The Impact of Fertility on Maternal Mortality in Three Rural Districts of Tanzania

Colin Baynes, Columbia University and Ifakara Health Institute (IHI)
Malick Kante, Columbia University
Ayaga A. Bawah, Columbia University
James F. Phillips, Columbia University
Mrema Sigilbert, Ifakara Health Institute (IHI)
Matthew Alexander, Ifakara Health Institute (IHI)
Elizabeth F. Jackson, Columbia University

Little is known about the relative roles of fertility and parity specific risk in explaining risk of maternal mortality. To address this problem, this paper employs decomposition methods to analyze large scale longitudinal data on the timing and causes of death, collected in three demographic surveillance sites in rural Tanzania that follow 207,000 individuals. We use these data to decompose measures of maternal mortality risk into components associated with 1) high fertility and 2) age and parity-specific risk of maternal mortality. We will use data gathered between 1998 and 2010 when both maternal mortality and fertility remained high, at approximately 600 per 100,000 and 6.2 births per woman. Our model projects the volume of maternal deaths to be expected if these rates are applied to all women in Tanzania, and the number of maternal deaths that could be averted if unmet need for family planning in Tanzania were attained.