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Trop Med Int Health. 2014 Dec;19(12):1488-99. doi: 10.1111/tmi.12394. Epub 2014 Oct 20.

The contribution of unimproved water and toilet facilities to pregnancy-related mortality in Afghanistan: analysis of the Afghan Mortality Survey.

Author information

1
Department of Epidemiology and Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.

Abstract

OBJECTIVE:

To estimate the effect of unimproved household water and toilet facilities on pregnancy-related mortality in Afghanistan.

METHODS:

The data source was a population-based cross-sectional study, the Afghan Mortality Survey 2010. Descriptive, univariate and multivariate logistic regression analyses were carried out, comparing 69 pregnancy-related deaths (cases) and 15386 surviving women (non-cases) who had a live birth or stillbirth between 2007 and 2010.

RESULTS:

After adjusting for confounders, households with unimproved water access had 1.91 the odds of pregnancy-related mortality [95% confidence interval (CI) 1.11-3.30] compared to households with improved water access. We also found an association between unimproved toilet facilities and pregnancy-related mortality (OR = 2.25; 95% CI 0.71-7.19; P-value = 0.169), but it was not statistically significant.

CONCLUSIONS:

Unimproved household water access was an important risk factor for pregnancy-related mortality in Afghanistan. However, we were unable to discern whether unimproved water source is a marker of unhygienic environments or socio-economic position. There was weak evidence for the association between unimproved toilet facilities and pregnancy-related mortality; this association requires confirmation from larger studies.

KEYWORDS:

Afganistán; Afghanistan; assainissement; cross-sectional study; estudio croseccional; fuentes de agua; instalaciones sanitarias mortalidad materna; installations de toilette; maternal mortality; mortalité maternelle; ressources d'eau; sanitation; toilet facilities; water resources; étude transversale

PMID:
25330354
DOI:
10.1111/tmi.12394
[Indexed for MEDLINE]
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