Inequality and maternal survival cluster analysis of 49 Sub Saharan countries

Sub-Saharan Africa has the highest burden of gender inequality and maternal mortality globally. Female secondary education is a key determinant of both, yet comparative evidence across the region remains limited. This study provides a multi-dimensional comparative analysis of gender inequality and maternal survival across 49 Sub-Saharan African countries using the 2023 Gender Inequality Index (GII) and cluster analysis to identify distinct country profiles for differentiated policy responses. Data were extracted from the United Nations Development Programme (UNDP) 2023/2024 Human Development Report, covering 40–49 countries. Descriptive statistics, Pearson correlations, multiple linear regression, and k-means clustering were performed. GII values range from 0.325 (Cabo Verde) to 0.677 (Nigeria); maternal mortality ratios from 3.3 (Seychelles) to 1,223 (South Sudan) per 100,000 live births. Female secondary education correlated negatively with GII (r = − 0.67) and maternal mortality (r = − 0.51). Regression identified female secondary education (β = − 0.51, p < 0.001) and adolescent birth rate (β = 0.37, p < 0.01) as the strongest GII predictors. Cluster analysis revealed three country profiles: “High inequality – high mortality” (n = 17), “Moderate performers” (n = 15), and “Lower inequality – better health” (n = 8). Gender gaps persist in secondary education (–9.8% points) and labour force participation (–17.4 points). Strengthening girls’ secondary education and reducing adolescent childbearing are critical for reducing gender inequality and improving maternal survival in Sub-Saharan Africa. Policy efforts must be tailored to cluster-specific challenges, prioritizing the Sahel and conflict-affected states.

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Publication Details

Journal
Discover Public Health
Published
2026-05-23
DOI
https://doi.org/10.1186/s12982-026-02069-9
Primary Topic
Global Maternal and Child Health
Type
article
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article

Inequality and maternal survival cluster analysis of 49 Sub Saharan countries

Rachael Gakii Murithi, Kun Tang
Discover Public Health
Global Maternal and Child Health
article

Inequality and maternal survival cluster analysis of 49 Sub Saharan countries

Rachael Gakii Murithi, Kun Tang
article en

Abstract

Sub-Saharan Africa has the highest burden of gender inequality and maternal mortality globally. Female secondary education is a key determinant of both, yet comparative evidence across the region remains limited. This study provides a multi-dimensional comparative analysis of gender inequality and maternal survival across 49 Sub-Saharan African countries using the 2023 Gender Inequality Index (GII) and cluster analysis to identify distinct country profiles for differentiated policy responses. Data were extracted from the United Nations Development Programme (UNDP) 2023/2024 Human Development Report, covering 40–49 countries. Descriptive statistics, Pearson correlations, multiple linear regression, and k-means clustering were performed. GII values range from 0.325 (Cabo Verde) to 0.677 (Nigeria); maternal mortality ratios from 3.3 (Seychelles) to 1,223 (South Sudan) per 100,000 live births. Female secondary education correlated negatively with GII (r = − 0.67) and maternal mortality (r = − 0.51). Regression identified female secondary education (β = − 0.51, p < 0.001) and adolescent birth rate (β = 0.37, p < 0.01) as the strongest GII predictors. Cluster analysis revealed three country profiles: “High inequality – high mortality” (n = 17), “Moderate performers” (n = 15), and “Lower inequality – better health” (n = 8). Gender gaps persist in secondary education (–9.8% points) and labour force participation (–17.4 points). Strengthening girls’ secondary education and reducing adolescent childbearing are critical for reducing gender inequality and improving maternal survival in Sub-Saharan Africa. Policy efforts must be tailored to cluster-specific challenges, prioritizing the Sahel and conflict-affected states.

Discover Public HealthVol. 23(1)
University of Nairobi (KE), Vanke (China) (CN), Tsinghua University (CN)
Openalex Percentile: Top 4%
Global Maternal and Child Health
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Inequality and maternal survival cluster analysis of 49 Sub Saharan countries — Rachael Gakii Murithi, Kun Tang · Discover Public Health (2026) | TGRS Research Map | TGRS