Anne ölümleri: Afganistan ve komşu ülkelerin karşılaştırılması

Yıl 2017, Cilt: 15 Sayı: 3, 222 - 232, 05.01.2018

Nasar Ahmad Shayan Hilal Özcebe

https://doi.org/10.20518/tjph.375355

Cited By: 1

Öz

Amaç: Afganistan, anne ölüm oranının dünyada yüksek olduğu ülkelerden biridir. Bu raporda Afganistan’ın anne ölüm oranı ve nedenlerinin, benzer sosyokültürel örüntüye sahip olan İran, Pakistan, Tacikistan, Özbekistan ve Türkmenistan ile karşılaştırılması amaçlanmıştır. Yöntem: Bu raporun hazırlanması sırasında, Dünya Sağlık Örgütü, UNICEF, Countdown to 2015 ve UNESCO’da yer alan verilerle, Afganistan ölümleri çalışması (2010) sonuçlarından yararlanılmıştır. Ülkelerin seçimi sırasında komşu olması ve sosyokültürel olarak benzer gruplar olma kriterleri kullanılmıştır. Karşılaştırma yapılan göstergeler sırasıyla nüfus, sağlık göstergeleri, doğurganlık, anne ölüm oranı ve nedenleri şeklindedir. Herkesin ulaşabileceği veri kaynakları kullanıldığı için etik izin alınmamıştır. Bulgular: Afganistan, komşu ülkelere göre daha fazla genç ve kırsal nüfusuna sahip iken kadınların okur-yazarlık ve istihdam yüzdeleri daha düşüktür. Afganistan’da sağlık hizmetlerine ulaşılabilirlikle ilgili müdahaleler yapılmasına karşılık göstergeler halen oldukça yüksektir. Afganistan’da toplam doğurganlık sayısı ve anne ölüm oranı, karşılaştırma yapılan ülkeler içinde en yüksek değere sahiptir. Afganistan’da anne ölüm nedenlerinin ilk iki nedeni aşırı kanama ve enfeksiyon olarak bildirilmiştir. Sonuç: Afganistan, komşu ülkeleri arasında sosyoekonomik olarak en düşük gelişmişlik düzeyine sahip olan ülkedir; anne sağlığı göstergeleri de en düşük değerlere sahiptir. Afganistan’da kadının statüsünün yükseltilmesinin yanı sıra anne sağlığının geliştirilmesine yönelik müdahalelerin ivedilikle geliştirilmesi gerekmektedir.

Anahtar Kelimeler

anne ölümü, afganistan

Maternal mortality: A comparison of Afghanistan and its neighboring countries

Öz

Objective: Afghanistan is a country with one of the highest maternal mortality ratios in the world. This report aims to compare the Maternal Mortality Ratios and the causes of maternal death in Afghanistan, with countries of similar socio-cultural statuses, such as Iran, Pakistan, Tajikistan, Uzbekistan and Turkmenistan. Methods: For the preparation of this report, data from the World Health Organization, UNICEF, Countdown to 2015, UNESCO and the Afghanistan Mortality Survey (AMS) 2010 were used.  The selection of countries for the comparisons was based on their geographical proximity to Afghanistan, and the presence of similar socio-cultural criteria. The indicators used for the comparison were population, health indicators, fertility, maternal mortality ratios and causes of maternal death. No ethical consent was obtained as only publicly available data sources were utilised. Results:When compared to the aforementioned countries, Afghanistan was found to have a more youthful population, a more rural population and lower literacy and employment rates among women. In Afghanistan, despite improvements in the accessibility of health services, the indicators were still high. Amongst the countries compared, Afghanistan held the highest figures for both fertility and maternal mortality ratios.  The principle causes of maternal deaths in Afghanistan were found to be excessive bleeding and infections. Conclusion: Afghanistan has the lowest socio-economic development level, as well as the lowest mother health indicators, among neighboring countries. Besides increasing the status of women in society, interventions regarding health services for the improvement of maternal health should be urgently developed.

