Ardeshir, Khubchandani, Jagdish, Kim, Yun Jin, Kivipelto, Miia, Knibbs, Luke D., Kokubo, Yoshihiro, Kosen, Soewarta, Koul, Parvaiz A., Koyanagi, Ai, Krishnaswami, Sanjay, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A., Kulikoff, Xie Rachel, Kulkarni, Chanda, Kumar, G. Anil, Kutz, Michael J., Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lamadrid-Figueroa, Hector, Lan, Qing, Larsson, Anders, Laryea, Dennis Odai, Leigh, James, Leung, Ricky, Li, Yichong, Li, Yongmei, Lipshultz, Steven E., Liu, Patrick Y., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Lotufo, Paulo A., Lunevicius, Raimundas, Ma, Stefan, El Razek, Hassan Magdy Abd, El Razek, Mohammed Magdy Abd, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Mapoma, Chabila C., Marcenes, Wagner, Margolis, David Joel, Marquez, Neal, Masiye, Felix, Marzan, Melvin Barrientos, Mason-Jones, Amanda J., Mazorodze, Tasara T., Meaney, Peter A., Mehari, Alem, Mehndiratta, Man Mohan, Mena-Rodriguez, Fabiola, Mekonnen, Alemayehu B., Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J., Mhimbira, Francis Apolinary, Miller, Ted R., Mills, Edward J., Mirarefin, Mojde, Misganaw, Awoke, Ibrahim, Norlinah Mohamed, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mola, Glen Liddell D., Monasta, Lorenzo, Monis, Jonathan De la Cruz, Hernandez, Julio Cesar Montanez, Montero, Pablo, Montico, Marcella, Mooney, Meghan D., Moore, Ami R., Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Nachega, Jean B., Naheed, Aliya, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Nash, Denis, Neupane, Subas, Newton, John N., Ng, Marie, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Le Nguyen, Quyen, Nisar, Muhammad Imran, Nomura, Marika, Norheim, Ole F., Norman, Rosana E., Nyakarahuka, Luke, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Ojelabi, Foluke Adetola, Olivares, Pedro R., Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ota, Erika, Oyekale, Abayomi Samuel, Pa, Mahesh, Pain, Amanda, Papantoniou, Nikolaos, Park, Eun-Kee, Park, Hye-Youn, Caicedo, Angel J. Paternina, Patten, Scott B., Paul, Vinod K., Pereira, David M., Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Pillay, Julian David, Pishgar, Farhad, Polinder, Suzanne, Pope, Daniel, Pourmalek, Farshad, Qorbani, Mostafa, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Rangaswamy, Thara, Rao, Paturi Vishnupriya, Refaat, Amany H., Remuzzi, Giuseppe, Kassebaum, Nicholas J., Barber, Ryan M., Bhutta, Zulfiqar A., Dandona, Lalit, Gething, Peter W., Hay, Simon I., Kinfu, Yohannes, Larson, Heidi J., Liang, Xiaofeng, Lim, Stephen S., Lopez, Alan D., Lozano, Rafael, Mensah, George A., Mokdad, Ali H., Naghavi, Mohsen, Pinho, Christine, Salomon, Joshua A., Steiner, Caitlyn, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M., Abd-Allah, Foad, Abdallat, Mahmud A., Abdulle, Abdishakur M., Abera, Semaw Ferede, Aboyans, Victor, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M. E., Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Adelekan, Ademola Lukman, Adou, Arsene Kouablan, Afanvi, Kossivi Agbelenko, Agarwal, Arnav, Kiadaliri, Aliasghar Ahmad, Ajala, Oluremi N., Akinyemiju, Tomi F., Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore K. M., Alasfoor, Deena, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alhabib, Samia, Ali, Raghib, Alkerwi, Ala'a, Alla, Francois, Al-Raddadi, Rajaa, Alsharif, Ubai, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T., Amberbir, Alemayehu, Amegah, Adeladza Kofi, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H., Anderson, Gregory M., Antoine, Rose Mayerline, Antonio, Carl Abelardo T., Aregay, Atsede Fantahun, Ärnlöv, Johan, Arora, Megha, Arsenijevic, Valentina S. Arsic, Artaman, Al, Asayesh, Hamid, Atique, Suleman, Avokpaho, Euripide Frinel G. Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Bahit, Maria C., Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barker-Collo, Suzanne L., Barnighausen, Till, Basu, Sanjay, Bayou, Tigist Assefa, Bayou, Yibeltal Tebekaw, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, NeerajHaidong Wang, Bekele, Tolesa, Bell, Michelle L., Bennett, Derrick A., Bensenor, Isabela M., Berhane, Adugnaw, Bernabe, Eduardo, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Biadgilign, Sibhatu, Bikbov, Boris, Bin Abdulhak, Aref A., Biroscak, Brian J., Biryukov, Stan, Bisanzio, Donal, Bjertness, Espen, Blore, Jed D., Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J. K., Brugha, Traolach S., Butt, Zahid A., Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Cardenas, Rosario, Carrero, Juan Jesus, Carter, Austin, Casey, Daniel C., Castaneda-Oquela, Carlos A., Castro, Ruben Estanislao, Catala-Lopez, Ferran, Cavalleri, Fiorella, Chang, Hsing-Yi, Chang, Jung -Chen, Chavan, Laxmikant, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Cirillo, Massimo, Coates, Matthew M., Coggeshall, Megan, Colistro, Valentina, Colquhoun, Samantha M., Cooper, Cyrus, Cooper, Leslie Trumbull, Cortinovis, Monica, Dahiru, Tukur, Damasceno, Albertino, Danawi, Hadi, Dandona, Rakhi, Das Neves, Jose, De Leo, Diego, Dellavalle, Robert P., Deribe, Kebede, Deribew, Amare, Jarlais, Don C. Des, Dharmaratne, Samath D., Dicker, Daniel J., Ding, Eric L., Dossou, Edem, Dubey, Manisha, Ebel, Beth E., Ellingsen, Christian Lycke, Elyazar, Iqbal, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Esteghamati, Alireza, Faraon, Emerito Jose Aquino, Farid, Talha A., Farinha, Carla Sofia E. Sa, Faro, Andre, Farvid, Maryam S., Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C., Fischer, Florian, Fitchett, Joseph R. A., Fleming, Tom, Gt, Nataliya Fo, Franca, Elisabeth Barboza, Franklin, Richard C., Fraser, Maya S., Friedman, Joseph, Pullman, Nancy, Furst, Thomas, Futran, Neal D., Gambashidze, Ketevan, Gamkrelidze, Amiran, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebremedhin, Mengistu, Gebru, Alemseged Aregay, Geleijnse, Johanna M., Gibney, Katherine B., Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Glaser, Elizabeth, Goenka, Shifalika, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Goto, Atsushi, Graetz, Nicholas, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hancock, Jamie, Handal, Alexis J., Hankey, Graeme J., Harb, Hilda L., Harikrishnan, Sivadasanpillai, Harun, Kimani M., Havmoeller, Rasmus, Hoek, Hans W., Horino, Masako, Horita, Nobuyuki, Hosgood, H. Dean, Hoy, Damian G., Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Huang, John J., Huybrechts, Inge, Huynh, Chantal, Iannarone, Marissa, Iburg, Kim Moesgaard, Idrisov, Bulat T., Iyer, Veena J., Jacobsen, Kathryn H., Jahanmehr, Nader, Jakovljevic, Mihajlo B., Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jibat, Tariku, Jonas, Jost B., Kabir, Zubair, Kamal, Ritul, Kan, Haidong, Karch, Andre, Karletsos, Dimitris, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Francoise, Kazanjan, Konstantin, Kazi, Dhruv S., Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khonelidze, Irma, Khosravi, Ardeshir, Khubchandani, Jagdish, Kim, Yun Jin, Kivipelto, Miia, Knibbs, Luke D., Kokubo, Yoshihiro, Kosen, Soewarta, Koul, Parvaiz A., Koyanagi, Ai, Krishnaswami, Sanjay, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A., Kulikoff, Xie Rachel, Kulkarni, Chanda, Kumar, G. Anil, Kutz, Michael J., Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lamadrid-Figueroa, Hector, Lan, Qing, Larsson, Anders, Laryea, Dennis Odai, Leigh, James, Leung, Ricky, Li, Yichong, Li, Yongmei, Lipshultz, Steven E., Liu, Patrick Y., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Lotufo, Paulo A., Lunevicius, Raimundas, Ma, Stefan, El Razek, Hassan Magdy Abd, El Razek, Mohammed Magdy Abd, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Mapoma, Chabila C., Marcenes, Wagner, Margolis, David Joel, Marquez, Neal, Masiye, Felix, Marzan, Melvin Barrientos, Mason-Jones, Amanda J., Mazorodze, Tasara T., Meaney, Peter A., Mehari, Alem, Mehndiratta, Man Mohan, Mena-Rodriguez, Fabiola, Mekonnen, Alemayehu B., Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J., Mhimbira, Francis Apolinary, Miller, Ted R., Mills, Edward J., Mirarefin, Mojde, Misganaw, Awoke, Ibrahim, Norlinah Mohamed, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mola, Glen Liddell D., Monasta, Lorenzo, Monis, Jonathan De la Cruz, Hernandez, Julio Cesar Montanez, Montero, Pablo, Montico, Marcella, Mooney, Meghan D., Moore, Ami R., Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Nachega, Jean B., Naheed, Aliya, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Nash, Denis, Neupane, Subas, Newton, John N., Ng, Marie, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Le Nguyen, Quyen, Nisar, Muhammad Imran, Nomura, Marika, Norheim, Ole F., Norman, Rosana E., Nyakarahuka, Luke, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Ojelabi, Foluke Adetola, Olivares, Pedro R., Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ota, Erika, Oyekale, Abayomi Samuel, Pa, Mahesh, Pain, Amanda, Papantoniou, Nikolaos, Park, Eun-Kee, Park, Hye-Youn, Caicedo, Angel J. Paternina, Patten, Scott B., Paul, Vinod K., Pereira, David M., Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Pillay, Julian David, Pishgar, Farhad, Polinder, Suzanne, Pope, Daniel, Pourmalek, Farshad, Qorbani, Mostafa, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Rangaswamy, Thara, Rao, Paturi Vishnupriya, Refaat, Amany H., and Remuzzi, Giuseppe
Abstract: Background In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015. Methods We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages 10-54 years by systematically compiling and processing all available data sources from 186 of 195 countries and territories, 11 of which were analysed at the subnational level. We quantified eight underlying causes of maternal death and four timing categories, improving estimation methods since GBD 2013 for adult all-cause mortality, HIV-related maternal mortality, and late maternal death. Secondary analyses then allowed systematic examination of drivers of trends, including the relation between maternal mortality and coverage of specific reproductive health-care services as well as assessment of observed versus expected maternal mortality as a function of Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Findings Only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1. Geographical disparities widened between 1990 and 2015 and, in 2015, 24 countries still had a maternal mortality ratio greater than 400. The proportion of all maternal deaths occurring in the bottom two SDI quintiles, where haemorrhage is the dominant cause of maternal death, increased from roughly 68% in 1990 to more than 80% in 2015. The middle SDI quintile improved the most from 1990 to 2015, but also has the most complicated causal profile. Maternal mortality in the highest SDI quintile is mostly due to other direct maternal disorders, indirect maternal disorders, and abortion, ectopic pregnancy, and
Published: 2016
