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Global, Regional, and National Levels of Maternal Mortality, 1990–2015: A Systematic Analysis for the Global Burden of Disease Study 2015 Publisher Pubmed



Kassebaum NJ1 ; Barber RM1 ; Dandona L1, 4 ; Hay SI1, 5 ; Larson HJ1, 7 ; Lim SS1 ; Lopez AD1, 9 ; Mokdad AH1 ; Naghavi M1 ; Pinho C1 ; Steiner C1 ; Vos T1 ; Wang H1 ; Achoki T1 Show All Authors
Authors
  1. Kassebaum NJ1
  2. Barber RM1
  3. Dandona L1, 4
  4. Hay SI1, 5
  5. Larson HJ1, 7
  6. Lim SS1
  7. Lopez AD1, 9
  8. Mokdad AH1
  9. Naghavi M1
  10. Pinho C1
  11. Steiner C1
  12. Vos T1
  13. Wang H1
  14. Achoki T1
  15. Anderson GM1
  16. Arora M1
  17. Biryukov S1
  18. Blore JD1
  19. Carter A1
  20. Casey DC1
  21. Coates MM1
  22. Coggeshall M1
  23. Dicker DJ1
  24. Dossou E1
  25. Fleming T1
  26. Fraser MS1
  27. Friedman J1
  28. Fullman N1
  29. Graetz N1
  30. Hancock J1
  31. Huynh C1
  32. Iannarone M1
  33. Kemmer L1
  34. Kulikoff XR1
  35. Kutz MJ1
  36. Liu PY1
  37. Marquez N1
  38. Misganaw A1
  39. Mooney MD1
  40. Moradilakeh M1
  41. Ng M1
  42. Nguyen G1
  43. Pain A1
  44. Shackelford KA1
  45. Silpakit N1
  46. Sligar A1
  47. Smith JM1
  48. Sorensen RJD1
  49. Vollset SE1, 140, 180
  50. Wagner JA1
  51. Wolock T1
  52. Zhao Y1, 430
  53. Zhou M1, 8
  54. Murray CJL1
  55. Ebel BE1
  56. Futran ND1
  57. Harun KM1, 188
  58. Bhutta ZA2, 3
  59. Nisar MI2
  60. Akseer N3, 32
  61. Jeemon P4, 212, 213
  62. Dandona R4
  63. Goenka S4
  64. Kumar GA4
  65. Gething PW5
  66. Bisanzio D5
  67. Deribew A5, 135
  68. Cooper C5, 124, 125
  69. Ali R5
  70. Bennett DA5
  71. Jha V5, 214
  72. Rahimi K5
  73. Kinfu Y6
  74. Murthy GVS7, 294
  75. Li Y8, 251
  76. Liu S8
  77. Wang L8
  78. Liang X8
  79. Yu S8
  80. Azzopardi P9, 72
  81. Gibney KB9, 167
  82. Meretoja A9, 275
  83. Szoeke CEI9
  84. Alam K9, 39
  85. Colquhoun SM9
  86. Weintraub RG9, 414
  87. Wijeratne T9, 416
  88. Lozano R10
  89. Camposnonato IR10, 12
  90. Campuzano JC10
  91. Gomezdantes H10
  92. Lamadridfigueroa H10
  93. Mejiarodriguez F10
  94. Montanez Hernandez JC10
  95. Montero P10
  96. Mensah GA11
  97. Salomon JA12
  98. Thornelyman AL12, 393
  99. Ajala ON12, 36
  100. Barnighausen T12, 78, 79
  101. Ding EL12
  102. Farvid MS12, 152
  103. Fitchett JRA12
  104. Abajobir AA13
  105. Knibbs LD13
  106. Lalloo R13
  107. Alam NKM13, 40
  108. Guo Y13
  109. Abate KH14
  110. Gebrehiwot TT14
  111. Gebremedhin AT14, 164
  112. Abbas KM15
  113. Abdallah F16
  114. Abdallat MA17
  115. Abdulle AM18
  116. Abera SF19, 20, 21
  117. Melaku YA19, 51
  118. Tesfay FH19, 330
  119. Aregay AF19
  120. Bayou TA19
  121. Betsu BD19
  122. Gebremedhin M19
  123. Gebru AA19, 165
  124. Hailu GB19, 165
  125. Tekle T19
  126. Yalew AZ19
  127. Yebyo HG19, 422
  128. Aboyans V22
  129. Abubakar I23
  130. Aldridge RW23
  131. Banerjee A23
  132. Aburmeileh NM24
  133. Adebiyi AO25, 26
  134. Adelekan AL25, 28
  135. Ojelabi FA25
  136. Adedeji IA27
  137. Adou AK29
  138. Afanvi KA30, 31
  139. Badawi A32, 74
  140. Agarwal A32, 33
  141. Kiadaliri AA34, 35
  142. Akinyemiju TF37
  143. Schwebel DC37
  144. Singh JA37
  145. Alaly Z38
  146. Kemp AH39, 230
  147. Leigh J39
  148. Mekonnen AB39, 271
  149. Alasfoor D41
  150. Aldhahri SF42, 43
  151. Terkawi AS43, 390, 391
  152. Alhabib S44
  153. Alkerwi A45
  154. Alla F46
  155. Alraddadi R47
  156. Alsharif U48
  157. Martin EA49
  158. Alvisguzman N50
  159. Amare AT51, 52
  160. Ciobanu LG51
  161. Tessema GA51, 271
  162. Setegn T52
  163. Amberbir A53
  164. Amegah AK54
  165. Kudom AA54
  166. Ammar W55
  167. Harb HL55
  168. Amrock SM56
  169. Andersen HH57
  170. Antoine RM58
  171. Antonio CAT59
  172. Faraon EJA59, 147
  173. Arnlov J60, 61
  174. Larsson A60
  175. Arsic Arsenijevic VS62, 63
  176. Barac A62
  177. Artaman A64
  178. Asayesh H65
  179. Atique S66
  180. Avokpaho EFGA67, 68
  181. Awasthi A69
  182. Ayala Quintanilla BP70, 71
  183. Bacha U73
  184. Bahit MC75
  185. Balakrishnan K76
  186. Barkercollo SL77
  187. Mohammed S79, 285
  188. Basu S80
  189. Bayou YT81
  190. Bazarganhejazi S82, 83, 84
  191. Beardsley J85
  192. Bedi N86
  193. Bekele T87
  194. Bell ML88
  195. Biroscak BJ88, 96
  196. Huang JJ88
  197. Santos IS89
  198. Bensenor IM89
  199. Lotufo PA89
  200. Berhane A90
  201. Wolfe CD91, 418
  202. Bernabe E91
  203. Beyene AS92
  204. Biadgilign S93
  205. Bikbov B94
  206. Bin Abdulhak AA95
  207. Bjertness E97
  208. Htet AS97, 196
  209. Brainin M98
  210. Brazinova A99, 100
  211. Majdan M99
  212. Shen J101, 363
  213. Breitborde NJK101
  214. Brugha TS102
  215. Butt ZA103
  216. Cardenas R104
  217. Fereshtehnejad S105
  218. Kivipelto M105
  219. Weiderpass E105, 411, 412, 413
  220. Havmoeller R105
  221. Sindi S105
  222. Castanedaorjuela CA106
  223. Castanedaorjuela CA106
  224. Castro RE108
  225. Catalalopez F109, 110
  226. Cavalleri F111
  227. Colistro V111, 123
  228. Chang H112, 113
  229. Chang J114
  230. Chavan L115
  231. Chibueze CE116, 292
  232. Chisumpa VH117, 118
  233. Mapoma CC117
  234. Masiye F117
  235. Choi JJ119
  236. Chowdhury R120
  237. Christopher DJ121
  238. Cirillo M122
  239. Cooper LT126
  240. Dahiru T127
  241. Damasceno A128
  242. Danawi H129
  243. Refaat AH129, 345
  244. Neves JD130
  245. Santos JV130
  246. De Leo D131
  247. Dellavalle RP132
  248. Deribe K133, 134
  249. Hailu AD134
  250. Tefera W134
  251. Giref AZ134
  252. Jibat T134, 166
  253. Shifa GT134
  254. Des Jarlais DC136, 137
  255. Dharmaratne SD138
  256. Dubey M139
  257. Rahman MHU139
  258. Ram U139
  259. Singh A139
  260. Yadav AK139
  261. Ellingsen CL140
  262. Savic M140
  263. Skirbekk V140, 190
  264. Elyazar I141
  265. Ermakov SP142, 143
  266. Soshnikov S143
  267. Eshrati B144, 145
  268. Farzadfar F146
  269. Kasaeian A146
  270. Pishgar F146
  271. Esteghamati A146
  272. Hafezinejad N146
  273. Sheikhbahaei S146
  274. Khosravi A146, 237
