Royal Melbourne Institute of Technology

ECON1193_SEM1_HN
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ASSIGNMENT 2
INDIVIDUAL CASE STUDY ANALYSIS –
MATERNAL MORTALITY RATIO

Lecturer: Wil Martens

Student name: Nguyen Yen Linh
ID number: s3814039
Class: ECON1193 – Group 2

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Hanoi, 29th April, 2020
TABLE OF CONTENTS

I – INTRODUCTION 3
II – DESCRIPTIVE STATISTICS AND PROBABILITY 3
a) Probability 3
b) Descriptive measures 4
III – CONFIDENCE INTERVALS 6

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 a) Calculating confidence intervals 6
b) Discussing the assumptions 7
c) Discussing the assumption and its results 7
IV – HYPOTHESIS TESTING 8
a) Testing the hypothesis 8
b) Discussing the assumption and its results9
V – OVERALL CONCLUSION 9
VI – REFERENCES 11
VII – APPENDICES 12
VIII - ACRONYMS AND ABBREVIATIONS 14

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I – INTRODUCTION
Maternal mortality refers to a woman's death from any pregnancy-related problems during
pregnancy or within 42 days of the postnatal period, except incidental or accidental causes
(WHO, n.d). To determine precisely the maternal mortality rate, many required detailed
information from cases such as pregnancy status, time of death, and causes (WHO, n.d). Also, in
recent years, the world average maternal mortality rate has experienced a downward tendency
(see Appendix 1), which shows countries' effort in reducing maternal deaths (see Appendix 2).
According to United Nations (n.d), ensuring good health and well-being at all levels of age is the
third goal in 17 SDGs to achieve a better and sustainable future, which is explicitly illustrated
through progress such as improving global health status, extending human life expectancy,
decreasing maternal and child mortality and fighting against the deadly epidemic. Then, the
reduction of maternal death ratio plays an essential role in the sustainable development since this
rate can measure the social and economic status in general and the overall health situation of
women and the context of healthcare system in particular in countries, including the patient's
accessibility and the responsiveness to patient's needs (DHS Program, n.d). Therefore, the United
Nations sets the first objectives of three targets by declining this ratio to less than 70 per 100,000
live births by 2030, with no nation having this rate of exceeding twice as the global average (UN,
n.d).  
On the other hand, Our World in Data indicates the relationship between GNI per capita and the
maternal mortality ratio (see Appendix 3). Specifically, the high and upper-middle-income
groups trends towards a low maternal mortality ratio per annum; meanwhile, the low and lower-
middle income groups are negatively correlated (see Appendix 3). Therefore, GNI is one of the
critical factors that exert an influence on maternal deaths.

II – DESCRIPTIVE STATISTICS AND PROBABILITY

a) Probability
Based on GNI per capita

Contingency Table Low Middle High

income income income Total
country (B) country (C) country (D)

High maternal
mortality ratio 2 12 0 14
Maternal
(A)
mortality
ratio (per Low maternal
100,000 live mortality ratio 0 10 6 16
births) (A’)

Total 2 22 6 30

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 Figure 1 – Contingency table based on the countries’ income category and having high or low
maternal mortality ratio
- Denote: A: high maternal mortality ratio;
- A’: low maternal mortality ratio.
B: low-income country;
C: middle-income country;
D: high-income country.
- Two events are independent when the probability of one event is not impacted by the other.
This situation occurs if, and only if:
- or P(Y|X) = P(Y).
Where: P(X|Y) is the conditional probability of X given that Y occurred.
P(X) is the marginal probability of X.
P(Y) is the marginal probability of Y.
- Figure 1 shows that:
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● P(A): P(A) = =
30 15
● P(A|B) and P(A):
2
P ( A∧B) 30
P(A|B) = = =1
P( B) 2
30
7
⇨ Because P(A|B) ≠ P(A) ( 1 ≠ ), A and B are statistically dependent.
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● P(A|C) and P(A):
12
P ( A∧C ) 30 6
P(A|C) = = =
P( C) 22 11
30
6 7
⇨ Because P(A|C) ≠ P(A) ( ≠ ), A and C are statistically dependent.
11 15
● P(A|D) and P(A):
0
P ( A∧D) 30
P (A|D) = = =0
P( D) 6
30
7
⇨ Because P(A|D) ≠ P(A) ( 0 ≠ ), A and D are statistically dependent.
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The calculated probability above demonstrates that poor countries witness a very high rate of
maternal mortality than other nations. The maternal death rate in low-income countries makes up
100% (P(A|B) = 1) whereas this ratio in middle and high-income states shows a different trend.