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4. Global, regional, and national levels of maternal mortality, 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Author: Kassebaum, Nicholas J., Barber, Ryan M., Bhutta, Zulfiqar A., Dandona, Lalit, Gething, Peter W., Hay, Simon I., Kinfu, Yohannes, Larson, Heidi J., Liang, Xiaofeng, Lim, Stephen S., Lopez, Alan D., Lozano, Rafael, Mensah, George A., Mokdad, Ali H., Naghavi, Mohsen, Pinho, Christine, Salomon, Joshua A., Steiner, Caitlyn, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M., Abd-Allah, Foad, Abdallat, Mahmud A., Abdulle, Abdishakur M., Abera, Semaw Ferede, Aboyans, Victor, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M. E., Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Adelekan, Ademola Lukman, Adou, Arsene Kouablan, Afanvi, Kossivi Agbelenko, Agarwal, Arnav, Kiadaliri, Aliasghar Ahmad, Ajala, Oluremi N., Akinyemiju, Tomi F., Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore K. M., Alasfoor, Deena, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alhabib, Samia, Ali, Raghib, Alkerwi, Ala'a, Alla, Francois, Al-Raddadi, Rajaa, Alsharif, Ubai, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T., Amberbir, Alemayehu, Amegah, Adeladza Kofi, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H., Anderson, Gregory M., Antoine, Rose Mayerline, Antonio, Carl Abelardo T., Aregay, Atsede Fantahun, Ärnlöv, Johan, Arora, Megha, Arsenijevic, Valentina S. Arsic, Artaman, Al, Asayesh, Hamid, Atique, Suleman, Avokpaho, Euripide Frinel G. Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Bahit, Maria C., Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barker-Collo, Suzanne L., Barnighausen, Till, Basu, Sanjay, Bayou, Tigist Assefa, Bayou, Yibeltal Tebekaw, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, NeerajHaidong Wang, Bekele, Tolesa, Bell, Michelle L., Bennett, Derrick A., Bensenor, Isabela M., Berhane, Adugnaw, Bernabe, Eduardo, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Biadgilign, Sibhatu, Bikbov, Boris, Bin Abdulhak, Aref A., Biroscak, Brian J., Biryukov, Stan, Bisanzio, Donal, Bjertness, Espen, Blore, Jed D., Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J. K., Brugha, Traolach S., Butt, Zahid A., Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Cardenas, Rosario, Carrero, Juan Jesus, Carter, Austin, Casey, Daniel C., Castaneda-Oquela, Carlos A., Castro, Ruben Estanislao, Catala-Lopez, Ferran, Cavalleri, Fiorella, Chang, Hsing-Yi, Chang, Jung -Chen, Chavan, Laxmikant, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Cirillo, Massimo, Coates, Matthew M., Coggeshall, Megan, Colistro, Valentina, Colquhoun, Samantha M., Cooper, Cyrus, Cooper, Leslie Trumbull, Cortinovis, Monica, Dahiru, Tukur, Damasceno, Albertino, Danawi, Hadi, Dandona, Rakhi, Das Neves, Jose, De Leo, Diego, Dellavalle, Robert P., Deribe, Kebede, Deribew, Amare, Jarlais, Don C. Des, Dharmaratne, Samath D., Dicker, Daniel J., Ding, Eric L., Dossou, Edem, Dubey, Manisha, Ebel, Beth E., Ellingsen, Christian Lycke, Elyazar, Iqbal, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Esteghamati, Alireza, Faraon, Emerito Jose Aquino, Farid, Talha A., Farinha, Carla Sofia E. Sa, Faro, Andre, Farvid, Maryam S., Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C., Fischer, Florian, Fitchett, Joseph R. A., Fleming, Tom, Gt, Nataliya Fo, Franca, Elisabeth Barboza, Franklin, Richard C., Fraser, Maya S., Friedman, Joseph, Pullman, Nancy, Furst, Thomas, Futran, Neal D., Gambashidze, Ketevan, Gamkrelidze, Amiran, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebremedhin, Mengistu, Gebru, Alemseged Aregay, Geleijnse, Johanna M., Gibney, Katherine B., Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Glaser, Elizabeth, Goenka, Shifalika, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Goto, Atsushi, Graetz, Nicholas, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hancock, Jamie, Handal, Alexis J., Hankey, Graeme J., Harb, Hilda L., Harikrishnan, Sivadasanpillai, Harun, Kimani M., Havmoeller, Rasmus, Hoek, Hans W., Horino, Masako, Horita, Nobuyuki, Hosgood, H. Dean, Hoy, Damian G., Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Huang, John J., Huybrechts, Inge, Huynh, Chantal, Iannarone, Marissa, Iburg, Kim Moesgaard, Idrisov, Bulat T., Iyer, Veena J., Jacobsen, Kathryn H., Jahanmehr, Nader, Jakovljevic, Mihajlo B., Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jibat, Tariku, Jonas, Jost B., Kabir, Zubair, Kamal, Ritul, Kan, Haidong, Karch, Andre, Karletsos, Dimitris, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Francoise, Kazanjan, Konstantin, Kazi, Dhruv S., Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khonelidze, Irma, Khosravi, Ardeshir, Khubchandani, Jagdish, Kim, Yun Jin, Kivipelto, Miia, Knibbs, Luke D., Kokubo, Yoshihiro, Kosen, Soewarta, Koul, Parvaiz A., Koyanagi, Ai, Krishnaswami, Sanjay, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A., Kulikoff, Xie Rachel, Kulkarni, Chanda, Kumar, G. Anil, Kutz, Michael J., Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lamadrid-Figueroa, Hector, Lan, Qing, Larsson, Anders, Laryea, Dennis Odai, Leigh, James, Leung, Ricky, Li, Yichong, Li, Yongmei, Lipshultz, Steven E., Liu, Patrick Y., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Lotufo, Paulo A., Lunevicius, Raimundas, Ma, Stefan, El Razek, Hassan Magdy Abd, El Razek, Mohammed Magdy Abd, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Mapoma, Chabila C., Marcenes, Wagner, Margolis, David Joel, Marquez, Neal, Masiye, Felix, Marzan, Melvin Barrientos, Mason-Jones, Amanda J., Mazorodze, Tasara T., Meaney, Peter A., Mehari, Alem, Mehndiratta, Man Mohan, Mena-Rodriguez, Fabiola, Mekonnen, Alemayehu B., Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J., Mhimbira, Francis Apolinary, Miller, Ted R., Mills, Edward J., Mirarefin, Mojde, Misganaw, Awoke, Ibrahim, Norlinah Mohamed, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mola, Glen Liddell D., Monasta, Lorenzo, Monis, Jonathan De la Cruz, Hernandez, Julio Cesar Montanez, Montero, Pablo, Montico, Marcella, Mooney, Meghan D., Moore, Ami R., Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Nachega, Jean B., Naheed, Aliya, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Nash, Denis, Neupane, Subas, Newton, John N., Ng, Marie, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Le Nguyen, Quyen, Nisar, Muhammad Imran, Nomura, Marika, Norheim, Ole F., Norman, Rosana E., Nyakarahuka, Luke, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Ojelabi, Foluke Adetola, Olivares, Pedro R., Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ota, Erika, Oyekale, Abayomi Samuel, Pa, Mahesh, Pain, Amanda, Papantoniou, Nikolaos, Park, Eun-Kee, Park, Hye-Youn, Caicedo, Angel J. Paternina, Patten, Scott B., Paul, Vinod K., Pereira, David M., Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Pillay, Julian David, Pishgar, Farhad, Polinder, Suzanne, Pope, Daniel, Pourmalek, Farshad, Qorbani, Mostafa, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Rangaswamy, Thara, Rao, Paturi Vishnupriya, Refaat, Amany H., Remuzzi, Giuseppe, Kassebaum, Nicholas J., Barber, Ryan M., Bhutta, Zulfiqar A., Dandona, Lalit, Gething, Peter W., Hay, Simon I., Kinfu, Yohannes, Larson, Heidi J., Liang, Xiaofeng, Lim, Stephen S., Lopez, Alan D., Lozano, Rafael, Mensah, George A., Mokdad, Ali H., Naghavi, Mohsen, Pinho, Christine, Salomon, Joshua A., Steiner, Caitlyn, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M., Abd-Allah, Foad, Abdallat, Mahmud A., Abdulle, Abdishakur M., Abera, Semaw Ferede, Aboyans, Victor, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M. E., Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Adelekan, Ademola Lukman, Adou, Arsene Kouablan, Afanvi, Kossivi Agbelenko, Agarwal, Arnav, Kiadaliri, Aliasghar Ahmad, Ajala, Oluremi N., Akinyemiju, Tomi F., Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore K. M., Alasfoor, Deena, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alhabib, Samia, Ali, Raghib, Alkerwi, Ala'a, Alla, Francois, Al-Raddadi, Rajaa, Alsharif, Ubai, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T., Amberbir, Alemayehu, Amegah, Adeladza Kofi, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H., Anderson, Gregory M., Antoine, Rose Mayerline, Antonio, Carl Abelardo T., Aregay, Atsede Fantahun, Ärnlöv, Johan, Arora, Megha, Arsenijevic, Valentina S. Arsic, Artaman, Al, Asayesh, Hamid, Atique, Suleman, Avokpaho, Euripide Frinel G. Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Bahit, Maria C., Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barker-Collo, Suzanne L., Barnighausen, Till, Basu, Sanjay, Bayou, Tigist Assefa, Bayou, Yibeltal Tebekaw, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, NeerajHaidong Wang, Bekele, Tolesa, Bell, Michelle L., Bennett, Derrick A., Bensenor, Isabela M., Berhane, Adugnaw, Bernabe, Eduardo, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Biadgilign, Sibhatu, Bikbov, Boris, Bin Abdulhak, Aref A., Biroscak, Brian J., Biryukov, Stan, Bisanzio, Donal, Bjertness, Espen, Blore, Jed D., Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J. K., Brugha, Traolach S., Butt, Zahid A., Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Cardenas, Rosario, Carrero, Juan Jesus, Carter, Austin, Casey, Daniel C., Castaneda-Oquela, Carlos A., Castro, Ruben Estanislao, Catala-Lopez, Ferran, Cavalleri, Fiorella, Chang, Hsing-Yi, Chang, Jung -Chen, Chavan, Laxmikant, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Cirillo, Massimo, Coates, Matthew M., Coggeshall, Megan, Colistro, Valentina, Colquhoun, Samantha M., Cooper, Cyrus, Cooper, Leslie Trumbull, Cortinovis, Monica, Dahiru, Tukur, Damasceno, Albertino, Danawi, Hadi, Dandona, Rakhi, Das Neves, Jose, De Leo, Diego, Dellavalle, Robert P., Deribe, Kebede, Deribew, Amare, Jarlais, Don C. Des, Dharmaratne, Samath D., Dicker, Daniel J., Ding, Eric L., Dossou, Edem, Dubey, Manisha, Ebel, Beth E., Ellingsen, Christian Lycke, Elyazar, Iqbal, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Esteghamati, Alireza, Faraon, Emerito Jose Aquino, Farid, Talha A., Farinha, Carla Sofia E. Sa, Faro, Andre, Farvid, Maryam S., Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C., Fischer, Florian, Fitchett, Joseph R. A., Fleming, Tom, Gt, Nataliya Fo, Franca, Elisabeth Barboza, Franklin, Richard C., Fraser, Maya S., Friedman, Joseph, Pullman, Nancy, Furst, Thomas, Futran, Neal D., Gambashidze, Ketevan, Gamkrelidze, Amiran, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebremedhin, Mengistu, Gebru, Alemseged Aregay, Geleijnse, Johanna M., Gibney, Katherine B., Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Glaser, Elizabeth, Goenka, Shifalika, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Goto, Atsushi, Graetz, Nicholas, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hancock, Jamie, Handal, Alexis J., Hankey, Graeme J., Harb, Hilda L., Harikrishnan, Sivadasanpillai, Harun, Kimani M., Havmoeller, Rasmus, Hoek, Hans W., Horino, Masako, Horita, Nobuyuki, Hosgood, H. Dean, Hoy, Damian G., Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Huang, John J., Huybrechts, Inge, Huynh, Chantal, Iannarone, Marissa, Iburg, Kim Moesgaard, Idrisov, Bulat T., Iyer, Veena J., Jacobsen, Kathryn H., Jahanmehr, Nader, Jakovljevic, Mihajlo B., Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jibat, Tariku, Jonas, Jost B., Kabir, Zubair, Kamal, Ritul, Kan, Haidong, Karch, Andre, Karletsos, Dimitris, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Francoise, Kazanjan, Konstantin, Kazi, Dhruv S., Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khonelidze, Irma, Khosravi, Ardeshir, Khubchandani, Jagdish, Kim, Yun Jin, Kivipelto, Miia, Knibbs, Luke D., Kokubo, Yoshihiro, Kosen, Soewarta, Koul, Parvaiz A., Koyanagi, Ai, Krishnaswami, Sanjay, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A., Kulikoff, Xie Rachel, Kulkarni, Chanda, Kumar, G. Anil, Kutz, Michael J., Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lamadrid-Figueroa, Hector, Lan, Qing, Larsson, Anders, Laryea, Dennis Odai, Leigh, James, Leung, Ricky, Li, Yichong, Li, Yongmei, Lipshultz, Steven E., Liu, Patrick Y., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Lotufo, Paulo A., Lunevicius, Raimundas, Ma, Stefan, El Razek, Hassan Magdy Abd, El Razek, Mohammed Magdy Abd, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Mapoma, Chabila C., Marcenes, Wagner, Margolis, David Joel, Marquez, Neal, Masiye, Felix, Marzan, Melvin Barrientos, Mason-Jones, Amanda J., Mazorodze, Tasara T., Meaney, Peter A., Mehari, Alem, Mehndiratta, Man Mohan, Mena-Rodriguez, Fabiola, Mekonnen, Alemayehu B., Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J., Mhimbira, Francis Apolinary, Miller, Ted R., Mills, Edward J., Mirarefin, Mojde, Misganaw, Awoke, Ibrahim, Norlinah Mohamed, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mola, Glen Liddell D., Monasta, Lorenzo, Monis, Jonathan De la Cruz, Hernandez, Julio Cesar Montanez, Montero, Pablo, Montico, Marcella, Mooney, Meghan D., Moore, Ami R., Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Nachega, Jean B., Naheed, Aliya, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Nash, Denis, Neupane, Subas, Newton, John N., Ng, Marie, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Le Nguyen, Quyen, Nisar, Muhammad Imran, Nomura, Marika, Norheim, Ole F., Norman, Rosana E., Nyakarahuka, Luke, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Ojelabi, Foluke Adetola, Olivares, Pedro R., Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ota, Erika, Oyekale, Abayomi Samuel, Pa, Mahesh, Pain, Amanda, Papantoniou, Nikolaos, Park, Eun-Kee, Park, Hye-Youn, Caicedo, Angel J. Paternina, Patten, Scott B., Paul, Vinod K., Pereira, David M., Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Pillay, Julian David, Pishgar, Farhad, Polinder, Suzanne, Pope, Daniel, Pourmalek, Farshad, Qorbani, Mostafa, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Rangaswamy, Thara, Rao, Paturi Vishnupriya, Refaat, Amany H., and Remuzzi, Giuseppe