  275. Malekzadeh R146
  276. Roshandel G146, 349
  277. Sepanlou SG146
  278. Rahimimovaghar V146
  279. Farid TA148
  280. Khan AR148
  281. Farinha CSES149, 150
  282. Faro A151
  283. Fernandes JC153
  284. Fischer F154
  285. Foigt N155
  286. Franca EB156
  287. Franklin RC157
  288. Furst T158, 159, 160
  289. Majeed A158
  290. Gambashidze K161
  291. Kazanjan K161
  292. Kereselidze M161
  293. Khonelidze I161
  294. Shakhnazarova M161
  295. Sturua L161
  296. Gamkrelidze A162
  297. Gebre T163
  298. Geleijnse JM166
  299. Giroud M168
  300. Gishu MD169, 170
  301. Tura AK169, 189
  302. Glaser E171
  303. Gona P172
  304. Goodridge A173
  305. Gopalani SV174
  306. Goto A175
  307. Gugnani HC176
  308. Gupta R177, 178
  309. Gupta V179
  310. Hailu AD134
  311. Norheim OF180
  312. Hamadeh RR181
  313. Hamidi S182
  314. Handal AJ183
  315. Hankey GJ184, 185, 186
  316. Harikrishnan S187
  317. Hoek HW189, 190
  318. Horino M191, 192
  319. Horita N193
  320. Hosgood HD194
  321. Hoy DG195
  322. Hu G197
  323. Huang H198
  324. Huybrechts I199, 200
  325. Iburg KM201
  326. Idrisov BT202, 203
  327. Iyer VJ204
  328. Jacobsen KH205
  329. Jahanmehr N206
  330. Jakovljevic MB207
  331. Javanbakht M208
  332. Jayatilleke AU209, 210
  333. Jee SH211
  334. Lal DK213, 294
  335. Zodpey S213, 294
  336. Jiang G215
  337. Jiang Y216
  338. Jonas JB217
  339. Kabir Z218
  340. Kamal R219
  341. Kesavachandran CN219
  342. She J220
  343. Kan H220
  344. Karch A221, 222
  345. Karletsos D223
  346. Kaul A224
  347. Kawakami N225
  348. Shibuya K225
  349. Kayibanda JF226
  350. Kazi DS227
  351. Keiyoro PN228, 229
  352. Kengne AP231, 232
  353. Wiysonge CS231, 298
  354. Sliwa K232
  355. Keren A233
  356. Khader YS234
  357. Khan EA235
  358. Khang YH236
  359. Won S236
  360. Khubchandani J238
  361. Kim YJ239
  362. Kokubo Y240
  363. Kosen S241
  364. Koul PA242
  365. Koyanagi A243
  366. Krishnaswami S244
  367. Defo BK245
  368. Bicer BK246
  369. Lam H247
  370. Lan Q248
  371. Laryea DO249
  372. Leung R250
  373. Lipshultz SE252, 253, 417
  374. Wilkinson JD252, 253, 417
  375. Simard EP254
  376. Liu Y254
  377. Phillips MR254, 333
  378. Xiao Q254
  379. Lloyd BK255, 256
  380. Lunevicius R257, 258
  381. Pope D258
  382. Ma S259, 260
  383. Abd El Razek HM261
  384. Abd El Razek MM262
  385. Marcenes W263
  386. Meaney PA264, 268
  387. Margolis DJ264
  388. Marzan MB265
  389. Masonjones AJ266
  390. Mazorodze TT267
  391. Mehari A269
  392. Mehndiratta MM270
  393. Woldeyohannes SM271
  394. Tedla BA271, 388
  395. Memish ZA272, 273
  396. Mendoza W274
  397. Meretoja TJ276, 277
  398. Mhimbira FA278
  399. Miller TR279, 280
  400. Mills EJ281
  401. Mohamed Ibrahim N282
  402. Mohammad KA283
  403. Mohammadi A284
  404. Mola GLD286
  405. Monasta L287
  406. Montico M287
  407. Ronfani L287
  408. Monis JD288
  409. Moore AR289
  410. Moradilakeh M1
  411. Morawska L291
  412. Norman RE291
  413. Mori R116, 292
  414. Werdecker A293
  415. Mueller UO293
  416. Westerman R293, 415
  417. Murthy S295
  418. Pourmalek F295
  419. Nachega JB296, 298, 299
  420. Paternina Caicedo AJ297, 325
  421. Seedat S298
  422. Tran BX299, 400
  423. Naheed A300
  424. Naldi L301
  425. Remuzzi G301, 329, 346
  426. Nand D302
  427. Nangia V303
  428. Nash D304
  429. Neupane S305
  430. Newton JN306
  431. Ngalesoni FN307
  432. Nguhiu P308
  433. Nguyen QL309
  434. Nomura M310
  435. Nyakarahuka L311
  436. Obermeyer CM312
  437. Ogbo FA313
  438. Oh I314
  439. Olivares PR315
  440. Olusanya BO316
  441. Olusanya JO316
  442. Opio JN317
  443. Oren E318
  444. Ota E319
  445. Oyekale AS320
  446. Mahesh PA321
  447. Papantoniou N322
  448. Stathopoulou V322
  449. Park E323
  450. Park H324
  451. Patten SB326
  452. Paul VK327
  453. Roy A327
  454. Sagar R327
  455. Satpathy M327
  456. Pereira DM328
  457. Cortinovis M329
  458. Perico N329
  459. Pesudovs K330
  460. Petzold M331, 332
  461. Pillay JD334
  462. Polinder S335
  463. Qorbani M336
  464. Rafay A337
  465. Rahman M338
  466. Rahman SU339
  467. Rai RK340
  468. Ranabhat CL341
  469. Rangaswamy T342
  470. Rao PV343, 344
  471. Resnikoff S347
  472. Rojasrueda D348
  473. Ruhago GM350
  474. Sunguya BF350
  475. Saleh MM351
  476. Sanabria JR352, 353
  477. Sancheznino MD354
  478. Sarmientosuarez R355
  479. Sartorius B356
  480. Sawhney M357
  481. Saylan MI358
  482. Schneider IJC359
  483. Silva DAS359
  484. Servanmori EE360
  485. Shaikh MA361
  486. Sharma R362
  487. Shin M364
  488. Yoon S364
  489. Shiri R365
  490. Shishani K366
  491. Shiue I367, 368
  492. Sigfusdottir ID369
  493. Silveira DGA370
  494. Silverberg JI371
  495. Yano Y371
  496. Singh OP372
  497. Singh PK373
  498. Singh V374
  499. Soneji S375
  500. Soriano JB376
  501. Sposato LA377
  502. Sreeramareddy CT378
  503. Stroumpoulis K379, 380
  504. Swaminathan S381
  505. Sykes BL382
  506. Tabaresseisdedos R383
  507. Tabb KM384
  508. Talongwa RT385
  509. Tavakkoli M386
  510. Taye B387
  511. Endries AY389
  512. Temam Shifa G389
  513. Thomson AJ392
  514. Tobegai R394
  515. Topormadry R395, 396
  516. Towbin JA397, 398, 399
  517. Tsala Dimbuene Z401
  518. Tyrovolas S402
  519. Ukwaja KN403
  520. Uthman OA404
  521. Vasankari T405
  522. Venketasubramanian N406
  523. Violante FS407
  524. Vladimirov SK408
  525. Vlassov VV409
  526. Weichenthal S410
  527. Wubshet M419
  528. Xu G420
  529. Yakob B421
  530. Yip P423
  531. Yonemoto N424
  532. Younis MZ425
  533. Yu C426
  534. Zaidi Z427
  535. Zaki ME428
  536. Zeeb H429
  537. Zuhlke LJ431
Show Affiliations
Authors Affiliations
  1. 1. Institute for Health Metrics and Evaluation Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, United States
  2. 2. Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
  3. 3. Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
  4. 4. Centre for Control of Chronic Conditions, Public Health Foundation of India, New Delhi, India
