Understanding Maternal Mortality in Colombia : the Influence of Health Insurance

In 2006, the city of Bogotá and the department of Antioquía registered 60 (64 per 100 000 live births) and 59 (63.6 per 100 000 live births) maternal deaths, respectively. Given the high coverage of prenatal care and institutional delivery in the country, these rates seem especially high. One possible explanation is the insurance status of the population. Colombia has a mandatory social insurance program based on contributions from employees and all those with a minimum income. The poor are subsidized. Maternal mortality in the city of Bogotá and the department of Antioquía is lowest for women who participate in the contributive insurance regime. But, the highest maternal mortality rates were among uninsured women in Antioquía, and among subsidized women in Bogotá.

This project will explore the causality of maternal mortality in Bogotá and Antioquía with respect to health insurance regime and contractual relationship between insurer and provider through a 24-month case-control study. Cases will be defined as all maternal deaths during the observation period in the two areas. Four controls per case will be randomly selected from a reference population of women delivered during the same period. The researchers will also examine other potential determinants of maternal mortality such as socioeconomic status, physical access to care, biological risks, etc.

The results will be published in national and international peer-reviewed journals and presented to academics, policymakers and the public at various forums.

Project ID

104373

Project status

Closed

Start Date

Friday, February 1, 2008

End Date

Monday, August 1, 2011

Duration

30 months

IDRC Officer

Ingabire, Marie-Gloriose

Total funding

CA$ 404,400

Countries

Colombia, South America, North and Central America

Program

Maternal and Child Health

Project Leader

Francisco J. Yepes

Institution

Asociación Colombiana de la Salud

Institution Country

Colombia