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Specifically, the pregnancy-related death rate in countries having middle earnings is
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approximately 55% (P(A|C) = ), which is nearly two times lower than poor nations.
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Additionally, rich countries experience an outstanding ratio since there is no estimated high
maternal mortality rate (P(A|D) = 0). Thus, those outcomes affirm the correlation between
maternal death rate and income categories, then, this can signify the social and economic status
in countries.
b) Descriptive measures
● The best measures of central tendency and variation

Categories Low–Income Middle–Income High–Income

countries (LI) countries (MI) countries (HI)
Median 400.5 52.5 5
Interquartile range 4.5 88 2.25
Figure 2 – Best measures of central tendency and variation of maternal mortality ratio by
countries’ income category
According to the given data set, two categories have a right-skewed distribution (middle and
high-income countries) and a group having an outlier (middle-income countries), which might
distort the average value, the standard deviation as well as the picture of spread (see Appendix 4).
Therefore, the median and interquartile range are considered the best measures of central
tendency and variation, respectively since they are less influenced by above statistical elements.
In statistics, the median is the middle value of the lists that helps us determine the distribution of
each category by comparing it with the mean. As is observed, the median in poor countries is the
same as the mean (400.5 = 400.5); then, it is a symmetrical or normal distribution. Besides,
middle and high-income countries are positive skewness as their median is smaller than their
mean, with 93.27273 > 52.5 and 5.333333 > 5, respectively. Nevertheless, the high-income
group tends to skew less than the middle-income category since its median is quite near the mean
value. 

Figure 2 also illustrates the difference in the interquartile range among the three countries’
income categories. In detail, this value of middle-income countries is larger than low and high-
income nations (88 > 4.5 > 2.25) that will significantly influence the length of the box-plot.
Additionally, the interquartile range also indicates the spread out of the data set’s middle half. To
be more specific, the middle-income category witnesses the highest interquartile range, which
implies that its data points spread out more than other groups. This value also shows unusual
data or the only visible outlier in the data set (602), which is too far from the central value. By
contrast, low and high earnings countries have smaller interquartile range values that reflect their
data points seem to be clustered around the mean, causing their shape of the histogram.
● The best measure of box-plot

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 Figure 3 – Box-and-whisker plots of maternal mortality ratio by countries’ income category
Figure 3 gives information about the shape of the distribution of maternal death rates for
different countries’ income categories. As is presented, middle and high-income countries share
the same propensity towards right skewness or positively skewed distribution since the mean is
greater than the median, with 93.27273 > 52.5 and 5.333333 > 5 respectively, leading to the
more values concentrating on lower maternal mortality rate. Hence, this situation gives a positive
indication in those countries when a large number of maternal death ratios are recorded for less
than the average value. Conversely, poor nations witness a high maternal mortality rate even
though the shape of data is symmetrical as the mean is equal to the median (400.5 = 400.5). In
part, values of variables in this category are at the regular frequencies. In other words, most
pregnancy-related death rates occur at the points as equivalent to the average value (400.5).
Despite this, low-income countries confront a bad context since this data is considered a very
high ratio.
III – CONFIDENCE INTERVALS
a) Calculating confidence intervals
The level of significance chosen is 5%: α = 0.05. Thus, the confident level is 95% (1 - α = 1 –
0.05 = 0.95).
Sample size (as data given): n = 30.
Population mean = world maternal mortality rate: X =¿96.16667.
Sample standard deviation: S = 139.4828.