Anahtar Kelimeler

Maternal mortality ratios, Afghanistan, status of women

Kaynakça

• 1. World Health Organization, The WHO application of ICD-10 to deaths during pregnancy, childbirth and the puerperium, IDC MM. Geneva: World Health Organization, 2012.
• 2. Fortney JA, “Implications of the ICD-10 definitions related to death in pregnancy, childbirth or the puerperium,” World Health Stat. Q. Rapp. Trimest. Stat. Sanit. Mond., vol. 43, no. 4, pp. 246–248, 1990.
• 3. World Health Organization et al., Trends in maternal mortality, 1990 to 2013: estimates by WHO, UNICEF, UNFPA, the World Bank estimates, and the United Nations Population Division. 2014.
• 4.“WHO | Maternal mortality,” WHO. [Online]. Available: http://www.who.int/mediacentre/factsheets/fs348/en/. [Accessed: 07-May-2017].
• 5. Karan A and Sodhi G, Protecting the Health of the Poor: Social Movements in the South. Zed Books Ltd., 2015.
• 6. Kuo AA, Coller RJ, Stewart-Brown S, and Blair M, Child Health: A Population Perspective. Oxford University Press, 2015.
• 7. İsmet K, Rudolf S, and Oona C, “Ulusal Anne Ölümleri Çalışması 2005,” Hacettepe Üniversitesi Nüfus Etütleri Enstitüs, Ankara, NEE-HÜ.06.02, 2005.
• 8. Arifeen S, Hill K, Ahsan KZ, Jamil K, Nahar Q, and Streatfield PK, “Maternal mortality in Bangladesh: a Countdown to 2015 country case study,” Lancet Lond. Engl., vol. 384, no. 9951, pp. 1366–1374, Oct. 2014.
• 9.“Goal 3.: Sustainable Development Knowledge Platform.” [Online]. Available: https://sustainabledevelopment.un.org/sdg3. [Accessed: 07-May-2017].
• 10. World Health Organization, UNICEF, United Nations, Department of Economic and Social Affairs, Population Division, and World Bank, Trends in maternal mortality: 1990 to 2015 : estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. 2015.
• 11. “WHO | World Health Organization.” [Online]. Available: http://gamapserver.who.int/gho/interactive_charts/mdg5_mm/atlas.html. [Accessed: 07-May-2017].
• 12. Mittra S and Kumar B, Encyclopaedia of Women in South Asia: Afghanistan. Gyan Publishing House, 2004.
• 13. “Afghanistan maternal mortality claims 1 life in every 2 hours - Khaama Press (KP) | Afghan News Agency.”
• 14. Afghan Public Health Institute Ministry of Public Health “Afghanistan Mortality Survey 2010- Mortality Survey 2010.” Kabul, Afghanistan, 2011.
• 15. “Afganistan ülkesi özellikleri.” [Online]. Available: http://www.ozelliklerinedir.com/afganistan-ulkesi-ozellikleri/. [Accessed: 10-May-2017].
• 16. “Statistics,” UNICEF. [Online]. Available: https://www.unicef.org/infobycountry/afghanistan_statistics.html. [Accessed: 07-May-2017].
• 17. “Education.” [Online]. Available: http://data.uis.unesco.org/Index.aspx?DataSetCode=EDULIT_DS. [Accessed: 07-May-2017].
• 18. “UIS Statistics.” [Online]. Available: http://data.uis.unesco.org/. [Accessed: 07-May-2017].
• 19. “Countdown to 2015.” [Online]. Available: http://countdown2030.org/?option=com_content&view=article&id=68. [Accessed: 07-May-2017].
• 20. “2014 Human Development Report (HDI),” UNDP. [Online]. Available: http://www.undp.org/content/undp/en/home/presscenter/events/2014/july/HDR2014.html. [Accessed: 07-May-2017].