  5. 5. Department of Zoology, Nuffield Department of Medicine, NIHR Musculoskeletal Biomedical Research Centre, Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
  6. 6. Centre for Research & Action in Public Health, Faculty of Health, University of Canberra, Canberra, ACT, Australia
  7. 7. Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
  8. 8. National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
  9. 9. Melbourne School of Population and Global Health, Department of Paediatrics, The Peter Doherty Institute for Infection and Immunity, Department of Medicine, Institute of Health and Ageing, Murdoch Childrens Research Institute, The University of Melbourne, Melbourne, VIC, Australia
  10. 10. National Institute of Public Health, Cuernavaca, Mexico
  11. 11. Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
  12. 12. Department of Global Health and Population, Department of Nutrition, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, United States
  13. 13. School of Public Health, School of Dentistry, University of Queensland, Brisbane, QLD, Australia
  14. 14. Jimma University, Jimma, Ethiopia
  15. 15. Virginia Tech, Blacksburg, VA, United States
  16. 16. Department of Neurology, Cairo University, Cairo, Egypt
  17. 17. Royal Jordanian Medical Services, Amman, Jordan
  18. 18. New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
  19. 19. School of Public Health, College of Health Sciences, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
  20. 20. Kilte Awlaelo-Health and Demographic Surveillance Site, Mekelle, Ethiopia
  21. 21. Food Security and Institute for Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart, Germany
  22. 22. Dupuytren University Hospital, Limoges, France
  23. 23. Institute for Global Health, Centre for Public Health Data Science, Institute of Health Informatics, Farr Institute of Health Informatics Research, University College London, London, United Kingdom
  24. 24. Institute of Community and Public Health, Birzeit University, Ramallah, Palestine
  25. 25. College of Medicine, University of Ibadan, Ibadan, Nigeria
  26. 26. University College Hospital, Ibadan, Nigeria
  27. 27. Olabisi Onabanjo University, Ago-Iwoye, Nigeria
  28. 28. Public Health Promotion Alliance, Osogbo, Nigeria
  29. 29. Association Ivoirienne pour le Bien-Etre Familial, Abidjan, Cote d'Ivoire
  30. 30. Direction du District Sanitaire de Haho, Notse, Togo
  31. 31. Faculte des Sciences de Sante, Universite de Lome, Lome, Togo
  32. 32. Dalla Lana School of Public Health, Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
  33. 33. McMaster University, Hamilton, ON, Canada
  34. 34. Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
  35. 35. Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
  36. 36. University of Pittsburgh Medical Center, McKeesport, PA, United States
  37. 37. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, United States
  38. 38. Washington University in Saint Louis, St Louis, MO, United States
  39. 39. University of Sydney, Sydney, NSW, Australia
  40. 40. Queensland Health, Herston, QLD, Australia
  41. 41. Ministry of Health, Al Khuwair, Oman
  42. 42. King Saud University, Riyadh, Saudi Arabia
  43. 43. Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia
  44. 44. King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
  45. 45. Luxembourg Institute of Health (LIH), Strassen, Luxembourg
  46. 46. School of Public Health, University of Lorraine, Nancy, France
  47. 47. Ministry of Health, Jeddah, Saudi Arabia
  48. 48. Charite Universitatsmedizin, Berlin, Germany
  49. 49. Spanish Observatory on Drugs, Government Delegation for the National Plan on Drugs, Ministry of Health, Social Policy and Equality, Madrid, Spain
  50. 50. Universidad de Cartagena, Cartagena de Indias, Colombia
  51. 51. School of Medicine, University of Adelaide, Adelaide, SA, Australia
  52. 52. College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
  53. 53. Dignitas International, Zomba, Malawi
  54. 54. University of Cape Coast, Cape Coast, Ghana
  55. 55. Ministry of Public Health, Beirut, Lebanon
  56. 56. Oregon Health & Science University, Portland, OR, United States
  57. 57. Center of Sensory-Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
  58. 58. Rose Foundation of Haiti, Port-au-Prince, Haiti
  59. 59. Department of Health Policy and Administration, College of Public Health, College of Public Health, University of the Philippines Manila, Manila, Philippines
  60. 60. Department of Medical Sciences, Uppsala University, Uppsala, Sweden
  61. 61. Dalarna University, Falun, Sweden
  62. 62. School of Medicine, Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  63. 63. University Children’s Hospital, Belgrade, Serbia
  64. 64. University of Manitoba, Winnipeg, MB, Canada
  65. 65. Department of Medical Emergency, School of Paramedic, Qom University of Medical Sciences, Qom, Iran
  66. 66. Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan
  67. 67. Institut de Recherche Clinique du Benin, Cotonou, Benin
  68. 68. Laboratoire d’Etudes et de Recherche-Action en Sante (LERAS Afrique), Parakou, Benin
  69. 69. Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
  70. 70. The Judith Lumley Centre for Mother, Infant and Family Health Research, La Trobe University, Melbourne, VIC, Australia
  71. 71. Peruvian National Institute of Health, Lima, Peru
  72. 72. Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
  73. 73. School of Health Sciences, University of Management and Technology, Lahore, Pakistan
  74. 74. Public Health Agency of Canada, Toronto, ON, Canada
  75. 75. INECO Neurociencias, Rosario, Argentina
  76. 76. Sri Ramachandra University, Chennai, India
  77. 77. School of Psychology, University of Auckland, Auckland, New Zealand
  78. 78. Africa Health Research Institute, Mtubatuba, South Africa
  79. 79. Institute of Public Health, Heidelberg University, Heidelberg, Germany
