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

Giorgia Gon, Laura Monzon-Llamas, Lenka Benova, Barbara Willey, Oona M R Campbell

Research output: Contribution to journalA1: Web of Science-article

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.

Original languageEnglish
JournalTropical Medicine and International Health
Volume19
Issue number12
Pages (from-to)1488-99
Number of pages12
ISSN1360-2276
DOIs
Publication statusPublished - Dec-2014
Externally publishedYes

Keywords

  • Adult
  • Afghanistan/epidemiology
  • Cross-Sectional Studies
  • Data Collection
  • Environment
  • Family Characteristics
  • Female
  • Humans
  • Infant
  • Logistic Models
  • Maternal Mortality
  • Pregnancy
  • Pregnancy Complications/etiology
  • Risk Factors
  • Sanitation/standards
  • Socioeconomic Factors
  • Toilet Facilities/standards
  • Water
  • Water Supply/standards
  • Young Adult

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