Abstract: Background In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015. Methods We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages 10-54 years by systematically compiling and processing all available data sources from 186 of 195 countries and territories, 11 of which were analysed at the subnational level. We quantified eight underlying causes of maternal death and four timing categories, improving estimation methods since GBD 2013 for adult all-cause mortality, HIV-related maternal mortality, and late maternal death. Secondary analyses then allowed systematic examination of drivers of trends, including the relation between maternal mortality and coverage of specific reproductive health-care services as well as assessment of observed versus expected maternal mortality as a function of Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Findings Only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1. Geographical disparities widened between 1990 and 2015 and, in 2015, 24 countries still had a maternal mortality ratio greater than 400. The proportion of all maternal deaths occurring in the bottom two SDI quintiles, where haemorrhage is the dominant cause of maternal death, increased from roughly 68% in 1990 to more than 80% in 2015. The middle SDI quintile improved the most from 1990 to 2015, but also has the most complicated causal profile. Maternal mortality in the highest SDI quintile is mostly due to other direct maternal disorders, indirect maternal disorders, and abortion, ectopic pregnancy, and
Published: 2016
Full Text: View/download PDF

5. Global, regional, and national levels of maternal mortality, 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Author: Kassebaum, Nicholas J., Barber, Ryan M., Bhutta, Zulfiqar A., Dandona, Lalit, Gething, Peter W., Hay, Simon I., Kinfu, Yohannes, Larson, Heidi J., Liang, Xiaofeng, Lim, Stephen S., Lopez, Alan D., Lozano, Rafael, Mensah, George A., Mokdad, Ali H., Naghavi, Mohsen, Pinho, Christine, Salomon, Joshua A., Steiner, Caitlyn, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M., Abd-Allah, Foad, Abdallat, Mahmud A., Abdulle, Abdishakur M., Abera, Semaw Ferede, Aboyans, Victor, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M. E., Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Adelekan, Ademola Lukman, Adou, Arsene Kouablan, Afanvi, Kossivi Agbelenko, Agarwal, Arnav, Kiadaliri, Aliasghar Ahmad, Ajala, Oluremi N., Akinyemiju, Tomi F., Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore K. M., Alasfoor, Deena, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alhabib, Samia, Ali, Raghib, Alkerwi, Ala'a, Alla, Francois, Al-Raddadi, Rajaa, Alsharif, Ubai, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T., Amberbir, Alemayehu, Amegah, Adeladza Kofi, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H., Anderson, Gregory M., Antoine, Rose Mayerline, Antonio, Carl Abelardo T., Aregay, Atsede Fantahun, Ärnlöv, Johan, Arora, Megha, Arsenijevic, Valentina S. Arsic, Artaman, Al, Asayesh, Hamid, Atique, Suleman, Avokpaho, Euripide Frinel G. Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Bahit, Maria C., Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barker-Collo, Suzanne L., Barnighausen, Till, Basu, Sanjay, Bayou, Tigist Assefa, Bayou, Yibeltal Tebekaw, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, NeerajHaidong Wang, Bekele, Tolesa, Bell, Michelle L., Bennett, Derrick A., Bensenor, Isabela M., Berhane, Adugnaw, Bernabe, Eduardo, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Biadgilign, Sibhatu, Bikbov, Boris, Bin Abdulhak, Aref A., Biroscak, Brian J., Biryukov, Stan, Bisanzio, Donal, Bjertness, Espen, Blore, Jed D., Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J. K., Brugha, Traolach S., Butt, Zahid A., Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Cardenas, Rosario, Carrero, Juan Jesus, Carter, Austin, Casey, Daniel C., Castaneda-Oquela, Carlos A., Castro, Ruben Estanislao, Catala-Lopez, Ferran, Cavalleri, Fiorella, Chang, Hsing-Yi, Chang, Jung -Chen, Chavan, Laxmikant, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Cirillo, Massimo, Coates, Matthew M., Coggeshall, Megan, Colistro, Valentina, Colquhoun, Samantha M., Cooper, Cyrus, Cooper, Leslie Trumbull, Cortinovis, Monica, Dahiru, Tukur, Damasceno, Albertino, Danawi, Hadi, Dandona, Rakhi, Das Neves, Jose, De Leo, Diego, Dellavalle, Robert P., Deribe, Kebede, Deribew, Amare, Jarlais, Don C. Des, Dharmaratne, Samath D., Dicker, Daniel J., Ding, Eric L., Dossou, Edem, Dubey, Manisha, Ebel, Beth E., Ellingsen, Christian Lycke, Elyazar, Iqbal, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Esteghamati, Alireza, Faraon, Emerito Jose Aquino, Farid, Talha A., Farinha, Carla Sofia E. Sa, Faro, Andre, Farvid, Maryam S., Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C., Fischer, Florian, Fitchett, Joseph R. A., Fleming, Tom, Gt, Nataliya Fo, Franca, Elisabeth Barboza, Franklin, Richard C., Fraser, Maya S., Friedman, Joseph, Pullman, Nancy, Furst, Thomas, Futran, Neal D., Gambashidze, Ketevan, Gamkrelidze, Amiran, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebremedhin, Mengistu, Gebru, Alemseged Aregay, Geleijnse, Johanna M., Gibney, Katherine B., Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Glaser, Elizabeth, Goenka, Shifalika, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Goto, Atsushi, Graetz, Nicholas, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hancock, Jamie, Handal, Alexis J., Hankey, Graeme J., Harb, Hilda L., Harikrishnan, Sivadasanpillai, Harun, Kimani M., Havmoeller, Rasmus, Hoek, Hans W., Horino, Masako, Horita, Nobuyuki, Hosgood, H. Dean, Hoy, Damian G., Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Huang, John J., Huybrechts, Inge, Huynh, Chantal, Iannarone, Marissa, Iburg, Kim Moesgaard, Idrisov, Bulat T., Iyer, Veena J., Jacobsen, Kathryn H., Jahanmehr, Nader, Jakovljevic, Mihajlo B., Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jibat, Tariku, Jonas, Jost B., Kabir, Zubair, Kamal, Ritul, Kan, Haidong, Karch, Andre, Karletsos, Dimitris, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Francoise, Kazanjan, Konstantin, Kazi, Dhruv S., Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khonelidze, Irma, Khosravi, Ardeshir, Khubchandani, Jagdish, Kim, Yun Jin, Kivipelto, Miia, Knibbs, Luke D., Kokubo, Yoshihiro, Kosen, Soewarta, Koul, Parvaiz A., Koyanagi, Ai, Krishnaswami, Sanjay, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A., Kulikoff, Xie Rachel, Kulkarni, Chanda, Kumar, G. Anil, Kutz, Michael J., Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lamadrid-Figueroa, Hector, Lan, Qing, Larsson, Anders, Laryea, Dennis Odai, Leigh, James, Leung, Ricky, Li, Yichong, Li, Yongmei, Lipshultz, Steven E., Liu, Patrick Y., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Lotufo, Paulo A., Lunevicius, Raimundas, Ma, Stefan, El Razek, Hassan Magdy Abd, El Razek, Mohammed Magdy Abd, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Mapoma, Chabila C., Marcenes, Wagner, Margolis, David Joel, Marquez, Neal, Masiye, Felix, Marzan, Melvin Barrientos, Mason-Jones, Amanda J., Mazorodze, Tasara T., Meaney, Peter A., Mehari, Alem, Mehndiratta, Man Mohan, Mena-Rodriguez, Fabiola, Mekonnen, Alemayehu B., Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J., Mhimbira, Francis Apolinary, Miller, Ted R., Mills, Edward J., Mirarefin, Mojde, Misganaw, Awoke, Ibrahim, Norlinah Mohamed, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mola, Glen Liddell D., Monasta, Lorenzo, Monis, Jonathan De la Cruz, Hernandez, Julio Cesar Montanez, Montero, Pablo, Montico, Marcella, Mooney, Meghan D., Moore, Ami R., Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Nachega, Jean B., Naheed, Aliya, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Nash, Denis, Neupane, Subas, Newton, John N., Ng, Marie, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Le Nguyen, Quyen, Nisar, Muhammad Imran, Nomura, Marika, Norheim, Ole F., Norman, Rosana E., Nyakarahuka, Luke, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Ojelabi, Foluke Adetola, Olivares, Pedro R., Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ota, Erika, Oyekale, Abayomi Samuel, Pa, Mahesh, Pain, Amanda, Papantoniou, Nikolaos, Park, Eun-Kee, Park, Hye-Youn, Caicedo, Angel J. Paternina, Patten, Scott B., Paul, Vinod K., Pereira, David M., Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Pillay, Julian David, Pishgar, Farhad, Polinder, Suzanne, Pope, Daniel, Pourmalek, Farshad, Qorbani, Mostafa, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Rangaswamy, Thara, Rao, Paturi Vishnupriya, Refaat, Amany H., Remuzzi, Giuseppe, Kassebaum, Nicholas J., Barber, Ryan M., Bhutta, Zulfiqar A., Dandona, Lalit, Gething, Peter W., Hay, Simon I., Kinfu, Yohannes, Larson, Heidi J., Liang, Xiaofeng, Lim, Stephen S., Lopez, Alan D., Lozano, Rafael, Mensah, George A., Mokdad, Ali H., Naghavi, Mohsen, Pinho, Christine, Salomon, Joshua A., Steiner, Caitlyn, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M., Abd-Allah, Foad, Abdallat, Mahmud A., Abdulle, Abdishakur M., Abera, Semaw Ferede, Aboyans, Victor, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M. E., Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Adelekan, Ademola Lukman, Adou, Arsene Kouablan, Afanvi, Kossivi Agbelenko, Agarwal, Arnav, Kiadaliri, Aliasghar Ahmad, Ajala, Oluremi N., Akinyemiju, Tomi F., Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore K. M., Alasfoor, Deena, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alhabib, Samia, Ali, Raghib, Alkerwi, Ala'a, Alla, Francois, Al-Raddadi, Rajaa, Alsharif, Ubai, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T., Amberbir, Alemayehu, Amegah, Adeladza Kofi, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H., Anderson, Gregory M., Antoine, Rose Mayerline, Antonio, Carl Abelardo T., Aregay, Atsede Fantahun, Ärnlöv, Johan, Arora, Megha, Arsenijevic, Valentina S. Arsic, Artaman, Al, Asayesh, Hamid, Atique, Suleman, Avokpaho, Euripide Frinel G. Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Bahit, Maria C., Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barker-Collo, Suzanne L., Barnighausen, Till, Basu, Sanjay, Bayou, Tigist Assefa, Bayou, Yibeltal Tebekaw, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, NeerajHaidong Wang, Bekele, Tolesa, Bell, Michelle L., Bennett, Derrick A., Bensenor, Isabela M., Berhane, Adugnaw, Bernabe, Eduardo, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Biadgilign, Sibhatu, Bikbov, Boris, Bin Abdulhak, Aref A., Biroscak, Brian J., Biryukov, Stan, Bisanzio, Donal, Bjertness, Espen, Blore, Jed D., Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J. K., Brugha, Traolach S., Butt, Zahid A., Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Cardenas, Rosario, Carrero, Juan Jesus, Carter, Austin, Casey, Daniel C., Castaneda-Oquela, Carlos A., Castro, Ruben Estanislao, Catala-Lopez, Ferran, Cavalleri, Fiorella, Chang, Hsing-Yi, Chang, Jung -Chen, Chavan, Laxmikant, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Cirillo, Massimo, Coates, Matthew M., Coggeshall, Megan, Colistro, Valentina, Colquhoun, Samantha M., Cooper, Cyrus, Cooper, Leslie Trumbull, Cortinovis, Monica, Dahiru, Tukur, Damasceno, Albertino, Danawi, Hadi, Dandona, Rakhi, Das Neves, Jose, De Leo, Diego, Dellavalle, Robert P., Deribe, Kebede, Deribew, Amare, Jarlais, Don C. Des, Dharmaratne, Samath D., Dicker, Daniel J., Ding, Eric L., Dossou, Edem, Dubey, Manisha, Ebel, Beth E., Ellingsen, Christian Lycke, Elyazar, Iqbal, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Esteghamati, Alireza, Faraon, Emerito Jose Aquino, Farid, Talha A., Farinha, Carla Sofia E. Sa, Faro, Andre, Farvid, Maryam S., Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C., Fischer, Florian, Fitchett, Joseph R. A., Fleming, Tom, Gt, Nataliya Fo, Franca, Elisabeth Barboza, Franklin, Richard C., Fraser, Maya S., Friedman, Joseph, Pullman, Nancy, Furst, Thomas, Futran, Neal D., Gambashidze, Ketevan, Gamkrelidze, Amiran, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebremedhin, Mengistu, Gebru, Alemseged Aregay, Geleijnse, Johanna M., Gibney, Katherine B., Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Glaser, Elizabeth, Goenka, Shifalika, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Goto, Atsushi, Graetz, Nicholas, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hancock, Jamie, Handal, Alexis J., Hankey, Graeme J., Harb, Hilda L., Harikrishnan, Sivadasanpillai, Harun, Kimani M., Havmoeller, Rasmus, Hoek, Hans W., Horino, Masako, Horita, Nobuyuki, Hosgood, H. Dean, Hoy, Damian G., Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Huang, John J., Huybrechts, Inge, Huynh, Chantal, Iannarone, Marissa, Iburg, Kim Moesgaard, Idrisov, Bulat T., Iyer, Veena J., Jacobsen, Kathryn H., Jahanmehr, Nader, Jakovljevic, Mihajlo B., Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jibat, Tariku, Jonas, Jost B., Kabir, Zubair, Kamal, Ritul, Kan, Haidong, Karch, Andre, Karletsos, Dimitris, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Francoise, Kazanjan, Konstantin, Kazi, Dhruv S., Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khonelidze, Irma, Khosravi, Ardeshir, Khubchandani, Jagdish, Kim, Yun Jin, Kivipelto, Miia, Knibbs, Luke D., Kokubo, Yoshihiro, Kosen, Soewarta, Koul, Parvaiz A., Koyanagi, Ai, Krishnaswami, Sanjay, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A., Kulikoff, Xie Rachel, Kulkarni, Chanda, Kumar, G. Anil, Kutz, Michael J., Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lamadrid-Figueroa, Hector, Lan, Qing, Larsson, Anders, Laryea, Dennis Odai, Leigh, James, Leung, Ricky, Li, Yichong, Li, Yongmei, Lipshultz, Steven E., Liu, Patrick Y., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Lotufo, Paulo A., Lunevicius, Raimundas, Ma, Stefan, El Razek, Hassan Magdy Abd, El Razek, Mohammed Magdy Abd, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Mapoma, Chabila C., Marcenes, Wagner, Margolis, David Joel, Marquez, Neal, Masiye, Felix, Marzan, Melvin Barrientos, Mason-Jones, Amanda J., Mazorodze, Tasara T., Meaney, Peter A., Mehari, Alem, Mehndiratta, Man Mohan, Mena-Rodriguez, Fabiola, Mekonnen, Alemayehu B., Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J., Mhimbira, Francis Apolinary, Miller, Ted R., Mills, Edward J., Mirarefin, Mojde, Misganaw, Awoke, Ibrahim, Norlinah Mohamed, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mola, Glen Liddell D., Monasta, Lorenzo, Monis, Jonathan De la Cruz, Hernandez, Julio Cesar Montanez, Montero, Pablo, Montico, Marcella, Mooney, Meghan D., Moore, Ami R., Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Nachega, Jean B., Naheed, Aliya, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Nash, Denis, Neupane, Subas, Newton, John N., Ng, Marie, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Le Nguyen, Quyen, Nisar, Muhammad Imran, Nomura, Marika, Norheim, Ole F., Norman, Rosana E., Nyakarahuka, Luke, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Ojelabi, Foluke Adetola, Olivares, Pedro R., Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ota, Erika, Oyekale, Abayomi Samuel, Pa, Mahesh, Pain, Amanda, Papantoniou, Nikolaos, Park, Eun-Kee, Park, Hye-Youn, Caicedo, Angel J. Paternina, Patten, Scott B., Paul, Vinod K., Pereira, David M., Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Pillay, Julian David, Pishgar, Farhad, Polinder, Suzanne, Pope, Daniel, Pourmalek, Farshad, Qorbani, Mostafa, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Rangaswamy, Thara, Rao, Paturi Vishnupriya, Refaat, Amany H., and Remuzzi, Giuseppe
Abstract: Background In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015. Methods We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages 10-54 years by systematically compiling and processing all available data sources from 186 of 195 countries and territories, 11 of which were analysed at the subnational level. We quantified eight underlying causes of maternal death and four timing categories, improving estimation methods since GBD 2013 for adult all-cause mortality, HIV-related maternal mortality, and late maternal death. Secondary analyses then allowed systematic examination of drivers of trends, including the relation between maternal mortality and coverage of specific reproductive health-care services as well as assessment of observed versus expected maternal mortality as a function of Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Findings Only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1. Geographical disparities widened between 1990 and 2015 and, in 2015, 24 countries still had a maternal mortality ratio greater than 400. The proportion of all maternal deaths occurring in the bottom two SDI quintiles, where haemorrhage is the dominant cause of maternal death, increased from roughly 68% in 1990 to more than 80% in 2015. The middle SDI quintile improved the most from 1990 to 2015, but also has the most complicated causal profile. Maternal mortality in the highest SDI quintile is mostly due to other direct maternal disorders, indirect maternal disorders, and abortion, ectopic pregnancy, and
Published: 2016
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6. Global, regional, and national levels of maternal mortality, 1990-2015

Author: University of Helsinki, Department of Neurosciences, University of Helsinki, Department of Surgery, Kassebaum, Nicholas J., Barber, Ryan M., Bhutta, Zulfiqar A., Dandona, Lalit, Gething, Peter W., Hay, Simon I., Kinfu, Yohannes, Larson, Heidi J., Liang, Xiaofeng, Lim, Stephen S., Lopez, Alan D., Lozano, Rafael, Mensah, George A., Mokdad, Ali H., Naghavi, Mohsen, Pinho, Christine, Salomon, Joshua A., Steiner, Caitlyn, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M., Abd-Allah, Foad, Abdallat, Mahmud A., Abdulle, Abdishakur M., Abera, Semaw Ferede, Aboyans, Victor, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M. E., Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Adelekan, Ademola Lukman, Adou, Arsene Kouablan, Afanvi, Kossivi Agbelenko, Agarwal, Arnav, Kiadaliri, Aliasghar Ahmad, Ajala, Oluremi N., Akinyemiju, Tomi F., Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore K. M., Alasfoor, Deena, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alhabib, Samia, Ali, Raghib, Alkerwi, Ala'a, Alla, Francois, Al-Raddadi, Rajaa, Alsharif, Ubai, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T., Amberbir, Alemayehu, Amegah, Adeladza Kofi, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H., Anderson, Gregory M., Antoine, Rose Mayerline, Antonio, Carl Abelardo T., Aregay, Atsede Fantahun, Arnlov, Johan, Arora, Megha, Arsenijevic, Valentina S. Arsic, Al Artaman, Asayesh, Hamid, Atique, Suleman, Avokpaho, Euripide Frinel G. Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Bahit, Maria C., Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barker-Collo, Suzanne L., Barnighausen, Till, Basu, Sanjay, Bayou, Tigist Assefa, Bayou, Yibeltal Tebekaw, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, NeerajHaidong Wang, Bekele, Tolesa, Bell, Michelle L., Bennett, Derrick A., Bensenor, Isabela M., Berhane, Adugnaw, Bernabe, Eduardo, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Biadgilign, Sibhatu, Bikbov, Boris, Bin Abdulhak, Aref A., Biroscak, Brian J., Biryukov, Stan, Bisanzio, Donal, Bjertness, Espen, Blore, Jed D., Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J. K., Brugha, Traolach S., Butt, Zahid A., Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Cardenas, Rosario, Carrero, Juan Jesus, Carter, Austin, Casey, Daniel C., Castaneda-Oquela, Carlos A., Castro, Ruben Estanislao, Catala-Lopez, Ferran, Cavalleri, Fiorella, Chang, Hsing-Yi, Chang, Jung -Chen, Chavan, Laxmikant, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Cirillo, Massimo, Coates, Matthew M., Coggeshall, Megan, Colistro, Valentina, Colquhoun, Samantha M., Cooper, Cyrus, Cooper, Leslie Trumbull, Cortinovis, Monica, Dahiru, Tukur, Damasceno, Albertino, Danawi, Hadi, Dandona, Rakhi, Das Neves, Jose, De Leo, Diego, Dellavalle, Robert P., Deribe, Kebede, Deribew, Amare, Jarlais, Don C. Des, Dharmaratne, Samath D., Dicker, Daniel J., Ding, Eric L., Dossou, Edem, Dubey, Manisha, Ebel, Beth E., Ellingsen, Christian Lycke, Elyazar, Iqbal, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Esteghamati, Alireza, Faraon, Emerito Jose Aquino, Farid, Talha A., Farinha, Carla Sofia E. Sa, Faro, Andre, Farvid, Maryam S., Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C., Fischer, Florian, Fitchett, Joseph R. A., Fleming, Tom, Gt, Nataliya Fo, Franca, Elisabeth Barboza, Franklin, Richard C., Fraser, Maya S., Friedman, Joseph, Pullman, Nancy, Furst, Thomas, Futran, Neal D., Gambashidze, Ketevan, Gamkrelidze, Amiran, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebremedhin, Mengistu, Gebru, Alemseged Aregay, Geleijnse, Johanna M., Gibney, Katherine B., Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Glaser, Elizabeth, Goenka, Shifalika, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Goto, Atsushi, Graetz, Nicholas, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hancock, Jamie, Handal, Alexis J., Hankey, Graeme J., Harb, Hilda L., Harikrishnan, Sivadasanpillai, Harun, Kimani M., Havmoeller, Rasmus, Hoek, Hans W., Horino, Masako, Horita, Nobuyuki, Hosgood, H. Dean, Hoy, Damian G., Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Huang, John J., Huybrechts, Inge, Huynh, Chantal, Iannarone, Marissa, Iburg, Kim Moesgaard, Idrisov, Bulat T., Iyer, Veena J., Jacobsen, Kathryn H., Jahanmehr, Nader, Jakovljevic, Mihajlo B., Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jibat, Tariku, Jonas, Jost B., Kabir, Zubair, Kamal, Ritul, Kan, Haidong, Karch, Andre, Karletsos, Dimitris, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Francoise, Kazanjan, Konstantin, Kazi, Dhruv S., Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khonelidze, Irma, Khosravi, Ardeshir, Khubchandani, Jagdish, Kim, Yun