  80. 80. Stanford University, Stanford, CA, United States
  81. 81. Jhpiego-Ethiopia, Addis Ababa, Ethiopia
  82. 82. Charles R Drew University of Medicine and Science, Los Angeles, CA, United States
  83. 83. David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
  84. 84. Kermanshah University of Medical Science, Kermanshah, Iran
  85. 85. Oxford University, Ho Chi Minh City, Viet Nam
  86. 86. College of Public Health and Tropical Medicine, Jazan, Saudi Arabia
  87. 87. Madawalabu University, Bale Goba, Ethiopia
  88. 88. Yale University, New Haven, CT, United States
  89. 89. Internal Medicine Department, University of Sao Paulo, Sao Paulo, Brazil
  90. 90. Debre Berhane University, Debre Berhan, Ethiopia
  91. 91. Division of Health and Social Care Research, King’s College London, London, United Kingdom
  92. 92. Haramaya University, Harar, Ethiopia
  93. 93. Independent Public Health Consultants, Addis Ababa, Ethiopia
  94. 94. Department of Nephrology Issues of Transplanted Kidney, Academician V I Shumakov, Federal Research Center of Transplantology and Artificial Organs, Moscow, Russian Federation
  95. 95. University of Iowa Hospitals and Clinics, Iowa City, IA, United States
  96. 96. University of South Florida, Tampa, FL, United States
  97. 97. Department of Community Medicine, University of Oslo, Oslo, Norway
  98. 98. Danube-University Krems, Krems, Austria
  99. 99. Faculty of Health Sciences and Social Work, Department of Public Health, Trnava University, Trnava, Slovakia
  100. 100. International Neurotrauma Research Organization, Vienna, Austria
  101. 101. College of Medicine, Ohio State University, Columbus, OH, United States
  102. 102. University of Leicester, Leicester, United Kingdom
  103. 103. Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
  104. 104. Metropolitan Autonomous University, Mexico City, Mexico
  105. 105. Department of Neurobiology, Care Sciences and Society (NVS), Aging Research Center, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  106. 106. Colombian National Health Observatory, Instituto Nacional de Salud, Bogota, Colombia
  107. 107. Epidemiology and Public Health Evaluation Group, Public Health Department, Universidad Nacional de Colombia, Bogota, Colombia
  108. 108. Universidad Diego Portales, Santiago, Chile
  109. 109. Department of Medicine, University of Valencia/INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain
  110. 110. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
  111. 111. Faculty of Medicine, University of the Republic, Montevideo, Uruguay
  112. 112. National Health Research Institutes, Zhunan Town, Taiwan
  113. 113. National Yang-Ming University, Taipei, Taiwan
  114. 114. School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
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  117. 117. University of Zambia, Lusaka, Zambia
  118. 118. University of Witwatersrand, Johannesburg, South Africa
  119. 119. Seoul National University Medical Library, Seoul, South Korea
  120. 120. Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
  121. 121. Christian Medical College, Vellore, India
  122. 122. University of Salerno, Baronissi, Italy
  123. 123. Ministerio de Salud Publica, Montevideo, Uruguay
  124. 124. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
  125. 125. NIHR Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
  126. 126. Mayo Clinic, Jacksonville, FL, United States
  127. 127. Ahmadu Bello University Zaria, Zaria, Nigeria
  128. 128. Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
  129. 129. Walden University, Minneapolis, MN, United States
  130. 130. i3S-Instituto de Investigacao e Inovacao em Saude and INEB-Instituto de Engenharia Biomedica, Faculty of Medicine, University of Porto, Porto, Portugal
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  132. 132. University of Colorado School of Medicine and the Colorado School of Public Health, Aurora, CO, United States
  133. 133. Brighton and Sussex Medical School, Brighton, United Kingdom
  134. 134. School of Public Health, College of Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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  137. 137. Icahn School of Medicine at Mount Sinai, New York City, NY, United States
  138. 138. Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
  139. 139. International Institute for Population Sciences, Mumbai, India
  140. 140. Centre for Disease Burden, Norwegian Institute of Public Health, Oslo, Norway
  141. 141. Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia
  142. 142. The Institute of Social and Economic Studies of Population, Russian Academy of Sciences, Moscow, Russian Federation
  143. 143. Federal Research Institute for Health Organization and Informatics, Ministry of Health of the Russian Federation, Moscow, Russian Federation
  144. 144. Ministry of Health and Medical Education, Tehran, Iran
  145. 145. Arak University of Medical Sciences, Arak, Iran
  146. 146. Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Hematology-Oncology and Stem Cell Transplantation Research Center, NonCommunicable Diseases Research Center, Digestive Diseases Research Institute, Uro-Oncology Research Center, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
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  148. 148. University of Louisville, Louisville, KY, United States
  149. 149. DGS Directorate General of Health, Lisboa, Portugal
  150. 150. Universidade Aberta, Lisboa, Portugal
  151. 151. Federal University of Sergipe, Aracaju, Brazil
  152. 152. Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, United States
  153. 153. Centre for Experimental Medicine & Rheumatology, William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom
  154. 154. Bielefeld University, Bielefeld, Germany
  155. 155. Institute of Gerontology, Academy of Medical Science, Kyiv, Ukraine
  156. 156. Federal University of Minas Gerais, Belo Horizonte, Brazil
