Situational analysis of maternal and infant mortality in Kazakhstan

Background. Previous studies from Western countries have shown an association between maternal and infant mortality and sociomedical problems. The social environment, which influences the health status of mothers and infants, is a function of the economic resources and forms of production of different regions. This study, for the first time, includes the study of preventable mortality from Pregnancy, childbirth, and the perinatal period, and Congenital malformations in Kazakhstan in the context of regions. For 2015-2019, maternal mortality decreased by 16.5% in Kazakhstan. However, since the start of the pandemic in 2020, the maternal mortality ratio has increased by 2.7 times, highlighting the urgent need for action. This study aims to provide the latest maternal and infant mortality policy and analyze their mortality ratios. The findings of this study have the potential to significantly impact healthcare policies and practices, making a substantial contribution to the field of maternal and child health. Methods. The regulatory documents related to maternal and child health in the Kazakhstan health system were appraised over the last ten years. To identify changes in avoidable mortality ratio trends for the period 2011-2021, joinpoint regression was used to calculate the average annual percentage change for every age group using the JoinPoint Regression Program, Version 4.9.1.0. Results. Crude mortality associated with pregnancy, childbirth, and the postpartum period was high in the 30-34 age group from 2015 to 2018. From 2019 to 2021, there has been an increase in mortality in the 35-39 age group from 0.48 (95% CI: - 0.06; 1.03) to 4.37 (95% CI: 2.83; 5.91) per 100,000 women. In general, there is a twofold increase in mortality in the period from 2018 to 2021. Treatable mortality from pregnancy, childbirth, and puerperium fluctuated between 0.34 and 0.37 from 2015-2019, after which it rose to 1.07 in 2021 per 100.000 population. The highest increase can be seen in Atyrau, South and East Kazakhstan, Karagandy, and Almaty regions. The treatable mortality decreased in Kyzylorda and Akmola regions in the 2015-2021. Conclusion. Several regions need to increase efforts to reduce maternal mortality, which remains high nationally compared to OECD countries. This is the first study to examine the prevention of deaths from pregnancy, childbirth, and the perinatal period, as well as the development of birth defects in Kazakhstan by region, which helps physician decision-makers reconsider possible approaches to providing care at the primary health care level.