The Achievement of the 5th MDG: Regional Differences in Colombia

Introduction: Colombia’s maternal and child health has improved over the past 40 years. However, the maternal mortality rate (MMR) is still higher than in other developing countries, and consequently the 5th Millennium Development Goal (MDG) of decreasing the MMR by three quarters, will not be reached.

Objective: Identifying regional differences of the MMR in Colombia since 1973 to 2009.

Methodology: An ecological study was designed, using databases from DANE (National Administrative Statistics Department), the National Survey of Demography and Health Analysis and governmental sources. We calculated the MMR, and related it, to the geographical distribution of Colombia´s Departments, their stage or level of development and their financial resources. We used STATA to conduct analysis and ARCVIEW for the geographical mapping. 

Results: Throughout time the Colombian MMR shows a downward trend, on both, the national and regional level (fitted linear regression, p<0.01). However, the curve has two peaks, the first in 1974 and the other in 2000. There were 184 and 104.94 maternal deaths per 100,000 live births, respectively. On the contrary, the lowest MMR is observed in 1995 with 57.07 maternal deaths per 100,000 live births. Since year 2000 the MMR begins constantly decreasing, but in 2009 it is higher again. In addition, focusing on the geographical distribution of the MMR. It could be observed that those Departments with lower tax revenues, lower socioeconomic status, lower income levels, subsidized insurance or non social security, and less access to health care services, have higher MMRs.

Conclusions: Current initiatives to reduce Colombia’s MMR have not been effective. In order to allocate public resources more effectively, regional differences and characteristics have to be taken into account. Emphasis should be placed on regions, where basic human needs are not met and maternal health care is less accessible.