Examining the Causal Effect of Social Development on Maternal Mortality in Sub-Saharan Africa Using Partial Least Squares (PLS) Structural Equation Modeling (SEM)

Frank Okwan; Peter Kovacs

doi:doi:10.11648/j.pamj.20231202.11

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Examining the Causal Effect of Social Development on Maternal Mortality in Sub-Saharan Africa Using Partial Least Squares (PLS) Structural Equation Modeling (SEM)

Frank Okwan, Peter Kovacs

Published in Pure and Applied Mathematics Journal (Volume 12, Issue 2)

Received: 4 August 2022 Accepted: 9 September 2022 Published: 26 July 2023

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Abstract

The threat of a woman in a low-income economy dying due to pregnancy and childbirth-related complications during her lifetime is about 120 times higher than for a woman living in a high-income economy. Social factors are seen as important factors contributing to maternal mortality and the conceptual framework developed for the reduction of maternal mortality has found the need to include social factors in intervention for maternal mortality reduction. The objective of this study is to examine the effect of social development on maternal mortality in Sub-Saharan Africa by applying Sen’s development theory and the Partial Least Squares Structural Equation Modeling (PLS-SEM) technique. The result of the empirical analysis shows that social development has both direct and indirect effects on maternal mortality. The direct effect is greater than the indirect effect. The direct effect is the effect of social development on reproductive capability, and the indirect effect is the effect of social development on maternal mortality through reproductive capability and freedom. The result also reveals a direct and positive effect of economic and political development on social development. Social development has the greatest effect on maternal mortality, compared to all the other effects in the model. The result of the PLS-SEM analysis and the final model supports all the hypotheses for the study.

Published in	Pure and Applied Mathematics Journal (Volume 12, Issue 2)
DOI	10.11648/j.pamj.20231202.11
Page(s)	23-33
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Maternal Mortality, PLS-SEM, Sen’s Theory, Sub-Saharan Africa, Social Development

