Characterisation of maternal mortality in Colombian indigenous communities, 2011 to 2013. Study of the surveillance epidemiological records of sentinel cases
DOI:
https://doi.org/10.18597/rcog.2925Keywords:
Maternal mortality, indigenous population, eclampsia, postpartum haemorrhage, puerperal infectionAbstract
Objective: To characterise the behaviour of maternal mortality (MM) in Colombian indigenous populations during the triennium 2011-2013.
Materials and methods: Study based on epidemiological surveillance of maternal mortality cases. The study population included all maternal deaths, direct and indirect, and live births reported in the indigenous population in the country. Cases of mortality coinciding with pregnancy, such as deaths due to injuries from external causes, accidental and incidental causes, were excluded. The search of MM sentinel cases was made in the databases of the National Public Health Surveillance System (SIVIGILA) from the National Health Institute (INS), and registries of births and deaths of the National Administrative Statistics Department (DANE) for the time period between 2011 and 2013. Sociodemographic variables, maternal and childbirth care variables, geographical area and place of death, and grouped and specific causes of maternal death were measured. A descriptive analysis of the information was carried out using absolute and relative frequency measurements for the data.
Results: In Colombia, 1546 cases of deaths in pregnant women were reported during the triennium 2011-2013, of which 143 cases of MM were analysed in indigenous communities: 130 met the inclusion criteria and 13 were excluded due to incidental or accidental causes. The maternal mortality ratio (MMR) for this population was 327.5 per 100,000 live births during the triennium, while in the non-indigenous population it was 60.9. Of maternal deaths in indigenous population, 22.3% were in girls under 19 years of age and 29.2% in women over 35 years of age. The main causes of MM were postpartum haemorrhage, eclampsia and puerperal sepsis.
Conclusion: In indigenous communities, maternal mortality is five times greater than in the non-indigenous population of the country. Multisectorial interventions that take into consideration the cultures of these peoples are needed in order to reduce inequities that affect them.
Author Biographies
Laura Margarita Bello-Álvarez, Universidad Nacional de Colombia
Médica con Énfasis en Salud Pública, Universidad de La Sabana; MSc(e) Public Health, University of London – London School of Hygiene and Tropical Medicine; Especialista en Obstetricia y Ginecología, Universidad
Nacional de Colombia. Cali, Colombia. lmbelloa@unal.edu.co
Arturo José Parada Baños, Universidad Nacional de Colombia
Especialista en Obstetricia y Ginecología, Universidad Nacional
de Colombia. Profesor Asociado, Departamento de Obstetricia y
Ginecología, Facultad de Medicina, Universidad Nacional de Colombia. Bogotá, Colombia. ajparadab@unal.edu.co
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