  157. 157. James Cook University, Townsville, QLD, Australia
  158. 158. Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
  159. 159. Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
  160. 160. University of Basel, Basel, Switzerland
  161. 161. National Center for Disease Control and Public Health, Tbilisi, Georgia
  162. 162. National Center for Disease Control & Public Health, Tbilisi, Georgia
  163. 163. The Task Force for Global Health, Decatur, GA, United States
  164. 164. Ludwig Maximilians University, Munich, Germany
  165. 165. Kilte Awlaelo Health and Demographic Surveillance System, Mekelle, Ethiopia
  166. 166. Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
  167. 167. The Royal Melbourne Hospital, Melbourne, VIC, Australia
  168. 168. University Hospital of Dijon, Dijon, France
  169. 169. Haramaya University, Dire Dawa, Ethiopia
  170. 170. Kersa Health and Demographic Surveillance System, Harar, Ethiopia
  171. 171. Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States
  172. 172. University of Massachusetts Boston, Boston, MA, United States
  173. 173. Instituto de Investigaciones Cientificas y Servicios de Alta Tecnologia-INDICASAT-AIP, Cuidad del Saber, Panama
  174. 174. Department of Health and Social Affairs, Government of the Federated States of Micronesia, Palikir, Federated States of Micronesia
  175. 175. Division of Epidemiology, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
  176. 176. Departments of Microbiology and Epidemiology & Biostatistics, Saint James School of Medicine, The Quarter, Anguilla
  177. 177. West Virginia Bureau for Public Health, Charleston, WV, United States
  178. 178. Eternal Heart Care Centre and Research Institute, Jaipur, India
  179. 179. Department of Anthropology, University of Delhi, Delhi, India
  180. 180. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  181. 181. Arabian Gulf University, Manama, Bahrain
  182. 182. Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
  183. 183. University of New Mexico, Albuquerque, NM, United States
  184. 184. School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
  185. 185. Harry Perkins Institute of Medical Research, Nedlands, WA, Australia
  186. 186. Western Australian Neuroscience Research Institute, Nedlands, WA, Australia
  187. 187. Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
  188. 188. Kenyatta University, Nairobi, Kenya
  189. 189. Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
  190. 190. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
  191. 191. Nevada Division of Behavior and Public Health, Carson City, NV, United States
  192. 192. Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States
  193. 193. Yokohama City University School of Medicine, Yokohama, Japan
  194. 194. Albert Einstein College of Medicine, Bronx, NY, United States
  195. 195. Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia
  196. 196. International Relations Division, Ministry of Health, Nay Pyi Taw, Myanmar
  197. 197. Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, China
  198. 198. Cambridge Health Alliance, Cambridge, MA, United States
  199. 199. International Agency for Research on Cancer (IARC), Lyon, France
  200. 200. Ghent University, Ghent, Belgium
  201. 201. Aarhus University, Aarhus, Denmark
  202. 202. Bashkir State Medical University, Ufa, Russian Federation
  203. 203. Boston Medical Center, Boston University, Boston, MA, United States
  204. 204. Indian Institute of Public Health Gandhinagar, Ahmedabad, India
  205. 205. Department of Global and Community Health, George Mason University, Fairfax, VA, United States
  206. 206. School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  207. 207. Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
  208. 208. University of Aberdeen, Aberdeen, United Kingdom
  209. 209. Postgraduate Institute of Medicine, Colombo, Sri Lanka
  210. 210. Institute of Violence and Injury Prevention, Colombo, Sri Lanka
  211. 211. Graduate School of Public Health, Yonsei University, Seoul, South Korea
  212. 212. Centre for Chronic Disease Control, New Delhi, India
  213. 213. Centre for Control of Chronic Conditions, Public Health Foundation of India, Gurgaon, India
  214. 214. Postgraduate Institute of Medical Education and Research, Chandigarh, India
  215. 215. Tianjin Centers for Disease Control and Prevention, Tianjin, China
  216. 216. Department of Health Development, Institute of Industrial Ecological Sciences, Department of Environmental Epidemiology, University of Occupational and Environmental Health, Kitakyushu, Japan
  217. 217. Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
  218. 218. University College Cork, Cork, Ireland
  219. 219. CSIR-Indian Institute of Toxicology Research, Lucknow, India
  220. 220. Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
  221. 221. Epidemiological and Statistical Methods Research Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
  222. 222. Hannover-Braunschweig Site, German Center for Infection Research, Braunschweig, Germany
  223. 223. Center for Research in Health and Economics, Universitat Pompeu Fabra, Barcelona, Spain
  224. 224. Oklahoma State University, Tulsa, OK, United States
  225. 225. School of Public Health, University of Tokyo, Tokyo, Japan
  226. 226. Institut de recherche de l’hopital de Monttfort, Ottawa, ON, Canada
  227. 227. University of California San Francisco, San Francisco, CA, United States
  228. 228. Institute of Tropical and Infectious Diseases, Nairobi, Kenya
  229. 229. School of Continuing and Distance Education, Nairobi, Kenya
  230. 230. Swansea University, Swansea, United Kingdom
  231. 231. South African Medical Research Council, Cape Town, South Africa
  232. 232. Faculty of Health Sciences, Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa
  233. 233. Assuta Hospitals, Assuta Hashalom, Tel Aviv, Israel
  234. 234. Jordan University of Science and Technology, Irbid, Jordan