References

[1]	WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division (2017). "Trends in Maternal Mortality," 2000 to 2017 Geneva, World Health Organization, 2019. https://apps.who.int/iris/handle/10665/327596 (accessed Oct, 1, 2020).
[2]	WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division. (2015). "Trends in Maternal Mortality, "1990 to 2015. Geneva, World Health Organization. https://www.who.int/reproductivehealth/publications/monitoring/maternal-mortality-2015/en/(accessed 1 Oct. 2019).
[3]	McCarthy, J., Maine, D. (1992) "A framework for analyzing the determinants of maternal mortality," Studies in family planning, vol. 23 no. 1, pp. 23-33, 1992. DOI: https://doi.org/10.2307/1966825
[4]	Thaddeus, S. & Maine, D. (1994) "Too far to walk maternal mortality in context," Social science & medicine, vol. 38 no. 8, pp. 1091-1110. DOI: 10.1016/0277-9536(94)90226-7.
[5]	UNICEF (2008) "The State of the World's Childre." United Nations Children's Fund, New York https://www.unicef.org/media/84866/file/SOWC-2009.pdf (accessed 5 Sept. 2020).
[6]	Mukami, V., Millham, R., Puckree, T (2016)."Comparison of frameworks and models for analyzing determinants of maternal mortality and morbidity," In 2016 IST-Africa Week Conference, (pp. 1-8). IEEE. DOI: 10.1109/ISTAFRICA.2016.7530653.
[7]	Shen, C., Williamson, J. B. (1999) "Maternal mortality, women's status, and economic dependency in less developed countries: a cross-national analysis". Social science & medicine, vol. 49 no. 2, pp. 197-214. DOI: 10.1016/S0277-9536(99)00112-4.
[8]	Okwan, F. – Kovács, P. (2019) Determinants of maternal mortality in Sub-Saharan Africa: a cause-effect model assessment. Hungarian Statistical Review, 2 (2), PP 15-31. DOI: 10.35618/hsr2019.02.en015.
[9]	Ellen, I. G., Mijanovich, T., Dillman, K. N. (2001). "Neighborhood effects on health: exploring the links and assessing the evidence," Journal of urban affairs, vol. 23 no. 3-4, pp. 391-408, 2001. DOI: 10.1111/0735-2166.00096.
[10]	DeJong, J. (2006) "Capabilities, reproductive health, and well-being,". The Journal of Development Studies, vol. 24, no. 7, pp. 1158-1179..
[11]	Robeyns, I. (2002) "Sen’s capability approach and gender inequality," In Conference Proceedings. Promoting Women‘s Capabilities: Examining Nussbaum‘s Capabilities Approach. Web accessed from https://pdfs.semanticscholar.org/b4f9/139c13371f8e553e390bd1211cd583224043. pdf.
[12]	Mohan, B. (2010) "Requiem for Keynes, ideology, and reform: A keynote on transformative practice," Poverty & Public Policy, vol. 2, pp. 131–159. DOI: 10.2202/1944-2858.1131.
[13]	Mohan, B, " Fallacies of development: Crises of human and social development,", Atlantic Publishers & Dist. 2007. Pp 1-186.
[14]	Sen, A. (2007) "Keynote address. Presented at the 15th symposium of the International Consortium for Social Development," Hong Kong.
[15]	Sen, A. (1999), "Beyond the crisis: Development strategies in Asia", Vol No. 2, Institute of Southeast Asian.
[16]	Ul Haq, M. (1995): "Reflections on human development," oxford university, Press, Pp. 1-252.
[17]	Sen, A. (1992) "Inequality re-examined. New York": Harvard University Press. pp. 1-206.
[18]	Sen, A. (1999a) "Development as freedom, " New York: Anchor Books, pp. 252.
[19]	Fukuda-Parr, S. (2003)"The human development paradigm: operationalizing Sen's ideas on capabilities," Feminist economics, vol. 9 no. 2-3, pp. 301-317. DOI: 10.1080/1354570022000077980.
[20]	Wold, H. (1975)"Soft modeling by latent variables: the non-linear iterative partial least squares (NIPALS) approach". Journal of Applied Probability, vol. 12 no. S1, pp. 117-142. DOI: 10.1017/S0021900200047604.
[21]	Fornell, C., Larcker, D. F. (1981). "Structural equation models with unobservable variables and measurement error," Algebra and statistics. DOI: 10.1177/002224378101800313.
[22]	Henseler, J., Ringle, C. M., Sarstedt, M. (2015). "A new criterion for assessing discriminant validity in variance-based structural equation modeling," Journal of the academy of marketing science, vol. 43 no. 1, pp. 115-135. DOI 10.1007/s11747-014-0403-8.
[23]	Chin, W. W., Marcolin, B. L., Newsted, P. R. (2003). "A partial least squares latent variable modeling approach for measuring interaction effects: Results from a Monte Carlo simulation study and an electronic-mail emotion/adoption study,". Information systems research, vol. 14 no. 2, pp. 189-217. DOI: 10.1287/isre.14.2.189.16018.