Jin, Kivipelto, Miia, Knibbs, Luke D., Kokubo, Yoshihiro, Kosen, Soewarta, Koul, Parvaiz A., Koyanagi, Ai, Krishnaswami, Sanjay, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A., Kulikoff, Xie Rachel, Kulkarni, Chanda, Kumar, G. Anil, Kutz, Michael J., Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lamadrid-Figueroa, Hector, Lan, Qing, Larsson, Anders, Laryea, Dennis Odai, Leigh, James, Leung, Ricky, Li, Yichong, Li, Yongmei, Lipshultz, Steven E., Liu, Patrick Y., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Lotufo, Paulo A., Lunevicius, Raimundas, Ma, Stefan, El Razek, Hassan Magdy Abd, El Razek, Mohammed Magdy Abd, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Mapoma, Chabila C., Marcenes, Wagner, Margolis, David Joel, Marquez, Neal, Masiye, Felix, Marzan, Melvin Barrientos, Mason-Jones, Amanda J., Mazorodze, Tasara T., Meaney, Peter A., Mehari, Alem, Mehndiratta, Man Mohan, Mena-Rodriguez, Fabiola, Mekonnen, Alemayehu B., Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J., Mhimbira, Francis Apolinary, Miller, Ted R., Mills, Edward J., Mirarefin, Mojde, Misganaw, Awoke, Ibrahim, Norlinah Mohamed, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mola, Glen Liddell D., Monasta, Lorenzo, Monis, Jonathan De la Cruz, Hernandez, Julio Cesar Montanez, Montero, Pablo, Montico, Marcella, Mooney, Meghan D., Moore, Ami R., Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Nachega, Jean B., Naheed, Aliya, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Nash, Denis, Neupane, Subas, Newton, John N., Ng, Marie, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Le Nguyen, Quyen, Nisar, Muhammad Imran, Nomura, Marika, Norheim, Ole F., Norman, Rosana E., Nyakarahuka, Luke, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Ojelabi, Foluke Adetola, Olivares, Pedro R., Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ota, Erika, Oyekale, Abayomi Samuel, Pa, Mahesh, Pain, Amanda, Papantoniou, Nikolaos, Park, Eun-Kee, Park, Hye-Youn, Caicedo, Angel J. Paternina, Patten, Scott B., Paul, Vinod K., Pereira, David M., Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Pillay, Julian David, Pishgar, Farhad, Polinder, Suzanne, Pope, Daniel, Pourmalek, Farshad, Qorbani, Mostafa, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Rangaswamy, Thara, Rao, Paturi Vishnupriya, Refaat, Amany H., Remuzzi, Giuseppe, GBD 2015 Maternal Mortality, University of Helsinki, Department of Neurosciences, University of Helsinki, Department of Surgery, Kassebaum, Nicholas J., Barber, Ryan M., Bhutta, Zulfiqar A., Dandona, Lalit, Gething, Peter W., Hay, Simon I., Kinfu, Yohannes, Larson, Heidi J., Liang, Xiaofeng, Lim, Stephen S., Lopez, Alan D., Lozano, Rafael, Mensah, George A., Mokdad, Ali H., Naghavi, Mohsen, Pinho, Christine, Salomon, Joshua A., Steiner, Caitlyn, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M., Abd-Allah, Foad, Abdallat, Mahmud A., Abdulle, Abdishakur M., Abera, Semaw Ferede, Aboyans, Victor, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M. E., Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Adelekan, Ademola Lukman, Adou, Arsene Kouablan, Afanvi, Kossivi Agbelenko, Agarwal, Arnav, Kiadaliri, Aliasghar Ahmad, Ajala, Oluremi N., Akinyemiju, Tomi F., Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore K. M., Alasfoor, Deena, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alhabib, Samia, Ali, Raghib, Alkerwi, Ala'a, Alla, Francois, Al-Raddadi, Rajaa, Alsharif, Ubai, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T., Amberbir, Alemayehu, Amegah, Adeladza Kofi, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H., Anderson, Gregory M., Antoine, Rose Mayerline, Antonio, Carl Abelardo T., Aregay, Atsede Fantahun, Arnlov, Johan, Arora, Megha, Arsenijevic, Valentina S. Arsic, Al Artaman, Asayesh, Hamid, Atique, Suleman, Avokpaho, Euripide Frinel G. Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Bahit, Maria C., Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barker-Collo, Suzanne L., Barnighausen, Till, Basu, Sanjay, Bayou, Tigist Assefa, Bayou, Yibeltal Tebekaw, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, NeerajHaidong Wang, Bekele, Tolesa, Bell, Michelle L., Bennett, Derrick A., Bensenor, Isabela M., Berhane, Adugnaw, Bernabe, Eduardo, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Biadgilign, Sibhatu, Bikbov, Boris, Bin Abdulhak, Aref A., Biroscak, Brian J., Biryukov, Stan, Bisanzio, Donal, Bjertness, Espen, Blore, Jed D., Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J. K., Brugha, Traolach S., Butt, Zahid A., Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Cardenas, Rosario, Carrero, Juan Jesus, Carter, Austin, Casey, Daniel C., Castaneda-Oquela, Carlos A., Castro, Ruben Estanislao, Catala-Lopez, Ferran, Cavalleri, Fiorella, Chang, Hsing-Yi, Chang, Jung -Chen, Chavan, Laxmikant, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Cirillo, Massimo, Coates, Matthew M., Coggeshall, Megan, Colistro, Valentina, Colquhoun, Samantha M., Cooper, Cyrus, Cooper, Leslie Trumbull, Cortinovis, Monica, Dahiru, Tukur, Damasceno, Albertino, Danawi, Hadi, Dandona, Rakhi, Das Neves, Jose, De Leo, Diego, Dellavalle, Robert P., Deribe, Kebede, Deribew, Amare, Jarlais, Don C. Des, Dharmaratne, Samath D., Dicker, Daniel J., Ding, Eric L., Dossou, Edem, Dubey, Manisha, Ebel, Beth E., Ellingsen, Christian Lycke, Elyazar, Iqbal, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Esteghamati, Alireza, Faraon, Emerito Jose Aquino, Farid, Talha A., Farinha, Carla Sofia E. Sa, Faro, Andre, Farvid, Maryam S., Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C., Fischer, Florian, Fitchett, Joseph R. A., Fleming, Tom, Gt, Nataliya Fo, Franca, Elisabeth Barboza, Franklin, Richard C., Fraser, Maya S., Friedman, Joseph, Pullman, Nancy, Furst, Thomas, Futran, Neal D., Gambashidze, Ketevan, Gamkrelidze, Amiran, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebremedhin, Mengistu, Gebru, Alemseged Aregay, Geleijnse, Johanna M., Gibney, Katherine B., Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Glaser, Elizabeth, Goenka, Shifalika, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Goto, Atsushi, Graetz, Nicholas, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hancock, Jamie, Handal, Alexis J., Hankey, Graeme J., Harb, Hilda L., Harikrishnan, Sivadasanpillai, Harun, Kimani M., Havmoeller, Rasmus, Hoek, Hans W., Horino, Masako, Horita, Nobuyuki, Hosgood, H. Dean, Hoy, Damian G., Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Huang, John J., Huybrechts, Inge, Huynh, Chantal, Iannarone, Marissa, Iburg, Kim Moesgaard, Idrisov, Bulat T., Iyer, Veena J., Jacobsen, Kathryn H., Jahanmehr, Nader, Jakovljevic, Mihajlo B., Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jibat, Tariku, Jonas, Jost B., Kabir, Zubair, Kamal, Ritul, Kan, Haidong, Karch, Andre, Karletsos, Dimitris, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Francoise, Kazanjan, Konstantin, Kazi, Dhruv S., Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khonelidze, Irma, Khosravi, Ardeshir, Khubchandani, Jagdish, Kim, Yun Jin, Kivipelto, Miia, Knibbs, Luke D., Kokubo, Yoshihiro, Kosen, Soewarta, Koul, Parvaiz A., Koyanagi, Ai, Krishnaswami, Sanjay, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A., Kulikoff, Xie Rachel, Kulkarni, Chanda, Kumar, G. Anil, Kutz, Michael J., Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lamadrid-Figueroa, Hector, Lan, Qing, Larsson, Anders, Laryea, Dennis Odai, Leigh, James, Leung, Ricky, Li, Yichong, Li, Yongmei, Lipshultz, Steven E., Liu, Patrick Y., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Lotufo, Paulo A., Lunevicius, Raimundas, Ma, Stefan, El Razek, Hassan Magdy Abd, El Razek, Mohammed Magdy Abd, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Mapoma, Chabila C., Marcenes, Wagner, Margolis, David Joel, Marquez, Neal, Masiye, Felix, Marzan, Melvin Barrientos, Mason-Jones, Amanda J., Mazorodze, Tasara T., Meaney, Peter A., Mehari, Alem, Mehndiratta, Man Mohan, Mena-Rodriguez, Fabiola, Mekonnen, Alemayehu B., Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J., Mhimbira, Francis Apolinary, Miller, Ted R., Mills, Edward J., Mirarefin, Mojde, Misganaw, Awoke, Ibrahim, Norlinah Mohamed, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mola, Glen Liddell D., Monasta, Lorenzo, Monis, Jonathan De la Cruz, Hernandez, Julio Cesar Montanez, Montero, Pablo, Montico, Marcella, Mooney, Meghan D., Moore, Ami R., Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Nachega, Jean B., Naheed, Aliya, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Nash, Denis, Neupane, Subas, Newton, John N., Ng, Marie, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Le Nguyen, Quyen, Nisar, Muhammad Imran, Nomura, Marika, Norheim, Ole F., Norman, Rosana E., Nyakarahuka, Luke, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Ojelabi, Foluke Adetola, Olivares, Pedro R., Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ota, Erika, Oyekale, Abayomi Samuel, Pa, Mahesh, Pain, Amanda, Papantoniou, Nikolaos, Park, Eun-Kee, Park, Hye-Youn, Caicedo, Angel J. Paternina, Patten, Scott B., Paul, Vinod K., Pereira, David M., Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Pillay, Julian David, Pishgar, Farhad, Polinder, Suzanne, Pope, Daniel, Pourmalek, Farshad, Qorbani, Mostafa, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Rangaswamy, Thara, Rao, Paturi Vishnupriya, Refaat, Amany H., Remuzzi, Giuseppe, and GBD 2015 Maternal Mortality
Abstract: Background In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015. Methods We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages 10-54 years by systematically compiling and processing all available data sources from 186 of 195 countries and territories, 11 of which were analysed at the subnational level. We quantified eight underlying causes of maternal death and four timing categories, improving estimation methods since GBD 2013 for adult all-cause mortality, HIV-related maternal mortality, and late maternal death. Secondary analyses then allowed systematic examination of drivers of trends, including the relation between maternal mortality and coverage of specific reproductive health-care services as well as assessment of observed versus expected maternal mortality as a function of Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Findings Only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1. Geographical disparities widened between 1990 and 2015 and, in 2015, 24 countries still had a maternal mortality ratio greater than 400. The proportion of all maternal deaths occurring in the bottom two SDI quintiles, where haemorrhage is the dominant cause of maternal death, increased from roughly 68% in 1990 to more than 80% in 2015. The middle SDI quintile improved the most from 1990 to 2015, but also has the most complicated causal profile. Maternal mortality in the highest SDI quintile is mostly due to other direct maternal disorders, indirect maternal disorders, and abortion, ectopic pregnancy, and
Published: 2016