  235. 235. Health Services Academy, Islamabad, Pakistan
  236. 236. College of Medicine, Graduate School of Public Health, Seoul National University, Seoul, South Korea
  237. 237. Iranian Ministry of Health and Medical Education, Tehran, Iran
  238. 238. Ball State University, Muncie, IN, United States
  239. 239. Southern University College, Skudai, Malaysia
  240. 240. Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
  241. 241. Center for Community Empowerment, Health Policy and Humanities, NIHRD, Jakarta, Indonesia
  242. 242. Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
  243. 243. Research and Development Unit, Parc Sanitari Sant Joan de Deu (CIBERSAM), Barcelona, Spain
  244. 244. Oregon Health and Science University, Portland, OR, United States
  245. 245. Department of Demography and Public Health Research Institute, Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada
  246. 246. Institute of Public Health, Hacettepe University, Ankara, Turkey
  247. 247. Institute of Health Policy and Development Studies, National Institutes of Health, Manila, Philippines
  248. 248. National Cancer Institute, Rockville, MD, United States
  249. 249. Komfo Anokye Teaching Hospital, Kumasi, Ghana
  250. 250. State University of New York, Albany, Rensselaer, NY, United States
  251. 251. San Francisco VA Medical Center, San Francisco, CA, United States
  252. 252. School of Medicine, Wayne State University, Detroit, MI, United States
  253. 253. Children’s Hospital of Michigan, Detroit, MI, United States
  254. 254. Rollins School of Public Health, Emory University, Atlanta, GA, United States
  255. 255. Eastern Health Clinical School, Monash University, Fitzroy, VIC, Australia
  256. 256. Turning Point, Eastern Health, Melbourne, VIC, Australia
  257. 257. Aintree University Hospital National Health Service Foundation Trust, Liverpool, United Kingdom
  258. 258. School of Medicine, University of Liverpool, Liverpool, United Kingdom
  259. 259. Ministry of Health Singapore, Singapore, Singapore
  260. 260. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
  261. 261. Mansoura Faculty of Medicine, Mansoura, Egypt
  262. 262. Aswan University Hospital, Aswan Faculty of Medicine, Aswan, Egypt
  263. 263. Division of Population and Patient Health, King’s College London Dental Institute, London, United Kingdom
  264. 264. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
  265. 265. University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
  266. 266. Department of Health Sciences, University of York, York, United Kingdom
  267. 267. Automotive Industry Development Centre Eastern Cape, Port Elizabeth, South Africa
  268. 268. Children’s Hospital of Philadelphia, Philadelphia, PA, United States
  269. 269. College of Medicine, Howard University, Washington, DC, United States
  270. 270. Janakpuri Superspecialty Hospital, New Delhi, India
  271. 271. Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
  272. 272. Saudi Ministry of Health, Riyadh, Saudi Arabia
  273. 273. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
  274. 274. United Nations Population Fund, Lima, Peru
  275. 275. Department of Neurology, Helsinki University Hospital, Helsinki, Finland
  276. 276. Helsinki University Hospital, Comprehensive Cancer Center, Breast Surgery Unit, Helsinki, Finland
  277. 277. University of Helsinki, Helsinki, Finland
  278. 278. Ifakara Health Institute, Bagamoyo, Tanzania
  279. 279. Pacific Institute for Research & Evaluation, Calverton, MD, United States
  280. 280. Centre for Population Health, Curtin University, Perth, WA, Australia
  281. 281. University of Ottawa, Ottawa, ON, Canada
  282. 282. Department of Medicine, Universiti Kebangsaan Malaysia Medical Center, Bandar Tun Razak, Malaysia
  283. 283. University of Salahaddin, Erbil, Iraq
  284. 284. Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
  285. 285. Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
  286. 286. University of Papua New Guinea, Boroko, Papua New Guinea
  287. 287. Institute for Maternal and Child Health, IRCCS “Burlo Garofolo�, Trieste, Italy
  288. 288. Bureau of International Health Cooperation, Manila City, Philippines
  289. 289. University of North Texas, Denton, TX, United States
  290. 290. Department of Community Medicine, Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran
  291. 291. International Laboratory for Air Quality and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
  292. 292. National Center for Child Health and Development, Setagaya, Japan
  293. 293. Competence Center Mortality-Follow-Up of the German National Cohort, Federal Institute for Population Research, Wiesbaden, Germany
  294. 294. Indian Institute of Public Health, Public Health Foundation of India, Gurgaon, India
  295. 295. University of British Columbia, Vancouver, BC, Canada
  296. 296. Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
  297. 297. Public Health Dynamics Laboratory, University of Pittsburgh, Pittsburgh, PA, United States
  298. 298. Stellenbosch University, Cape Town, South Africa
  299. 299. Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
  300. 300. International Centre for Diarrhoeal Disease Research (icddr, b), Bangladesh, Dhaka, Bangladesh
  301. 301. Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
  302. 302. Ministry of Health, Suva, Fiji
  303. 303. Suraj Eye Institute, Nagpur, India
  304. 304. School of Public Health, City University of New York, New York, NY, United States
  305. 305. School of Health Sciences, University of Tampere, Tampere, Finland
  306. 306. Public Health England, London, United Kingdom
  307. 307. Ministry of Health and Social Welfare, Dar es Salaam, Tanzania
  308. 308. KEMRI-Wellcome Trust Research Program, Nairobi, Kenya
  309. 309. Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
  310. 310. National Institute of Public Health, Japan, Saitama, Japan
  311. 311. Makerere University, Kampala, Uganda