[24]	Cohen, J. (1998) "Statistical Power Analysis for the Behavioural Sciences,". Hillsdale, NJ: Laurence Erlbaum and Associates, 98-101.
[25]	Bagozzi, R. P. – Yi, Y (1998) "On the evaluation of structural equation models," Journal of the Academy of Marketing Science, vol. 16 no. 1, pp. 74–94. https://link.springer.com/article/10.1007/BF02723327
[26]	Chin, W. W., Marcolin, B. L., Newsted, P. R.. (1996) "A Partial Least Squares Latent Variable Modelling Approach for Measuring Interaction Effects," Results from a Monte-Carlo Simulation Study and Voice Mail Emotion/Adoption Study. DOI: 1047-7047/03/1402/0189$05.00.
[27]	Höck, Michael & Ringle, Christian M. (2006) "Strategic networks in the software industry," An empirical analysis of the value continuum, 2006, IFSAM VIIIth World. Congress, Berlin. DOI: 10.1504/IJKMS.2010.030789.
[28]	Hair, J. F., Black, W. C, Babin, B. J., Anderson, R. E., Tatham, R. L. (2009) "Análise Multivariada De Dados," Bookman Editora.
[29]	Hair, J. F., Ringle, C. M., Sarstedt, M. (2011) "PLS-SEM: Indeed a silver bullet," Journal of Marketing Theory and Practice, vol. 19 no. 2, pp. 139–152. DOI: 10.2753/MTP1069-6679190202.
[30]	Alvarez, J. L. – Gil, R., Hernández, V., Gil, A. (2009) "Factors associated with maternal mortality in Sub-Saharan Africa", an ecological study. BMC public health, vol. 9 no. 1, pp. 1-8. DOI: 10.1186/1471-2458-9-462.
[31]	Buor, D.,& Bream, K.(2004) "An analysis of the determinants of maternal mortality in sub-Saharan Africa," Journal of Women's Health, vol. 13 no. 8, pp. 926-938. DOI: 10.1089/jwh.2004.13.926.
[32]	Girum, T., & Wasie, A. (2017). Correlates of maternal mortality in developing countries: an ecological study in 82 countries. Maternal Health, Neonatology, and Perinatology, 3 (1), 1-6. DOI 10.1186/s40748-017-0059-8.
[33]	Ruiz-Cantero, M. T., Guijarro-Garvi, M., Bean, D. R., Martínez-Riera, J. R., & Fernández-Sáez. J. (2019). Governance commitment to reduce maternal mortality. A political determinant beyond the wealth of the countries. Health & place, 57, 313-320. DOI: 10.1016/j.healthplace.2019.05.012.
[34]	Sajedinejad, S., Majdzadeh, R., Vedadhir, A., Tabatabaei, M. (2015). Mohammad, K., Maternal mortality: a cross-sectional study in global health. Glob. Health 11, 4. DOI 10.1186/s12992-015-0087-y.
[35]	Almasi Hashiani, A., Ayubi, E., Fahimfar, N., Khosravi, A., Karamzad, N., Safiri, S. (2015). Economic inequality and infant, under-5-year-old, maternal, and crude mortality rates. Journal of Archives in Military Medicine, 3 (3).
[36]	Walker, M. E., Anonson, J., & Szafron, M. (2015). Economist intelligence unit democracy index in relation to health services accessibility: a regression analysis. International health, 7 (1), 49-59.
[37]	Neal, S., Falkingham, J. (2014). Neonatal death and national income in developing countries: will economic growth reduce deaths in the first month of life?. International Journal of Population Research, 2014, 1-6.
[38]	Batist, J. (2019). An intersectional analysis of maternal mortality in Sub-Saharan Africa: a human rights issue. Journal of global health, 9 (1).
[39]	Tlou, B. (2018). Underlying determinants of maternal mortality in a rural South African population with high HIV prevalence (2000–2014): A population-based cohort analysis. PloS one, 13 (9), 1-9.
[40]	Daniela Halidini Qendraj, Alban Xhafaj, Etleva Halidini (2021). Analysis and Evaluation of Factors Affecting the Use of Google Classroom in Albania: A Partial Least Squares Structural Equation Modelling Approach. Mathematics and Statistics, 9 (2), 112-126. DOI: 10.13189/ms.2021.090205.
[41]	Jacques W. Saïzonou, Alphonse M. Affo, Virginie Mongbo, Robert Zannou, Patrick Makoutodé, Alphonse Kpozèhouen, Thierry Tossou Boco, Soulemane Zan, Léopold Ouédraogo, Edgard-Marius Ouendo. (2021). Health Providers and Recommended Family Planning Guidelines in Benin. Universal Journal of Public Health, 9 (3), 103 - 112. DOI: 10.13189/ujph.2021.090301.
[42]	Gonzalez, M., Ren, R. (2017). Differences and Determinants of maternal mortality ratio in Sub-Saharan African countries. Annals of Global Health, 83 (1), 200. https://doi.org/10.1016/j.aogh.2017.03.496

