Abstract
Objective: To identify factors contributing to maternal
mortality in Kazakhstan. Design: A retrospective study of the
health and demography data set of Kazakhstan from 2000 to 2020.
Setting and population: The data from the annual statistical
report “Population health and healthcare organizations’ performance in
the Republic of Kazakhstan from 2000 to 2020”. Kazakhstan and its 14
regions and 3 main cities for the period 2019-2020. Methods: We
analyzed the MMR trend in Kazakhstan and in all 14 regions and 3 main
cities for the period 2000-2020. We applied Univariate Linear Regression
Models with Logarithmic Transformation of the outcome and predictors to
detect determinants of MMR for 2019 and 2020 in Kazakhstan. Main
Outcome Measures: Maternal mortality ratio and determinants.
Results: Trends in MMR in many regions of Kazakhstan show a
steady decline starting from 2000 until 2010-2015 with a subsequent
increase by 2020. MMR was associated with factors such as
socio-economic, health service-related, and population health
indicators. An increase in most of these indicators leads to a decrease
in maternal mortality, except obstetric beds per 1000 births, number of
inpatient facilities, and population median age, which leads to an
increase in MMR. Conclusions: Maternal mortality is a complex
issue that is influenced by various socio-economic factors, healthcare
system factors, and disease burden. Despite Kazakhstan’s alignment with
the SDG goals, including reducing maternal mortality, the country’s
middle-income status may have led to fluctuations in MMR.