Maternal Mortality in Developing Countries: Applicability of Sen's Theoretical Perspectives

Purpose: There is a significant lack of development studies on reproductive health, especially in developing countries. The field of social work has especially marginalized the study of reproductive health. Adding to this deficiency is the lack of meaningful theoretical frameworks guiding the reproductive field, especially in developing countries. Yet three out of the eight millennium goals identified for improvement by the United Nations and its member countries are reproductive health related: maternal mortality, infant mortality and HIV/AIDS. Of these three millennium goals, maternal mortality is of particular concern to women in developing countries. Despite the millennium commitment to eradicate reproductive health related deaths, maternal mortality remains an ongoing tragedy in developing countries. Maternal mortality cannot only wipe out women and productive labor from communities, but it can cause harm to future generations due to the impact maternal health and mortality has on young children. In light of these devastating realities and their consequences, it is important to pursue new approaches to reduce maternal mortality among women in developing countries. Consequently, the current paper empirically tested the applicability of the Nobel Prize winner economic theorist Amartya Sen's human development perspectives to maternal mortality. The proposed model hypotheses that, social development and reproductive capabilities negatively influence maternal mortality in developing countries controlling for economic growth and political development.

Methods: This analysis was conducted using secondary data. The sample for this study came from 142 developing countries out of 144 identified by the World Bank (World Bank, 2009). Data were collected from several international bodies such as World Health Organization, United Nations, World Bank, and several of their affiliated institutions. This study used several multivariate methods to analyze the data. The path analysis method was used to determine if the theoretically proposed paths and the model were empirically validated. Factor based scales were developed using factor analysis to measure the latent constructs; reproductive capability and social development.

Results: The path model provided an excellent fit for the observed variance-covariance matrix as indicated by very low chi square values 2.07 (df = 4), and high scores on CFI (1.00), TLI (1.01) and RAMSEA (.00). All hypothesized paths and the overall theoretical model was empirically validated by path analysis.

Implications: This study findings lead us to prescribe emphasis on social development efforts, especially focusing on adult literacy, reallocation of resources for example increases in public expenditure and social security expenditure, improvements to basic amenities such as access to water, and advancement in communication networks. These efforts should lead to and must also be followed by improvements in reproductive capabilities/freedoms, such as; abortion policies and healthcare access and advancements in female power to improve maternal health. The paper argued that capability and social development based approaches are more congruent with social work values than those based on economic development models alone and capability and social development based social work practice methods are outlined to alleviate maternal mortality in developing countries.