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Frank Okwan, Peter Kovacs. (2023). Examining the Causal Effect of Social Development on Maternal Mortality in Sub-Saharan Africa Using Partial Least Squares (PLS) Structural Equation Modeling (SEM). Pure and Applied Mathematics Journal, 12(2), 23-33. https://doi.org/10.11648/j.pamj.20231202.11

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ACS Style

Frank Okwan; Peter Kovacs. Examining the Causal Effect of Social Development on Maternal Mortality in Sub-Saharan Africa Using Partial Least Squares (PLS) Structural Equation Modeling (SEM). Pure Appl. Math. J. 2023, 12(2), 23-33. doi: 10.11648/j.pamj.20231202.11

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AMA Style

Frank Okwan, Peter Kovacs. Examining the Causal Effect of Social Development on Maternal Mortality in Sub-Saharan Africa Using Partial Least Squares (PLS) Structural Equation Modeling (SEM). Pure Appl Math J. 2023;12(2):23-33. doi: 10.11648/j.pamj.20231202.11

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@article{10.11648/j.pamj.20231202.11,
  author = {Frank Okwan and Peter Kovacs},
  title = {Examining the Causal Effect of Social Development on Maternal Mortality in Sub-Saharan Africa Using Partial Least Squares (PLS) Structural Equation Modeling (SEM)},
  journal = {Pure and Applied Mathematics Journal},
  volume = {12},
  number = {2},
  pages = {23-33},
  doi = {10.11648/j.pamj.20231202.11},
  url = {https://doi.org/10.11648/j.pamj.20231202.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.pamj.20231202.11},
  abstract = {The threat of a woman in a low-income economy dying due to pregnancy and childbirth-related complications during her lifetime is about 120 times higher than for a woman living in a high-income economy. Social factors are seen as important factors contributing to maternal mortality and the conceptual framework developed for the reduction of maternal mortality has found the need to include social factors in intervention for maternal mortality reduction. The objective of this study is to examine the effect of social development on maternal mortality in Sub-Saharan Africa by applying Sen’s development theory and the Partial Least Squares Structural Equation Modeling (PLS-SEM) technique. The result of the empirical analysis shows that social development has both direct and indirect effects on maternal mortality. The direct effect is greater than the indirect effect. The direct effect is the effect of social development on reproductive capability, and the indirect effect is the effect of social development on maternal mortality through reproductive capability and freedom. The result also reveals a direct and positive effect of economic and political development on social development. Social development has the greatest effect on maternal mortality, compared to all the other effects in the model. The result of the PLS-SEM analysis and the final model supports all the hypotheses for the study.},
 year = {2023}
}

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TY  - JOUR
T1  - Examining the Causal Effect of Social Development on Maternal Mortality in Sub-Saharan Africa Using Partial Least Squares (PLS) Structural Equation Modeling (SEM)
AU  - Frank Okwan
AU  - Peter Kovacs
Y1  - 2023/07/26
PY  - 2023
N1  - https://doi.org/10.11648/j.pamj.20231202.11
DO  - 10.11648/j.pamj.20231202.11
T2  - Pure and Applied Mathematics Journal
JF  - Pure and Applied Mathematics Journal
JO  - Pure and Applied Mathematics Journal
SP  - 23
EP  - 33
PB  - Science Publishing Group
SN  - 2326-9812
UR  - https://doi.org/10.11648/j.pamj.20231202.11
AB  - The threat of a woman in a low-income economy dying due to pregnancy and childbirth-related complications during her lifetime is about 120 times higher than for a woman living in a high-income economy. Social factors are seen as important factors contributing to maternal mortality and the conceptual framework developed for the reduction of maternal mortality has found the need to include social factors in intervention for maternal mortality reduction. The objective of this study is to examine the effect of social development on maternal mortality in Sub-Saharan Africa by applying Sen’s development theory and the Partial Least Squares Structural Equation Modeling (PLS-SEM) technique. The result of the empirical analysis shows that social development has both direct and indirect effects on maternal mortality. The direct effect is greater than the indirect effect. The direct effect is the effect of social development on reproductive capability, and the indirect effect is the effect of social development on maternal mortality through reproductive capability and freedom. The result also reveals a direct and positive effect of economic and political development on social development. Social development has the greatest effect on maternal mortality, compared to all the other effects in the model. The result of the PLS-SEM analysis and the final model supports all the hypotheses for the study.
VL  - 12
IS  - 2
ER  -

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Author Information

Frank Okwan

Department of Statistics and Demography, University of Szeged, Szeged, Hungary
Peter Kovacs

Department of Statistics and Demography, University of Szeged, Szeged, Hungary

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APA Style

Frank Okwan, Peter Kovacs. (2023). Examining the Causal Effect of Social Development on Maternal Mortality in Sub-Saharan Africa Using Partial Least Squares (PLS) Structural Equation Modeling (SEM). Pure and Applied Mathematics Journal, 12(2), 23-33. https://doi.org/10.11648/j.pamj.20231202.11

