Analysis of Inequalities and Inequities in Maternal Mortality in Chocó, Colombia

Jorge Martín Rodríguez Hernández, Liany Katerine Ariza Ruiz, Daniella Castro Barbudo, Paula Vivas Sánchez (), María Alexandra Matallana Gómez, Leidy Johanna Gómez Hernández, Lilibeth Romero Mendoza and Pablo Enrique Chaparro Narváez
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Jorge Martín Rodríguez Hernández: Public Health Institute (PHI), Pontificia Universidad Javeriana, Bogotá 110231, Colombia
Liany Katerine Ariza Ruiz: Public Health Institute (PHI), Pontificia Universidad Javeriana, Bogotá 110231, Colombia
Daniella Castro Barbudo: Public Health Institute (PHI), Pontificia Universidad Javeriana, Bogotá 110231, Colombia
Paula Vivas Sánchez: Public Health Institute (PHI), Pontificia Universidad Javeriana, Bogotá 110231, Colombia
María Alexandra Matallana Gómez: Public Health Institute (PHI), Pontificia Universidad Javeriana, Bogotá 110231, Colombia
Leidy Johanna Gómez Hernández: Public Health Institute (PHI), Pontificia Universidad Javeriana, Bogotá 110231, Colombia
Lilibeth Romero Mendoza: Public Health Institute (PHI), Pontificia Universidad Javeriana, Bogotá 110231, Colombia
Pablo Enrique Chaparro Narváez: Public Health Institute (PHI), Pontificia Universidad Javeriana, Bogotá 110231, Colombia

IJERPH, 2023, vol. 20, issue 12, 1-13

Abstract: We used a mixed design study to analyze the inequalities and inequities in Maternal Mortality (MM) for Chocó (Colombia) between 2010–2018. The quantitative component consisted of an analytical ecological design, where proportions, ratios, measures of central tendency and rates ratios, rate difference, Gini and concentration indices were calculated to measure inequalities. The qualitative component had a phenomenological and interpretive approach. One hundred thirty-one women died in Choco between 2010–2018. The Maternal Mortality Ratio was 224/100.000 live births. The Gini coefficient was 0.35, indicating inequality in the distribution of the number of MM with respect to live births. The health service offers have been concentrated in the private sector in urban areas (77%). The exercise of midwifery has played an important role in maternal and perinatal care processes, especially in territories where the State has been absent. Nevertheless, it occurs in complex circumstances such as the armed conflict, lack of transportation routes, and income deficits, affecting the timelines and care quality for these vulnerable groups. MM in Chocó has been a consequence of deficiencies in the health system and weaknesses in its infrastructure (absence of a high level of maternal-perinatal care). This is in addition to the territory’s geographical characteristics, which increase vulnerability and health risks for women and their newborns. In Colombia, as well as in other countries, many maternal and newborn deaths are preventable because their causes are due to social injustices.

Keywords: maternal mortality; social determinants of health; maternal health services; Colombia; midwifery (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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