7. Global, regional, and national levels of maternal mortality, 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Author: Kassebaum, Nicholas J., Barber, Ryan M., Bhutta, Zulfiqar A., Dandona, Lalit, Gething, Peter W., Hay, Simon I., Kinfu, Yohannes, Larson, Heidi J., Liang, Xiaofeng, Lim, Stephen S., Lopez, Alan D., Lozano, Rafael, Mensah, George A., Mokdad, Ali H., Naghavi, Mohsen, Pinho, Christine, Salomon, Joshua A., Steiner, Caitlyn, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M., Abd-Allah, Foad, Abdallat, Mahmud A., Abdulle, Abdishakur M., Abera, Semaw Ferede, Aboyans, Victor, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M. E., Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Adelekan, Ademola Lukman, Adou, Arsene Kouablan, Afanvi, Kossivi Agbelenko, Agarwal, Arnav, Kiadaliri, Aliasghar Ahmad, Ajala, Oluremi N., Akinyemiju, Tomi F., Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore K. M., Alasfoor, Deena, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alhabib, Samia, Ali, Raghib, Alkerwi, Ala'a, Alla, Francois, Al-Raddadi, Rajaa, Alsharif, Ubai, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T., Amberbir, Alemayehu, Amegah, Adeladza Kofi, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H., Anderson, Gregory M., Antoine, Rose Mayerline, Antonio, Carl Abelardo T., Aregay, Atsede Fantahun, Ärnlöv, Johan, Arora, Megha, Arsenijevic, Valentina S. Arsic, Artaman, Al, Asayesh, Hamid, Atique, Suleman, Avokpaho, Euripide Frinel G. Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Bahit, Maria C., Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barker-Collo, Suzanne L., Barnighausen, Till, Basu, Sanjay, Bayou, Tigist Assefa, Bayou, Yibeltal Tebekaw, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, NeerajHaidong Wang, Bekele, Tolesa, Bell, Michelle L., Bennett, Derrick A., Bensenor, Isabela M., Berhane, Adugnaw, Bernabe, Eduardo, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Biadgilign, Sibhatu, Bikbov, Boris, Bin Abdulhak, Aref A., Biroscak, Brian J., Biryukov, Stan, Bisanzio, Donal, Bjertness, Espen, Blore, Jed D., Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J. K., Brugha, Traolach S., Butt, Zahid A., Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Cardenas, Rosario, Carrero, Juan Jesus, Carter, Austin, Casey, Daniel C., Castaneda-Oquela, Carlos A., Castro, Ruben Estanislao, Catala-Lopez, Ferran, Cavalleri, Fiorella, Chang, Hsing-Yi, Chang, Jung -Chen, Chavan, Laxmikant, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Cirillo, Massimo, Coates, Matthew M., Coggeshall, Megan, Colistro, Valentina, Colquhoun, Samantha M., Cooper, Cyrus, Cooper, Leslie Trumbull, Cortinovis, Monica, Dahiru, Tukur, Damasceno, Albertino, Danawi, Hadi, Dandona, Rakhi, Das Neves, Jose, De Leo, Diego, Dellavalle, Robert P., Deribe, Kebede, Deribew, Amare, Jarlais, Don C. Des, Dharmaratne, Samath D., Dicker, Daniel J., Ding, Eric L., Dossou, Edem, Dubey, Manisha, Ebel, Beth E., Ellingsen, Christian Lycke, Elyazar, Iqbal, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Esteghamati, Alireza, Faraon, Emerito Jose Aquino, Farid, Talha A., Farinha, Carla Sofia E. Sa, Faro, Andre, Farvid, Maryam S., Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C., Fischer, Florian, Fitchett, Joseph R. A., Fleming, Tom, Gt, Nataliya Fo, Franca, Elisabeth Barboza, Franklin, Richard C., Fraser, Maya S., Friedman, Joseph, Pullman, Nancy, Furst, Thomas, Futran, Neal D., Gambashidze, Ketevan, Gamkrelidze, Amiran, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebremedhin, Mengistu, Gebru, Alemseged Aregay, Geleijnse, Johanna M., Gibney, Katherine B., Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Glaser, Elizabeth, Goenka, Shifalika, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Goto, Atsushi, Graetz, Nicholas, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hancock, Jamie, Handal, Alexis J., Hankey, Graeme J., Harb, Hilda L., Harikrishnan, Sivadasanpillai, Harun, Kimani M., Havmoeller, Rasmus, Hoek, Hans W., Horino, Masako, Horita, Nobuyuki, Hosgood, H. Dean, Hoy, Damian G., Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Huang, John J., Huybrechts, Inge, Huynh, Chantal, Iannarone, Marissa, Iburg, Kim Moesgaard, Idrisov, Bulat T., Iyer, Veena J., Jacobsen, Kathryn H., Jahanmehr, Nader, Jakovljevic, Mihajlo B., Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jibat, Tariku, Jonas, Jost B., Kabir, Zubair, Kamal, Ritul, Kan, Haidong, Karch, Andre, Karletsos, Dimitris, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Francoise, Kazanjan, Konstantin, Kazi, Dhruv S., Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khonelidze, Irma, Khosravi, Ardeshir, Khubchandani, Jagdish, Kim, Yun Jin, Kivipelto, Miia, Knibbs, Luke D., Kokubo, Yoshihiro, Kosen, Soewarta, Koul, Parvaiz A., Koyanagi, Ai, Krishnaswami, Sanjay, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A., Kulikoff, Xie Rachel, Kulkarni, Chanda, Kumar, G. Anil, Kutz, Michael J., Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lamadrid-Figueroa, Hector, Lan, Qing, Larsson, Anders, Laryea, Dennis Odai, Leigh, James, Leung, Ricky, Li, Yichong, Li, Yongmei, Lipshultz, Steven E., Liu, Patrick Y., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Lotufo, Paulo A., Lunevicius, Raimundas, Ma, Stefan, El Razek, Hassan Magdy Abd, El Razek, Mohammed Magdy Abd, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Mapoma, Chabila C., Marcenes, Wagner, Margolis, David Joel, Marquez, Neal, Masiye, Felix, Marzan, Melvin Barrientos, Mason-Jones, Amanda J., Mazorodze, Tasara T., Meaney, Peter A., Mehari, Alem, Mehndiratta, Man Mohan, Mena-Rodriguez, Fabiola, Mekonnen, Alemayehu B., Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J., Mhimbira, Francis Apolinary, Miller, Ted R., Mills, Edward J., Mirarefin, Mojde, Misganaw, Awoke, Ibrahim, Norlinah Mohamed, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mola, Glen Liddell D., Monasta, Lorenzo, Monis, Jonathan De la Cruz, Hernandez, Julio Cesar Montanez, Montero, Pablo, Montico, Marcella, Mooney, Meghan D., Moore, Ami R., Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Nachega, Jean B., Naheed, Aliya, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Nash, Denis, Neupane, Subas, Newton, John N., Ng, Marie, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Le Nguyen, Quyen, Nisar, Muhammad Imran, Nomura, Marika, Norheim, Ole F., Norman, Rosana E., Nyakarahuka, Luke, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Ojelabi, Foluke Adetola, Olivares, Pedro R., Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ota, Erika, Oyekale, Abayomi Samuel, Pa, Mahesh, Pain, Amanda, Papantoniou, Nikolaos, Park, Eun-Kee, Park, Hye-Youn, Caicedo, Angel J. Paternina, Patten, Scott B., Paul, Vinod K., Pereira, David M., Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Pillay, Julian David, Pishgar, Farhad, Polinder, Suzanne, Pope, Daniel, Pourmalek, Farshad, Qorbani, Mostafa, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Rangaswamy, Thara, Rao, Paturi Vishnupriya, Refaat, Amany H., Remuzzi, Giuseppe, Kassebaum, Nicholas J., Barber, Ryan M., Bhutta, Zulfiqar A., Dandona, Lalit, Gething, Peter W., Hay, Simon I., Kinfu, Yohannes, Larson, Heidi J., Liang, Xiaofeng, Lim, Stephen S., Lopez, Alan D., Lozano, Rafael, Mensah, George A., Mokdad, Ali H., Naghavi, Mohsen, Pinho, Christine, Salomon, Joshua A., Steiner, Caitlyn, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M., Abd-Allah, Foad, Abdallat, Mahmud A., Abdulle, Abdishakur M., Abera, Semaw Ferede, Aboyans, Victor, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M. E., Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Adelekan, Ademola Lukman, Adou, Arsene Kouablan, Afanvi, Kossivi Agbelenko, Agarwal, Arnav, Kiadaliri, Aliasghar Ahmad, Ajala, Oluremi N., Akinyemiju, Tomi F., Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore K. M., Alasfoor, Deena, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alhabib, Samia, Ali, Raghib, Alkerwi, Ala'a, Alla, Francois, Al-Raddadi, Rajaa, Alsharif, Ubai, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T., Amberbir, Alemayehu, Amegah, Adeladza Kofi, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H., Anderson, Gregory M., Antoine, Rose Mayerline, Antonio, Carl Abelardo T., Aregay, Atsede Fantahun, Ärnlöv, Johan, Arora, Megha, Arsenijevic, Valentina S. Arsic, Artaman, Al, Asayesh, Hamid, Atique, Suleman, Avokpaho, Euripide Frinel G. Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Bahit, Maria C., Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barker-Collo, Suzanne L., Barnighausen, Till, Basu, Sanjay, Bayou, Tigist Assefa, Bayou, Yibeltal Tebekaw, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, NeerajHaidong Wang, Bekele, Tolesa, Bell, Michelle L., Bennett, Derrick A., Bensenor, Isabela M., Berhane, Adugnaw, Bernabe, Eduardo, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Biadgilign, Sibhatu, Bikbov, Boris, Bin Abdulhak, Aref A., Biroscak, Brian J., Biryukov, Stan, Bisanzio, Donal, Bjertness, Espen, Blore, Jed D., Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J. K., Brugha, Traolach S., Butt, Zahid A., Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Cardenas, Rosario, Carrero, Juan Jesus, Carter, Austin, Casey, Daniel C., Castaneda-Oquela, Carlos A., Castro, Ruben Estanislao, Catala-Lopez, Ferran, Cavalleri, Fiorella, Chang, Hsing-Yi, Chang, Jung -Chen, Chavan, Laxmikant, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Cirillo, Massimo, Coates, Matthew M., Coggeshall, Megan, Colistro, Valentina, Colquhoun, Samantha M., Cooper, Cyrus, Cooper, Leslie Trumbull, Cortinovis, Monica, Dahiru, Tukur, Damasceno, Albertino, Danawi, Hadi, Dandona, Rakhi, Das Neves, Jose, De Leo, Diego, Dellavalle, Robert P., Deribe, Kebede, Deribew, Amare, Jarlais, Don C. Des, Dharmaratne, Samath D., Dicker, Daniel J., Ding, Eric L., Dossou, Edem, Dubey, Manisha, Ebel, Beth E., Ellingsen, Christian Lycke, Elyazar, Iqbal, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Esteghamati, Alireza, Faraon, Emerito Jose Aquino, Farid, Talha A., Farinha, Carla Sofia E. Sa, Faro, Andre, Farvid, Maryam S., Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C., Fischer, Florian, Fitchett, Joseph R. A., Fleming, Tom, Gt, Nataliya Fo, Franca, Elisabeth Barboza, Franklin, Richard C., Fraser, Maya S., Friedman, Joseph, Pullman, Nancy, Furst, Thomas, Futran, Neal D., Gambashidze, Ketevan, Gamkrelidze, Amiran, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebremedhin, Mengistu, Gebru, Alemseged Aregay, Geleijnse, Johanna M., Gibney, Katherine B., Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Glaser, Elizabeth, Goenka, Shifalika, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Goto, Atsushi, Graetz, Nicholas, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hancock, Jamie, Handal, Alexis J., Hankey, Graeme J., Harb, Hilda L., Harikrishnan, Sivadasanpillai, Harun, Kimani M., Havmoeller, Rasmus, Hoek, Hans W., Horino, Masako, Horita, Nobuyuki, Hosgood, H. Dean, Hoy, Damian G., Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Huang, John J., Huybrechts, Inge, Huynh, Chantal, Iannarone, Marissa, Iburg, Kim Moesgaard, Idrisov, Bulat T., Iyer, Veena J., Jacobsen, Kathryn H., Jahanmehr, Nader, Jakovljevic, Mihajlo B., Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jibat, Tariku, Jonas, Jost B., Kabir, Zubair, Kamal, Ritul, Kan, Haidong, Karch, Andre, Karletsos, Dimitris, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Francoise, Kazanjan, Konstantin, Kazi, Dhruv S., Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khonelidze, Irma, Khosravi, Ardeshir, Khubchandani, Jagdish, Kim, Yun Jin, Kivipelto, Miia, Knibbs, Luke D., Kokubo, Yoshihiro, Kosen, Soewarta, Koul, Parvaiz A., Koyanagi, Ai, Krishnaswami, Sanjay, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A., Kulikoff, Xie Rachel, Kulkarni, Chanda, Kumar, G. Anil, Kutz, Michael J., Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lamadrid-Figueroa, Hector, Lan, Qing, Larsson, Anders, Laryea, Dennis Odai, Leigh, James, Leung, Ricky, Li, Yichong, Li, Yongmei, Lipshultz, Steven E., Liu, Patrick Y., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Lotufo, Paulo A., Lunevicius, Raimundas, Ma, Stefan, El Razek, Hassan Magdy Abd, El Razek, Mohammed Magdy Abd, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Mapoma, Chabila C., Marcenes, Wagner, Margolis, David Joel, Marquez, Neal, Masiye, Felix, Marzan, Melvin Barrientos, Mason-Jones, Amanda J., Mazorodze, Tasara T., Meaney, Peter A., Mehari, Alem, Mehndiratta, Man Mohan, Mena-Rodriguez, Fabiola, Mekonnen, Alemayehu B., Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J., Mhimbira, Francis Apolinary, Miller, Ted R., Mills, Edward J., Mirarefin, Mojde, Misganaw, Awoke, Ibrahim, Norlinah Mohamed, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mola, Glen Liddell D., Monasta, Lorenzo, Monis, Jonathan De la Cruz, Hernandez, Julio Cesar Montanez, Montero, Pablo, Montico, Marcella, Mooney, Meghan D., Moore, Ami R., Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Nachega, Jean B., Naheed, Aliya, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Nash, Denis, Neupane, Subas, Newton, John N., Ng, Marie, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Le Nguyen, Quyen, Nisar, Muhammad Imran, Nomura, Marika, Norheim, Ole F., Norman, Rosana E., Nyakarahuka, Luke, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Ojelabi, Foluke Adetola, Olivares, Pedro R., Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ota, Erika, Oyekale, Abayomi Samuel, Pa, Mahesh, Pain, Amanda, Papantoniou, Nikolaos, Park, Eun-Kee, Park, Hye-Youn, Caicedo, Angel J. Paternina, Patten, Scott B., Paul, Vinod K., Pereira, David M., Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Pillay, Julian David, Pishgar, Farhad, Polinder, Suzanne, Pope, Daniel, Pourmalek, Farshad, Qorbani, Mostafa, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Rangaswamy, Thara, Rao, Paturi Vishnupriya, Refaat, Amany H., and Remuzzi, Giuseppe
