{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:01:50Z","timestamp":1787022110117,"version":"build-2736575974"},"reference-count":73,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T00:00:00Z","timestamp":1678147200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004828","name":"Grand Challenges Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004828","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Maternal mortality studies conducted at national level do not provide information needed for planning and monitoring health programs at lower administrative levels. The aim of this study was to measure maternal mortality, identify risk factors and district level variations in Sidama National Regional State, southern Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross sectional population-based survey was carried in households where women reported pregnancy and birth outcomes in the past five years. The study was conducted in the Sidama National Regional State, southern Ethiopia, from July 2019 to May 2020. Multi-stage cluster sampling technique was employed. The outcome variable of the study was maternal mortality. Complex sample logistic regression analysis was applied to assess variables independently associated with maternal mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We registered 10602 live births (LB) and 48 maternal deaths yielding the overall maternal mortality ratio (MMR) of 419; 95% CI: 260\u2013577 per 100,000 LB. Aroresa district had the highest MMR with 1142 (95% CI: 693\u20131591) per 100,000 LB. Leading causes of death were haemorrhage 21 (41%) and eclampsia 10 (27%). Thirty (59%) mothers died during labour or within 24 hours after delivery, 25 (47%) died at home and 17 (38%) at health facility. Mothers who did not have formal education had higher risk of maternal death (AOR: 4.4; 95% CI: 1.7\u201311.0). The risk of maternal death was higher in districts with low midwife to population ratio (AOR: 2.9; 95% CI: 1.0\u20138.9).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The high maternal mortality with district level variations in Sidama Region highlights the importance of improving obstetric care and employing targeted interventions in areas with high mortality rates. Due attention should be given to improving access to female education. Additional midwives have to be trained and deployed to improve maternal health services and consequently save the life of mothers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0272110","type":"journal-article","created":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T13:28:20Z","timestamp":1678195700000},"page":"e0272110","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":17,"title":["Variation in maternal mortality in Sidama National Regional State, southern Ethiopia: A population based cross sectional household survey"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0806-3503","authenticated-orcid":true,"given":"Aschenaki Zerihun","family":"Kea","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernt","family":"Lindtjorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achamyelesh","family":"Gebretsadik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven Gudmund","family":"Hinderaker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,3,7]]},"reference":[{"key":"pone.0272110.ref001","author":"World Bank","year":"2021","journal-title":"World Development Indicators data base"},{"key":"pone.0272110.ref002","author":"Ministry of Health- Ethiopia","year":"2021","journal-title":"Health Sector Transformation Plan II (HSTP II), 2020\u20132025"},{"key":"pone.0272110.ref003","author":"Central Statistical Agency Ethiopia:The DHS Program ICF Rockville Maryland, USA","year":"2017","journal-title":"Demographic and Health Survey 2016 Final Report"},{"key":"pone.0272110.ref004","article-title":"Trends in Maternal Mortality:2000\u20132017.","author":"WHO, UNICEF, UNFPA, BANK W, UNPD","year":"2019","journal-title":"WHO, UNICEF, UNFPA, UNDP and The World Bank estimates"},{"key":"pone.0272110.ref005","author":"WHO","year":"2015","journal-title":"Strategies towards ending preventable maternal mortality (EPMM)."},{"key":"pone.0272110.ref006","author":"Sustainable Development Goals","year":"2015","journal-title":"Every Woman, Every Child: The Global Strategy for Women\u2019s, Children\u2019s and Adolescents\u2019 Health, (2016\u20132030)"},{"key":"pone.0272110.ref007","doi-asserted-by":"crossref","DOI":"10.1596\/27533","article-title":"Rassekh Deborah Sarpong; 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