Objective: Maternal mortality reduction is a Millennium Development Goal. In Colombia, there is a large disparity in the maternal mortality ratio (MMR) between and into departments (states) and also between municipalities. We examined socioeconomics variables at the municipal and departmental levels which could be associated to the municipal maternal mortality in Colombia.
Methods: A multilevel ecology study was carried out using different national data sources in Colombia. The outcome variable was the MMR at municipal level in 2011 with multidimensional poverty at municipal and department level as the principal independent variables and other measures of the social and economic characteristics at municipal and departmental level were also considered explicative variables (overall fertility municipal rate, percentage of local rural population, health insurance coverage, per capita territorial participation allocated to the health sector, transparency index and Gini coefficient). The association between MMR and socioeconomic contextual conditions at municipal and departmental level was assessed using a multilevel Poisson regression model.
Results: The MMR in the Colombian municipalities was associated significantly with the multidimensional poverty (relative ratio of MMR: 3.52; CI 95%: 1.09-11.38). This association was stronger in municipalities from departments with the highest poverty (relative ratio of MMR: 7.14; CI 95%: 2.01-25.35). Additionally, the MMR at municipal level was marginally associated with municipally health insurance coverage (relative ratio of MMR: 0.99; CI 95%: 0.98-1.00), and significantly with transparency index at departmental level (relative ratio of MMR: 0.98; CI 95%: 0.97-0.99).
Conclusion: Poverty and transparency in a contextual level were associated with the increase of the municipal MMR in Colombia. The results of this study are useful evidence for informing the public policies discussion and formulation processes with a differential approach.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364963 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0118944 | PLOS |
Publication Analysis
Top Keywords
Similar Publications
Mismatch Repair Status and Surgical Outcomes in Localized Colorectal Cancer: A Nationwide Cohort Study.
Ann Surg Open
December 2024
From the Department of Surgery, Center for Surgical Science, Zealand University Hospital, Køge, Denmark.
Objective: This study examined the association between deficient mismatch repair (dMMR) versus proficient MMR (pMMR) status and overall survival and disease-free survival in patients with localized colorectal cancer.
Background: Several distinctions exist between patients with dMMR and pMMR colorectal cancer. However, the impact on prognosis is yet to be investigated in large-scale cohort studies.
Predicting maternal risk level using machine learning models.
BMC Pregnancy Childbirth
December 2024
School of Science, RMIT University, Melbourne, Victoria, Australia.
Background: Maternal morbidity and mortality remain critical health concerns globally. As a result, reducing the maternal mortality ratio (MMR) is part of goal 3 in the global sustainable development goals (SDGs), and previously, it was an important indicator in the Millennium Development Goals (MDGs). Therefore, identifying high-risk groups during pregnancy is crucial for decision-makers and medical practitioners to mitigate mortality and morbidity.
View Article and Find Full Text PDFSurvival of Patients with Resected Microsatellite Instability-High, Mismatch Repair Deficient, and Lynch Syndrome-Associated Pancreatic Ductal Adenocarcinomas.
Ann Surg Oncol
December 2024
Hepato-Pancreato-Biliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Background: Pancreatic ductal adenocarcinoma (PDAC) remains a challenging disease due to its aggressiveness, late-stage diagnosis, and limited treatment options. Microsatellite instability-high (MSI-H) cancers are susceptible to immune checkpoint inhibitors. Survival outcomes for patients with MSI-H PDAC are unknown as the disease is rare.
View Article and Find Full Text PDFAssociation between periodontal disease and systemic diseases: a cross-sectional analysis of current evidence.
Mil Med Res
December 2024
Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China.
Background: Numerous systematic reviews and meta-analyses have been published that evaluate the association between periodontal disease and systemic diseases, many of which address similar topics. Moreover, their quality requires assessment. Therefore, we performed a cross-sectional analysis to examine the evidence on the relationship between periodontal disease and systemic diseases.
View Article and Find Full Text PDFOverview of a comparative analysis of microsatellite instability and standard mismatch repair protein-deficiency tests in a large cancer cohort.
Pathologie (Heidelb)
December 2024
Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary.
Article Synopsis
- Mismatch repair deficiency (dMMR) and microsatellite instability (MSI) are important genetic markers in various cancers, especially gastrointestinal and endometrial types, and can indicate responsiveness to immune checkpoint inhibitors (ICIs).
- In a study involving 1,306 cancer cases, dMMR was determined through immunohistochemistry (IHC) testing for specific proteins, while MSI was assessed using pentaplex PCR, revealing an overall MSI-high incidence of 12.1% compared to a dMMR incidence of 20.3%.
- A significant discrepancy of 19.3% was found between dMMR and MSI results, particularly noted with a 60.9% discrepancy in
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!