Abstract: Background In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015. Methods We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages 10-54 years by systematically compiling and processing all available data sources from 186 of 195 countries and territories, 11 of which were analysed at the subnational level. We quantified eight underlying causes of maternal death and four timing categories, improving estimation methods since GBD 2013 for adult all-cause mortality, HIV-related maternal mortality, and late maternal death. Secondary analyses then allowed systematic examination of drivers of trends, including the relation between maternal mortality and coverage of specific reproductive health-care services as well as assessment of observed versus expected maternal mortality as a function of Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Findings Only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1. Geographical disparities widened between 1990 and 2015 and, in 2015, 24 countries still had a maternal mortality ratio greater than 400. The proportion of all maternal deaths occurring in the bottom two SDI quintiles, where haemorrhage is the dominant cause of maternal death, increased from roughly 68% in 1990 to more than 80% in 2015. The middle SDI quintile improved the most from 1990 to 2015, but also has the most complicated causal profile. Maternal mortality in the highest SDI quintile is mostly due to other direct maternal disorders, indirect maternal disorders, and abortion, ectopic pregnancy, and
Published: 2016
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8. Global, regional, and national levels of maternal mortality, 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Author: Kassebaum, Nicholas J., Barber, Ryan M., Bhutta, Zulfiqar A., Dandona, Lalit, Gething, Peter W., Hay, Simon I., Kinfu, Yohannes, Larson, Heidi J., Liang, Xiaofeng, Lim, Stephen S., Lopez, Alan D., Lozano, Rafael, Mensah, George A., Mokdad, Ali H., Naghavi, Mohsen, Pinho, Christine, Salomon, Joshua A., Steiner, Caitlyn, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M., Abd-Allah, Foad, Abdallat, Mahmud A., Abdulle, Abdishakur M., Abera, Semaw Ferede, Aboyans, Victor, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M. E., Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Adelekan, Ademola Lukman, Adou, Arsene Kouablan, Afanvi, Kossivi Agbelenko, Agarwal, Arnav, Kiadaliri, Aliasghar Ahmad, Ajala, Oluremi N., Akinyemiju, Tomi F., Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore K. M., Alasfoor, Deena, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alhabib, Samia, Ali, Raghib, Alkerwi, Ala'a, Alla, Francois, Al-Raddadi, Rajaa, Alsharif, Ubai, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T., Amberbir, Alemayehu, Amegah, Adeladza Kofi, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H., Anderson, Gregory M., Antoine, Rose Mayerline, Antonio, Carl Abelardo T., Aregay, Atsede Fantahun, Ärnlöv, Johan, Arora, Megha, Arsenijevic, Valentina S. Arsic, Artaman, Al, Asayesh, Hamid, Atique, Suleman, Avokpaho, Euripide Frinel G. Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Bahit, Maria C., Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barker-Collo, Suzanne L., Barnighausen, Till, Basu, Sanjay, Bayou, Tigist Assefa, Bayou, Yibeltal Tebekaw, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, NeerajHaidong Wang, Bekele, Tolesa, Bell, Michelle L., Bennett, Derrick A., Bensenor, Isabela M., Berhane, Adugnaw, Bernabe, Eduardo, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Biadgilign, Sibhatu, Bikbov, Boris, Bin Abdulhak, Aref A., Biroscak, Brian J., Biryukov, Stan, Bisanzio, Donal, Bjertness, Espen, Blore, Jed D., Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J. K., Brugha, Traolach S., Butt, Zahid A., Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Cardenas, Rosario, Carrero, Juan Jesus, Carter, Austin, Casey, Daniel C., Castaneda-Oquela, Carlos A., Castro, Ruben Estanislao, Catala-Lopez, Ferran, Cavalleri, Fiorella, Chang, Hsing-Yi, Chang, Jung -Chen, Chavan, Laxmikant, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Cirillo, Massimo, Coates, Matthew M., Coggeshall, Megan, Colistro, Valentina, Colquhoun, Samantha M., Cooper, Cyrus, Cooper, Leslie Trumbull, Cortinovis, Monica, Dahiru, Tukur, Damasceno, Albertino, Danawi, Hadi, Dandona, Rakhi, Das Neves, Jose, De Leo, Diego, Dellavalle, Robert P., Deribe, Kebede, Deribew, Amare, Jarlais, Don C. Des, Dharmaratne, Samath D., Dicker, Daniel J., Ding, Eric L., Dossou, Edem, Dubey, Manisha, Ebel, Beth E., Ellingsen, Christian Lycke, Elyazar, Iqbal, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Esteghamati, Alireza, Faraon, Emerito Jose Aquino, Farid, Talha A., Farinha, Carla Sofia E. Sa, Faro, Andre, Farvid, Maryam S., Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C., Fischer, Florian, Fitchett, Joseph R. A., Fleming, Tom, Gt, Nataliya Fo, Franca, Elisabeth Barboza, Franklin, Richard C., Fraser, Maya S., Friedman, Joseph, Pullman, Nancy, Furst, Thomas, Futran, Neal D., Gambashidze, Ketevan, Gamkrelidze, Amiran, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebremedhin, Mengistu, Gebru, Alemseged Aregay, Geleijnse, Johanna M., Gibney, Katherine B., Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Glaser, Elizabeth, Goenka, Shifalika, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Goto, Atsushi, Graetz, Nicholas, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hancock, Jamie, Handal, Alexis J., Hankey, Graeme J., Harb, Hilda L., Harikrishnan, Sivadasanpillai, Harun, Kimani M., Havmoeller, Rasmus, Hoek, Hans W., Horino, Masako, Horita, Nobuyuki, Hosgood, H. Dean, Hoy, Damian G., Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Huang, John J., Huybrechts, Inge, Huynh, Chantal, Iannarone, Marissa, Iburg, Kim Moesgaard, Idrisov, Bulat T., Iyer, Veena J., Jacobsen, Kathryn H., Jahanmehr, Nader, Jakovljevic, Mihajlo B., Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jibat, Tariku, Jonas, Jost B., Kabir, Zubair, Kamal, Ritul, Kan, Haidong, Karch, Andre, Karletsos, Dimitris, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Francoise, Kazanjan, Konstantin, Kazi, Dhruv S., Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khonelidze, Irma, Khosravi, Ardeshir, Khubchandani, Jagdish, Kim, Yun Jin, Kivipelto, Miia, Knibbs, Luke D., Kokubo, Yoshihiro, Kosen, Soewarta, Koul, Parvaiz A., Koyanagi, Ai, Krishnaswami, Sanjay, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A., Kulikoff, Xie Rachel, Kulkarni, Chanda, Kumar, G. Anil, Kutz, Michael J., Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lamadrid-Figueroa, Hector, Lan, Qing, Larsson, Anders, Laryea, Dennis Odai, Leigh, James, Leung, Ricky, Li, Yichong, Li, Yongmei, Lipshultz, Steven E., Liu, Patrick Y., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Lotufo, Paulo A., Lunevicius, Raimundas, Ma, Stefan, El Razek, Hassan Magdy Abd, El Razek, Mohammed Magdy Abd, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Mapoma, Chabila C., Marcenes, Wagner, Margolis, David Joel, Marquez, Neal, Masiye, Felix, Marzan, Melvin Barrientos, Mason-Jones, Amanda J., Mazorodze, Tasara T., Meaney, Peter A., Mehari, Alem, Mehndiratta, Man Mohan, Mena-Rodriguez, Fabiola, Mekonnen, Alemayehu B., Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J., Mhimbira, Francis Apolinary, Miller, Ted R., Mills, Edward J., Mirarefin, Mojde, Misganaw, Awoke, Ibrahim, Norlinah Mohamed, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mola, Glen Liddell D., Monasta, Lorenzo, Monis, Jonathan De la Cruz, Hernandez, Julio Cesar Montanez, Montero, Pablo, Montico, Marcella, Mooney, Meghan D., Moore, Ami R., Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Nachega, Jean B., Naheed, Aliya, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Nash, Denis, Neupane, Subas, Newton, John N., Ng, Marie, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Le Nguyen, Quyen, Nisar, Muhammad Imran, Nomura, Marika, Norheim, Ole F., Norman, Rosana E., Nyakarahuka, Luke, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Ojelabi, Foluke Adetola, Olivares, Pedro R., Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ota, Erika, Oyekale, Abayomi Samuel, Pa, Mahesh, Pain, Amanda, Papantoniou, Nikolaos, Park, Eun-Kee, Park, Hye-Youn, Caicedo, Angel J. Paternina, Patten, Scott B., Paul, Vinod K., Pereira, David M., Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Pillay, Julian David, Pishgar, Farhad, Polinder, Suzanne, Pope, Daniel, Pourmalek, Farshad, Qorbani, Mostafa, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Rangaswamy, Thara, Rao, Paturi Vishnupriya, Refaat, Amany H., Remuzzi, Giuseppe, Kassebaum, Nicholas J., Barber, Ryan M., Bhutta, Zulfiqar A., Dandona, Lalit, Gething, Peter W., Hay, Simon I., Kinfu, Yohannes, Larson, Heidi J., Liang, Xiaofeng, Lim, Stephen S., Lopez, Alan D., Lozano, Rafael, Mensah, George A., Mokdad, Ali H., Naghavi, Mohsen, Pinho, Christine, Salomon, Joshua A., Steiner, Caitlyn, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M., Abd-Allah, Foad, Abdallat, Mahmud A., Abdulle, Abdishakur M., Abera, Semaw Ferede, Aboyans, Victor, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M. E., Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Adelekan, Ademola Lukman, Adou, Arsene Kouablan, Afanvi, Kossivi Agbelenko, Agarwal, Arnav, Kiadaliri, Aliasghar Ahmad, Ajala, Oluremi N., Akinyemiju, Tomi F., Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore K. M., Alasfoor, Deena, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alhabib, Samia, Ali, Raghib, Alkerwi, Ala'a, Alla, Francois, Al-Raddadi, Rajaa, Alsharif, Ubai, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T., Amberbir, Alemayehu, Amegah, Adeladza Kofi, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H., Anderson, Gregory M., Antoine, Rose Mayerline, Antonio, Carl Abelardo T., Aregay, Atsede Fantahun, Ärnlöv, Johan, Arora, Megha, Arsenijevic, Valentina S. Arsic, Artaman, Al, Asayesh, Hamid, Atique, Suleman, Avokpaho, Euripide Frinel G. Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Bahit, Maria C., Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barker-Collo, Suzanne L., Barnighausen, Till, Basu, Sanjay, Bayou, Tigist Assefa, Bayou, Yibeltal Tebekaw, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, NeerajHaidong Wang, Bekele, Tolesa, Bell, Michelle L., Bennett, Derrick A., Bensenor, Isabela M., Berhane, Adugnaw, Bernabe, Eduardo, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Biadgilign, Sibhatu, Bikbov, Boris, Bin Abdulhak, Aref A., Biroscak, Brian J., Biryukov, Stan, Bisanzio, Donal, Bjertness, Espen, Blore, Jed D., Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J. K., Brugha, Traolach S., Butt, Zahid A., Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Cardenas, Rosario, Carrero, Juan Jesus, Carter, Austin, Casey, Daniel C., Castaneda-Oquela, Carlos A., Castro, Ruben Estanislao, Catala-Lopez, Ferran, Cavalleri, Fiorella, Chang, Hsing-Yi, Chang, Jung -Chen, Chavan, Laxmikant, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Cirillo, Massimo, Coates, Matthew M., Coggeshall, Megan, Colistro, Valentina, Colquhoun, Samantha M., Cooper, Cyrus, Cooper, Leslie Trumbull, Cortinovis, Monica, Dahiru, Tukur, Damasceno, Albertino, Danawi, Hadi, Dandona, Rakhi, Das Neves, Jose, De Leo, Diego, Dellavalle, Robert P., Deribe, Kebede, Deribew, Amare, Jarlais, Don C. Des, Dharmaratne, Samath D., Dicker, Daniel J., Ding, Eric L., Dossou, Edem, Dubey, Manisha, Ebel, Beth E., Ellingsen, Christian Lycke, Elyazar, Iqbal, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Esteghamati, Alireza, Faraon, Emerito Jose Aquino, Farid, Talha A., Farinha, Carla Sofia E. Sa, Faro, Andre, Farvid, Maryam S., Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C., Fischer, Florian, Fitchett, Joseph R. A., Fleming, Tom, Gt, Nataliya Fo, Franca, Elisabeth Barboza, Franklin, Richard C., Fraser, Maya S., Friedman, Joseph, Pullman, Nancy, Furst, Thomas, Futran, Neal D., Gambashidze, Ketevan, Gamkrelidze, Amiran, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebremedhin, Mengistu, Gebru, Alemseged Aregay, Geleijnse, Johanna M., Gibney, Katherine B., Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Glaser, Elizabeth, Goenka, Shifalika, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Goto, Atsushi, Graetz, Nicholas, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hancock, Jamie, Handal, Alexis J., Hankey, Graeme J., Harb, Hilda L., Harikrishnan, Sivadasanpillai, Harun, Kimani M., Havmoeller, Rasmus, Hoek, Hans W., Horino, Masako, Horita, Nobuyuki, Hosgood, H. Dean, Hoy, Damian G., Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Huang, John J., Huybrechts, Inge, Huynh, Chantal, Iannarone, Marissa, Iburg, Kim Moesgaard, Idrisov, Bulat T., Iyer, Veena J., Jacobsen, Kathryn H., Jahanmehr, Nader, Jakovljevic, Mihajlo B., Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jibat, Tariku, Jonas, Jost B., Kabir, Zubair, Kamal, Ritul, Kan, Haidong, Karch, Andre, Karletsos, Dimitris, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Francoise, Kazanjan, Konstantin, Kazi, Dhruv S., Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khonelidze, Irma, Khosravi, Ardeshir, Khubchandani, Jagdish, Kim, Yun Jin, Kivipelto, Miia, Knibbs, Luke D., Kokubo, Yoshihiro, Kosen, Soewarta, Koul, Parvaiz A., Koyanagi, Ai, Krishnaswami, Sanjay, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A., Kulikoff, Xie Rachel, Kulkarni, Chanda, Kumar, G. Anil, Kutz, Michael J., Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lamadrid-Figueroa, Hector, Lan, Qing, Larsson, Anders, Laryea, Dennis Odai, Leigh, James, Leung, Ricky, Li, Yichong, Li, Yongmei, Lipshultz, Steven E., Liu, Patrick Y., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Lotufo, Paulo A., Lunevicius, Raimundas, Ma, Stefan, El Razek, Hassan Magdy Abd, El Razek, Mohammed Magdy Abd, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Mapoma, Chabila C., Marcenes, Wagner, Margolis, David Joel, Marquez, Neal, Masiye, Felix, Marzan, Melvin Barrientos, Mason-Jones, Amanda J., Mazorodze, Tasara T., Meaney, Peter A., Mehari, Alem, Mehndiratta, Man Mohan, Mena-Rodriguez, Fabiola, Mekonnen, Alemayehu B., Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J., Mhimbira, Francis Apolinary, Miller, Ted R., Mills, Edward J., Mirarefin, Mojde, Misganaw, Awoke, Ibrahim, Norlinah Mohamed, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mola, Glen Liddell D., Monasta, Lorenzo, Monis, Jonathan De la Cruz, Hernandez, Julio Cesar Montanez, Montero, Pablo, Montico, Marcella, Mooney, Meghan D., Moore, Ami R., Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Nachega, Jean B., Naheed, Aliya, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Nash, Denis, Neupane, Subas, Newton, John N., Ng, Marie, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Le Nguyen, Quyen, Nisar, Muhammad Imran, Nomura, Marika, Norheim, Ole F., Norman, Rosana E., Nyakarahuka, Luke, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Ojelabi, Foluke Adetola, Olivares, Pedro R., Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ota, Erika, Oyekale, Abayomi Samuel, Pa, Mahesh, Pain, Amanda, Papantoniou, Nikolaos, Park, Eun-Kee, Park, Hye-Youn, Caicedo, Angel J. Paternina, Patten, Scott B., Paul, Vinod K., Pereira, David M., Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Pillay, Julian David, Pishgar, Farhad, Polinder, Suzanne, Pope, Daniel, Pourmalek, Farshad, Qorbani, Mostafa, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Rangaswamy, Thara, Rao, Paturi Vishnupriya, Refaat, Amany H., and Remuzzi, Giuseppe
Abstract: Background In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015. Methods We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages 10-54 years by systematically compiling and processing all available data sources from 186 of 195 countries and territories, 11 of which were analysed at the subnational level. We quantified eight underlying causes of maternal death and four timing categories, improving estimation methods since GBD 2013 for adult all-cause mortality, HIV-related maternal mortality, and late maternal death. Secondary analyses then allowed systematic examination of drivers of trends, including the relation between maternal mortality and coverage of specific reproductive health-care services as well as assessment of observed versus expected maternal mortality as a function of Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Findings Only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1. Geographical disparities widened between 1990 and 2015 and, in 2015, 24 countries still had a maternal mortality ratio greater than 400. The proportion of all maternal deaths occurring in the bottom two SDI quintiles, where haemorrhage is the dominant cause of maternal death, increased from roughly 68% in 1990 to more than 80% in 2015. The middle SDI quintile improved the most from 1990 to 2015, but also has the most complicated causal profile. Maternal mortality in the highest SDI quintile is mostly due to other direct maternal disorders, indirect maternal disorders, and abortion, ectopic pregnancy, and
Published: 2016
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9. Adhesion testing procedure for hot-poured crack sealants.

Author: United States. Federal Highway Administration, Virginia. Dept. of Transportation, Al-Qadi, Imad L., Fini, Eli H., Figueroa, Hector D., Masson, Jean-Francois Masson, McGhee, Kevin K., University of Illinois at Urbana-Champaign. Department of Civil and Environmental Engineering, Quality Engineering Solutions, Inc., National Research Council Canada, Virginia Transportation Research Council (VTRC), United States. Federal Highway Administration, Virginia. Dept. of Transportation, Al-Qadi, Imad L., Fini, Eli H., Figueroa, Hector D., Masson, Jean-Francois Masson, McGhee, Kevin K., University of Illinois at Urbana-Champaign. Department of Civil and Environmental Engineering, Quality Engineering Solutions, Inc., National Research Council Canada, and Virginia Transportation Research Council (VTRC)
Abstract: VTRC Project # 67775, TPF-5(045), Crack sealing is a common pavement maintenance treatment because it extends pavement service life significantly., However, crack sealant often fails prematurely due to a loss of adhesion. Because current test methods are mostly, empirical and only provide a qualitative measure of bond strength, they cannot predict sealant adhesive failure accurately., Hence, there is an urgent need for test methods based on bituminous sealant rheology that can better predict sealant field, performance. This study introduces three laboratory tests aimed to assess the bond property of hot-poured crack sealant to, pavement crack walls. The three tests are designed to serve the respective needs of producers, engineers, and, researchers. The first test implements the principle of surface energy to measure the thermodynamic work of adhesion, which is the energy spent in separating the two materials at the interface. The work of adhesion is reported as a measure of, material compatibility at an interface. The second test is a direct adhesion test, a mechanical test which is designed to, closely resemble both the installation process and the crack expansion due to thermal loading. This test uses the Direct, Tensile Test (DTT) machine. The principle of the test is to apply a tensile force to detach the sealant from its aggregate, counterpart. The maximum load, Pmax, and the energy to separation, E, are calculated and reported to indicate interface, bonding. The third test implements the principles of fracture mechanics in a pressurized circular blister test. The apparatus, is specifically designed to conduct the test for bituminous crack sealant, asphalt binder, or other bitumen-based materials., In this test, a fluid is injected at a constant rate at the interface between the substrate (aggregate or a standard material), and the adhesive (crack sealant) to create a blister. The fluid pressure and blister height are measured as functions of time, the data is used to calculate Interfacial Fracture Energy (IFE), which is a fundamental property that can be used to predict, adhesion. The stable interface debonding process makes this test attractive. This test may also provide a means to quantify, other factors, such as the moisture susceptibility of a bond. In addition, the elastic modulus of the sealant and its residual, stresses can be determined analytically. While the direct adhesion test is proposed as part of a newly developed, performance-based guideline for the selection of hot-poured crack sealant, the blister test can be used to estimate the, optimum annealing time and installation temperature.

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1. Can a simulation-based training program impact the use of evidence based routine practices at birth? Results of a hospital-based cluster randomized trial in Mexico.

2. Can a simulation-based training program impact the use of evidence based routine practices at birth? Results of a hospital-based cluster randomized trial in Mexico.

3. Global, regional, and national levels of maternal mortality, 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015

4. Global, regional, and national levels of maternal mortality, 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015

5. Global, regional, and national levels of maternal mortality, 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015

6. Global, regional, and national levels of maternal mortality, 1990-2015

7. Global, regional, and national levels of maternal mortality, 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015

8. Global, regional, and national levels of maternal mortality, 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015

9. Adhesion testing procedure for hot-poured crack sealants.

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