• 21. The State of Afghanistan’s Midwifery 2014 report presented - Ministry of Public Health Afghanistan [Internet]. [cited 2017 Jun 15]. Available from: http://moph.gov.af/en/news/the-state-of-afghanistans-midwifery-2014-report-presented.
• 22. “Education.” [Online]. Available: http://data.uis.unesco.org/Index.aspx?DataSetCode=EDULIT_DS&popupcustomise=true&lang=en. [Accessed: 07-May-2017].
• 23. “Country statistics,” UNICEF. [Online]. Available: https://www.unicef.org/statistics/index_countrystats.html. [Accessed: 07-May-2017].
• 24. “GHO | By country | Afghanistan - statistics summary (2002 - present),” WHO. [Online]. Available: http://apps.who.int/gho/data/node.country.country-AFG?lang=en. [Accessed: 07-May-2017].
• 25. “GHO | By category | Density per 1000- Data by country,” WHO. [Online]. Available: http://apps.who.int/gho/data/node.main.A1444. [Accessed: 07-May-2017].
• 26. “GDP ranking | Data.” [Online]. Available: http://data.worldbank.org/data-catalog/GDP-ranking-table. [Accessed: 07-May-2017].
• 27. “The World Factbook — Central Intelligence Agency.” [Online]. Available: https://www.cia.gov/library/publications/the-world-factbook/geos/mx.html. [Accessed: 07-May-2017].
• 28. Rasooly M. H. et al., “Success in reducing maternal and child mortality in Afghanistan,” Glob. Public Health, vol. 9 Suppl 1, pp. S29-42, 2014.
• 29. “Laura R. W, Rogelio F and Juliana V “Maternal Mortality in Afghanistan: a study for the Provinces of Bamiyan, Daykundi, Ghor, Kabul, Kapisa and Parwan”. [Online]. Available:’http://187.45.187.130/~abeporgb/xxencontro/files/paper/961-618.pdf
• 30. “National Maternal Mortality Surveillance System in İ.R.Of.İran 2015.” Available: http://darman.sums.ac.ir/MNI-healthoffice/images/mni/files/nezam.pdf
• 31. Chhabra P, “Maternal Near Miss: An Indicator for Maternal Health and Maternal Care,” Indian J. Community Med. Off. Publ. Indian Assoc. Prev. Soc. Med., vol. 39, no. 3, pp. 132–137, 2014.
• 32. “WHO | Women’s health,” WHO. [Online]. Available: http://www.who.int/topics/womens_health/en/. [Accessed: 11-May-2017].
• 33. “Women’s and Girls’ Education,” UNESCO, 25-Apr-2013. [Online]. Available: http://en.unesco.org/themes/women-s-and-girls-education. [Accessed: 11-May-2017].
• 34. KWOLEK D. S, “Women’s Health Education,” J. Gen. Intern. Med., vol. 18, no. 6, pp. 490–491, Jun. 2003.
• 35. “Factbox: Why are maternal deaths so high in Afghanistan?” Reuters, 12-Dec-2011. Available: http://www.reuters.com/article/us-afghanistan-maternity-fb-idUSTRE7BB0FJ20111212
• 36. Ahmadi Q. et al., “SWOT analysis of program design and implementation: a case study on the reduction of maternal mortality in Afghanistan,” Int. J. Health Plann. Manage., vol. 31, no. 3, pp. 247–259, Jul. 2016.
• 37. Azimi M, Najafızada S, Khaing I, And Hamajıma N, “Factors Influencıng Non-Institutional Deliveries In Afghanıstan: Secondary Analysis Of The Afghanıstan Mortality Survey 2010,” Nagoya J. Med. Sci., vol. 77, no. 1–2, pp. 133–143, Feb. 2015.
• 38. Ahadi S, Yoshida Y, Rabi M, Sarker M, Reyer J, Hamajima N. Clinical features, current treatments and outcome of pregnant women with preeclampsaia/eclampsia ın northern Afghanistan. Nagoya J Med Sci 2015;77(1–2):103–111.