Comparative evidence of years lived with reproductive age morbidity in sub-Saharan Africa (2010-2018)

Background: Despite remarkable progress in reducing maternal mortality over the past three decades, maternal morbidities remain high, particularly in sub-Saharan Africa (SSA). However, the number of years women spend with maternal morbidities, and how much each maternal complication contributes to unhealthy remaining years in reproductive ages is unknown. We estimate the number of life years that women of reproductive ages spend in poor health due to indirect maternal health morbidities. Methods: We use Demographic and Health Survey data from 23 SSA countries to estimate age-specific mortality prevalence in reproductive age women, and construct life tables to estimate the survival function and reproductive age life expectancy (RALE) with and without HIV and anemia using the Sullivan method. Results: There is a high prevalence of HIV (4.9%) and anemia (34.3%) among SSA women. There is also heterogeneity in prevalence across regions, with higher prevalence of anemia in East (27.9%), Central (36.5%) and West Africa (47.8%), and HIV in Southern Africa (13.0%). These conditions compromise women’s health by an average of 14.3 years [CI 95%, 14.3-14.4], approximately 42% of RALE life years. On average, SSA women spend 11.6 years [11.6-11.7] with anemia, 1.7 years [1.7-1.8] with HIV, and 1.1 years [1.1-1.2] with both conditions. Conclusions: The high burden of life years with reproductive age morbidities among SSA women highlights that to achieve healthy lives for women and children as part of Sustainable Development Goal 3, morbidity prevention and management measures among women will need to be enhanced over the entire reproductive age span.