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ACS Style

Frank Okwan; Peter Kovacs. Examining the Causal Effect of Social Development on Maternal Mortality in Sub-Saharan Africa Using Partial Least Squares (PLS) Structural Equation Modeling (SEM). Pure Appl. Math. J. 2023, 12(2), 23-33. doi: 10.11648/j.pamj.20231202.11

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AMA Style

Frank Okwan, Peter Kovacs. Examining the Causal Effect of Social Development on Maternal Mortality in Sub-Saharan Africa Using Partial Least Squares (PLS) Structural Equation Modeling (SEM). Pure Appl Math J. 2023;12(2):23-33. doi: 10.11648/j.pamj.20231202.11

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@article{10.11648/j.pamj.20231202.11,
  author = {Frank Okwan and Peter Kovacs},
  title = {Examining the Causal Effect of Social Development on Maternal Mortality in Sub-Saharan Africa Using Partial Least Squares (PLS) Structural Equation Modeling (SEM)},
  journal = {Pure and Applied Mathematics Journal},
  volume = {12},
  number = {2},
  pages = {23-33},
  doi = {10.11648/j.pamj.20231202.11},
  url = {https://doi.org/10.11648/j.pamj.20231202.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.pamj.20231202.11},
  abstract = {The threat of a woman in a low-income economy dying due to pregnancy and childbirth-related complications during her lifetime is about 120 times higher than for a woman living in a high-income economy. Social factors are seen as important factors contributing to maternal mortality and the conceptual framework developed for the reduction of maternal mortality has found the need to include social factors in intervention for maternal mortality reduction. The objective of this study is to examine the effect of social development on maternal mortality in Sub-Saharan Africa by applying Sen’s development theory and the Partial Least Squares Structural Equation Modeling (PLS-SEM) technique. The result of the empirical analysis shows that social development has both direct and indirect effects on maternal mortality. The direct effect is greater than the indirect effect. The direct effect is the effect of social development on reproductive capability, and the indirect effect is the effect of social development on maternal mortality through reproductive capability and freedom. The result also reveals a direct and positive effect of economic and political development on social development. Social development has the greatest effect on maternal mortality, compared to all the other effects in the model. The result of the PLS-SEM analysis and the final model supports all the hypotheses for the study.},
 year = {2023}
}

Copy | Download

TY  - JOUR
T1  - Examining the Causal Effect of Social Development on Maternal Mortality in Sub-Saharan Africa Using Partial Least Squares (PLS) Structural Equation Modeling (SEM)
AU  - Frank Okwan
AU  - Peter Kovacs
Y1  - 2023/07/26
PY  - 2023
N1  - https://doi.org/10.11648/j.pamj.20231202.11
DO  - 10.11648/j.pamj.20231202.11
T2  - Pure and Applied Mathematics Journal
JF  - Pure and Applied Mathematics Journal
JO  - Pure and Applied Mathematics Journal
SP  - 23
EP  - 33
PB  - Science Publishing Group
SN  - 2326-9812
UR  - https://doi.org/10.11648/j.pamj.20231202.11
AB  - The threat of a woman in a low-income economy dying due to pregnancy and childbirth-related complications during her lifetime is about 120 times higher than for a woman living in a high-income economy. Social factors are seen as important factors contributing to maternal mortality and the conceptual framework developed for the reduction of maternal mortality has found the need to include social factors in intervention for maternal mortality reduction. The objective of this study is to examine the effect of social development on maternal mortality in Sub-Saharan Africa by applying Sen’s development theory and the Partial Least Squares Structural Equation Modeling (PLS-SEM) technique. The result of the empirical analysis shows that social development has both direct and indirect effects on maternal mortality. The direct effect is greater than the indirect effect. The direct effect is the effect of social development on reproductive capability, and the indirect effect is the effect of social development on maternal mortality through reproductive capability and freedom. The result also reveals a direct and positive effect of economic and political development on social development. Social development has the greatest effect on maternal mortality, compared to all the other effects in the model. The result of the PLS-SEM analysis and the final model supports all the hypotheses for the study.
VL  - 12
IS  - 2
ER  -

Copy | Download