  312. 312. Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
  313. 313. University of Western Sydney, Sydney, NSW, Australia
  314. 314. Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
  315. 315. Universidad Autonoma de Chile, Talca, Chile
  316. 316. Center for Healthy Start Initiative, Lagos, Nigeria
  317. 317. Lira District Local Government, Lira Municipal Council, Uganda
  318. 318. University of Arizona, Tucson, AZ, United States
  319. 319. St Luke’s International University, Tokyo, Japan
  320. 320. North-West University, Mafikeng, South Africa
  321. 321. JSS Medical College, JSS University, Mysore, India
  322. 322. Department of Obstetrics & Gynecology, Attikon University Hospital, Athens, Greece
  323. 323. Department of Medical Humanities and Social Medicine, College of Medicine, Kosin University, Busan, South Korea
  324. 324. California Air Resources Board, Sacramento, CA, United States
  325. 325. Universidad de Cartagena, Cartagena, Colombia
  326. 326. Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
  327. 327. All India Institute of Medical Sciences, New Delhi, India
  328. 328. REQUIMTE/LAQV, Laboratorio de Farmacognosia, Departamento de Quimica, Faculdade de Farmacia, Universidade do Porto, Porto, Portugal
  329. 329. IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Bergamo, Italy
  330. 330. Flinders University, Adelaide, SA, Australia
  331. 331. Health Metrics Unit, Gothenburg, Sweden
  332. 332. University of the Witwatersrand, Johannesburg, South Africa
  333. 333. Shanghai Jiao Tong University School of Medicine, Shanghai, China
  334. 334. Durban University of Technology, Durban, South Africa
  335. 335. Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
  336. 336. Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
  337. 337. Contech School of Public Health, Lahore, Pakistan
  338. 338. Research and Evaluation Division, BRAC, Dhaka, Bangladesh
  339. 339. Hamad Medical Corporation, Doha, Qatar
  340. 340. Society for Health and Demographic Surveillance, Suri, India
  341. 341. Wonju College of Medicine, Institute for Poverty Alleviation and International Development, Yonsei University, Wonju, South Korea
  342. 342. Schizophrenia Research Foundation, Chennai, India
  343. 343. Diabetes Research Society, Hyderabad, India
  344. 344. Diabetes Research Center, Hyderabad, India
  345. 345. Suez Canal University, Ismailia, Egypt
  346. 346. Department of Biomedical and Clinical Sciences L Sacco, University of Milan, Milan, Italy
  347. 347. Brien Holden Vision Institute, University of New South Wales, Sydney, NSW, Australia
  348. 348. ISGlobal, Instituto de Salud Global de Barcelona, Barcelona, Spain
  349. 349. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  350. 350. Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
  351. 351. Development Research and Projects Center, Abuja, Nigeria
  352. 352. Marshall University J Edwards School of Medicine, Huntington, WV, United States
  353. 353. Case Western Reserve University, Cleveland, OH, United States
  354. 354. IIS-Fundacion Jimenez Diaz, Madrid, Spain
  355. 355. Universidad Ciencias Aplicadas y Ambientales, Bogota, Colombia
  356. 356. University of KwaZulu-Natal, Durban, South Africa
  357. 357. Marshall University, Huntington, WV, United States
  358. 358. Novartis Turkey, Istanbul, Turkey
  359. 359. Federal University of Santa Catarina, Florianopolis, Brazil
  360. 360. National Institute of Public Health, Morelos, Mexico
  361. 361. Independent Consultant, Karachi, Pakistan
  362. 362. Indian Institute of Technology Ropar, Roopnagar, India
  363. 363. Research Institute at Nationwide Children’s Hospital, Columbus, OH, United States
  364. 364. Department of Public Health Science, Graduate School, Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
  365. 365. Finnish Institute of Occupational Health, Helsinki, Finland
  366. 366. Washington State University, Spokane, WA, United States
  367. 367. Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
  368. 368. Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, United Kingdom
  369. 369. Reykjavik University, Reykjavik, Iceland
  370. 370. Brasilia University, Brasilia, Brazil
  371. 371. Feinberg School of Medicine, Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
  372. 372. Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
  373. 373. Institute for Human Development, New Delhi, India
  374. 374. Asthma Bhawan, Jaipur, India
  375. 375. Dartmouth College, Lebanon, NH, United States
  376. 376. Instituto de Investigacion Hospital Universitario de la Princesa, Universidad Autonoma de Madrid, Catedra UAM-Linde, Palma de Mallorca, Spain
  377. 377. Department of Clinical Neurological Sciences, Western University, London, ON, Canada
  378. 378. Department of Community Medicine, International Medical University, Kuala Lumpur, Malaysia
  379. 379. Alexandra General Hospital of Athens, Athens, Greece
  380. 380. Centre Hospitalier Public du Cotentin, Cherbourg, France
  381. 381. Indian Council of Medical Research, New Delhi, India
  382. 382. Departments of Criminology, Law & Society, Sociology, and Public Health, University of California, Irvine, Irvine, CA, United States
  383. 383. Department of Medicine, University of Valencia/CIBERSAM, Valencia, Spain
  384. 384. School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL, United States
  385. 385. Ministry of Health, MINSANTE, Yaounde, Cameroon
  386. 386. Westchester Medical Center, Valhalla, NY, United States
  387. 387. Department of Biology, Colgate University, Hamilton, NY, United States
  388. 388. James Cook University, Cairns, QLD, Australia
  389. 389. Arba Minch University, Arba Minch, Ethiopia
  390. 390. Department of Anesthesiology, University of Virginia, Charlottesville, VA, United States
  391. 391. Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH, United States
  392. 392. Adaptive Knowledge Management, Victoria, BC, Canada
