Reasons for Persistently High Maternal and Perinatal Mortalities in Ethiopia: Part I-Health System Factors

Abstract

BACKGROUND: Ethiopia is known for its high maternal and perinatal mortalities as in the case of many Sub Saharan African countries probably due to scarcity of health professionals and health facilities. However, there are no reviews that grossly estimated the maternal and perinatal mortality in relation to the number of physicians and hospitals in the country. The purpose of this review is to assess the contribution of health system factors for maternal and perinatal mortalities.

METHODS: A comprehensive literature review was conducted for the period of 1980 to 2012 using the national data for Ethiopia. Data were presented in comparison with the population size, with data from other African countries. Regression analyses of maternal mortality ratio, stillbirth and neonatal mortality rates in relation to number of physicians and hospitals were done.

RESULTS: During the study period, the number of all types of physicians per 10,000 people and number of hospitals per 100,000 people in Ethiopia were in the range of 0.1 to 0.3 and 0.1 to 0.2, respectively, which were  among the lowest in Africa. The regression analyses showed negative  correlation of maternal mortality ratio, stillbirth and neonatal mortality  rates with number of physicians and hospitals. Ethiopia has already  achieved the one health center for 25,000 population plan.

CONCLUSION: In Ethiopia, the physicians and hospitals to population ratios were extremely low, which have probably contributed to the high maternal and perinatal mortality in the last three decades.

KEYWORDS: Ethiopia, hospitals, maternal mortality, physicians, systematic review meta-analysis