Researchers from LSTM used the Lot Quality Assurance Sampling (LQAS) model in Uganda to gain a better understanding of the factors associated with safe delivery practices.
The research team from LSTM’s multi-disciplinary Monitoring and Evaluation Technical assistance and Research (METRe) group, working with colleagues at the University of Warwick, fitted a logistic regression model to LQAS data collected in Uganda from 2003-2011 to investigate the factors influencing mothers’ decisions to deliver their babies in a health facility.
The results, published in the journal Emerging Themes in Epidemiology, show that ease of access, maternal age and education are strongly associated with delivery in a health facility (which is known to reduce the risk of maternal and newborn death). Using these same data and known demographics the team then formulated an innovative but still nascent early warning system that identifies districts expected to have a low prevalence of health facility deliveries in the coming year and hence have higher risk of maternal and newborn death.
LSTM’s Professor Joseph Valadez, senior author of the paper, says “Our routinely collected LQAS results support the hypothesis that increased development, especially related to education and access to health facilities, increases facility-based deliveries, which we know is associated with reduced mortality rates of mothers and their babies. Our model also allowed us to make predictions about the future priority of districts, which were validated by the data collected the next year. Using routinely collected data gives us the opportunity to provide an inexpensive model that can answer complex public health questions in Uganda and other resource-poor settings.”
In 2010 an estimated 287,000 women died as a result of pregnancy or delivery related complications, with over 99% occurring in developing countries. Uganda is one of the least developed countries in the world and, with 360 maternal deaths per 100,000 live births in 2013 one of the highest values in the world and 22 times higher than those of more developed countries.