Reducing maternal and newborn deaths is a global priority, yet sub-Saharan Africa bears over 70% of maternal deaths despite having only 13% of the world’s population. Inequities in health outcomes and access persist even within countries, often framed as urban-rural or regional disparities. This thesis of Sisay Alemu goes deeper, examining the nuanced and complex patterns within these broad categories.
This thesis aims to map inequalities in maternal and newborn health, understand why these inequalities arise, and propose strategic solutions to reduce them using geospatial analysis. This thesis will first explore the applicability of geospatial analysis in maternal and newborn health across sub-Saharan Africa (Chapter 2), followed by mapping perinatal and pregnancy-related mortality inequalities in Ethiopia at the national (Chapter 3) and regional level (Chapter 4). Additionally, it investigated factors driving these inequalities (Chapters 3 and 4) and summarized the perceptions of different stakeholders in Ethiopia on the issue (Chapter 5), followed by proposing an ideal location for building new maternal and child health facilities for improving access to care, taking into account different scenarios (Chapter 6). Finally, the thesis generates and interprets the implication of the work for policy, researchers, and practice (chapter 7). Overall, this research aims to provide policymakers and program managers with evidence to design targeted interventions that improve maternal and newborn health equity in Ethiopia and beyond.
While progress has been made over time in reducing maternal and newborn mortality rates in Ethiopia1 and the wider sub-Saharan Africa, this thesis highlights the persistence of subnational inequalities, even as national-level mortality rates have declined over time.