  393. 393. WorldFish, Penang, Malaysia
  394. 394. National Center for Child Health and Development, Tokyo, Japan
  395. 395. Faculty of Health Sciences, Jagiellonian University, Krakow, Poland
  396. 396. Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
  397. 397. Le Bonheur Children’s Hospital, Memphis, TN, United States
  398. 398. University of Tennessee Health Science Center, Memphis, TN, United States
  399. 399. St Jude Children’s Research Hospital, Memphis, TN, United States
  400. 400. Hanoi Medical University, Hanoi, Viet Nam
  401. 401. Department of Population Sciences and Development, Faculty of Economics and Management, University of Kinshasa, Kinshasa, Democratic Republic Congo
  402. 402. Parc Sanitari Sant Joan de Deu, Fundacio Sant Joan de Deu, Universitat de Barcelona, CIBERSAM, Barcelona, Spain
  403. 403. Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Nigeria
  404. 404. Warwick Medical School, University of Warwick, Coventry, United Kingdom
  405. 405. UKK Institute for Health Promotion Research, Tampere, Finland
  406. 406. Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore
  407. 407. University of Bologna, Bologna, Italy
  408. 408. Federal Research Institute for Health Organization and Informatics, Moscow, Russian Federation
  409. 409. National Research University Higher School of Economics, Moscow, Russian Federation
  410. 410. McGill University, Montreal, QC, Canada
  411. 411. Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
  412. 412. Department of Community Medicine, Faculty of Health Sciences, University of Tromso, The Arctic University of Norway, Tromso, Norway
  413. 413. Genetic Epidemiology Group, Folkhalsan Research Center, Helsinki, Finland
  414. 414. Royal Children’s Hospital, Melbourne, VIC, Australia
  415. 415. German National Cohort Consortium, Heidelberg, Germany
  416. 416. Western Health, Footscray, VIC, Australia
  417. 417. Children’s Hospital of Michigan, Detroit, MI, United States
  418. 418. National Institute for Health Research Comprehensive Biomedical Research Centre, Guy’s & St Thomas’ NHS Foundation Trust and King’s College London, London, United Kingdom
  419. 419. St Paul’s Hospital, Millennium Medical College, Addis Ababa, Ethiopia
  420. 420. Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
  421. 421. Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu Natal, Durban, South Africa
  422. 422. University of Zurich, Zurich, Switzerland
  423. 423. Social Work and Social Administration Department and The Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China
  424. 424. Department of Biostatistics, School of Public Health, Kyoto University, Kyoto, Japan
  425. 425. Jackson State University, Jackson, MS, United States
  426. 426. Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Wuhan University, Wuhan, China
  427. 427. University Hospital, Setif, Algeria
  428. 428. Faculty of Medicine, Mansoura University, Mansoura, Egypt
  429. 429. Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
  430. 430. Chongqing Medical University, Chongqing, China
  431. 431. Red Cross War Memorial Children’s Hospital, Cape Town, South Africa

Source: The Lancet Published:2016


Abstract

Background In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015. Methods We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages 10–54 years by systematically compiling and processing all available data sources from 186 of 195 countries and territories, 11 of which were analysed at the subnational level. We quantified eight underlying causes of maternal death and four timing categories, improving estimation methods since GBD 2013 for adult all-cause mortality, HIV-related maternal mortality, and late maternal death. Secondary analyses then allowed systematic examination of drivers of trends, including the relation between maternal mortality and coverage of specific reproductive health-care services as well as assessment of observed versus expected maternal mortality as a function of Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Findings Only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1. Geographical disparities widened between 1990 and 2015 and, in 2015, 24 countries still had a maternal mortality ratio greater than 400. The proportion of all maternal deaths occurring in the bottom two SDI quintiles, where haemorrhage is the dominant cause of maternal death, increased from roughly 68% in 1990 to more than 80% in 2015. The middle SDI quintile improved the most from 1990 to 2015, but also has the most complicated causal profile. Maternal mortality in the highest SDI quintile is mostly due to other direct maternal disorders, indirect maternal disorders, and abortion, ectopic pregnancy, and/or miscarriage. Historical patterns suggest achievement of SDG 3.1 will require 91% coverage of one antenatal care visit, 78% of four antenatal care visits, 81% of in-facility delivery, and 87% of skilled birth attendance. Interpretation Several challenges to improving reproductive health lie ahead in the SDG era. Countries should establish or renew systems for collection and timely dissemination of health data; expand coverage and improve quality of family planning services, including access to contraception and safe abortion to address high adolescent fertility; invest in improving health system capacity, including coverage of routine reproductive health care and of more advanced obstetric care—including EmOC; adapt health systems and data collection systems to monitor and reverse the increase in indirect, other direct, and late maternal deaths, especially in high SDI locations; and examine their own performance with respect to their SDI level, using that information to formulate strategies to improve performance and ensure optimum reproductive health of their population. Funding Bill & Melinda Gates Foundation. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license
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