Maternal mortality decline in Zimbabwe, 2007/2008 to 2018/2019: results of mortality surveys using vital registration, vital statistics and health system data – Zimbabwe

Reuben Musarandega, Jenny Cresswell, Thulani Magwali, Davidzoyashe Makosa, Rhoderick Machekano, Solwayo Ngwenya, Lennarth Nystrom, Robert Pattinson, Stephen Munjanja

Summary

Background Target 3.1 of the Sustainable Development Goal (SDG) is to reduce the global maternal mortality ratio (MMR) to less than 70 maternal deaths per 100,000 live births by 2030. In the Ending Preventable Maternal Mortality strategy, an additional target was added, that no country has an MMR greater than 140 by 2030. We conducted two cross-sectional surveys of reproductive age mortality to analyze changes in Zimbabwe’s MMR between 2007-2008 and 2018- 2019 towards the SDG target.

Methods We collected data from civil registration, vital statistics and medical records on deaths of women of reproductive age (WRA), including maternal deaths in 11 districts, randomly selected from each province (n = 10) using cluster sampling. We calculated weighted mortality rates and MMRs using negative binomial models, with 95% CIs, performed one-way analysis of variance of MMRs, and calculated the annual mean reduction rate (AMR) of MMR.

Results In 2007-2008, we identified 6188 FAP deaths, 325 pregnancy-related deaths and 296 maternal deaths, and in 2018-2019, 1856, 137 and 130, respectively. The childbearing mortality rate, weighted by district, fell from 11 to 3 deaths per 1000 women. The MMR (95% CI) increased from 657 (485 to 829) to 217 (164 to 269) deaths per 100,000 live births at an annual ART of 10.1%.

conclusion Zimbabwe’s MMR decreased by an annual ART of 10.1%, against a target of 10.2%, in line with declining reproductive age mortality. Zimbabwe should continue to scale up interventions against the direct causes of maternal mortality to achieve SDG target 3.1 by 2030.

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