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Since the sample size is sufficiently large (n = 30), the CLT is applied. Then, the data set is
normally distributed.
As the Population standard deviation is unknown, we use t-table to find t-value:
α 0.05
Upper tail = Lower tail = = = 0.025
2 2
d.f = n – 1 = 30 – 1 = 29
=> t-value is 2.045

-2.045 0 2.045

Figure 4 – Critical region of t-value

Calculate confidence intervals:
S 139.4828
Upper bound: X +t = 96.16667 + 2.045 × = 148.2445554
√❑ √❑
S
Lower bound: X −t = 96.16667 - 2.045 ×
√❑
139.4828
= 44.08878456
√❑

Interpretation: We are 95% confident that the global average of maternal mortality rate is
between 44.08878456 and 148.2445554 women per 100.000 live births. In other words, it is 95%
confident that in 100,000 women, there are between 44.08878456 and 148.2445554 deaths
during pregnancy or up to 42 days of the end of pregnancy.
b) Discussing the assumptions
The CLT establishes that when the sample size is large enough (n ≥ 30), the data set is normally
distributed irrespective with the shape of population. Therefore, it is not required to have
assumptions to calculate the confidence intervals in this case as the given data set meets the
conditions of CLT (n = 30).
c) Discussing the assumption and its results
When the world standard deviation is given, the confidence intervals will decline. Specifically,
although the sample size is suitable for CLT requiresments, the world standard deviation is
unknown that forces the data set to initially use sample standard deviation. This statistic is
contingent upon the sample that enlarges the variability. Then, the more variabilities in the
sample we have, the larger sample standard error and margins of error we produce. Also, t-score,

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having a wide range, is used to calculate t-values in this situation, contributing to greater
confidence intervals. Meanwhile, if the world standard deviation is known, we can use z-score to
determine values, then, the confidence intervals will be more precise. Furthermore, the global
standard deviation is more stable and accurate than the sample standard deviation that helps us
limit the errors, uncertainties and have extra exact results.
IV – HYPOTHESIS TESTING
a) Testing the hypothesis
● Prediction: WHO published the rate of maternal mortality in average in 2014 which is 221
deaths per 100,000 live births. Nevertheless, the calculated data above indicates that the average
global maternal death ratio decreases as it was 96.16667 in the year 2015. Hence, in my view,
the maternal mortality ratio will decline in the future.
● Hypothesis testing
Take the level of significance of 5%: α = 0.05.
The data is normally distributed – the CLT is applied (n = 30).
As there is no proper population standard deviation for 2014’s data set, we have to use t-value to
take the hypothesis testing.
The maternal mortality rate of 2014 is considered as the same mean: μ=221.

The null hypothesis: H 0 ≥221 ; The alternative hypothesis: H 1 <221.

⇨ We apply one tail test (lower tail test).
Calculate critical value:
Lower tail = α = 0.05
d.f = n – 1 = 30 – 1 = 29
⇨ t CRITICALVALUE = - 1.699

Calculate test statistic t:

X−μ 96.16667−221
t STATISTIC = S = 139.4828 = - 4.901968613
√❑ √❑

-4.902 -1.699 0

Reject Do not reject

Figure 5 – Critical region of the test

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⇨ Because t STATISTIC < t CRITICALVALUE (- 4.901968613 < - 1.699), the test statistic is in the rejection
region. This means that we reject the null hypothesis ( H 0 ¿ and accept the alternative hypothesis (
H 1 ¿.
Interpretation:
As we reject H 0, there is sufficient evidence that the world maternal mortality rate will
decelerate in the future. In other words, I am 95% confident that the pregnancy-related mortality
rate will be lesser than 221 deaths per 100,000 live births in the future compared to 2014.

Since H 0 is rejected, we might have committed type I error (P(Type I) = α = 0.05). This error
means we conclude that there is enough proof that the future average world maternal mortality
rate is not more than 221, but might be it is equal or greater to 221.

To reduce the risk of type I error, we can decrease the level of significance ( α ) before taking the
hypothesis testing. The reason is that the level of significance is the same as the probability of a
type I error, then, choosing a smaller α will decline this probability. However, this situation
might diminish the power of hypothesis testing that causes for more strong evidences needed to
against the null hypothesis ( H 0) before rejecting it.

b) Discussing the assumption and its results

The larger sample size provides more information, thus, the power of hypothesis testing will be
supported intensely. Then, if the quantity of countries increases threefold in this data set, the
statistical decision will not change. In specific, the sample size triples (n = 30 × 3 = 90) that
results in the greater value of t-statistic and critical value of t. However, the t-statistic is still
smaller than the t-critical value (- 8.4905 < - 1.6622) which means the null hypothesis is still
false. Hence, this situation leads to the narrower acceptance region and reinforces the efficiency
of hypothesis testing, in other words, the more likely to reject the null hypothesis ( H 0) . In
S
addition, the increase in sample size makes the standard error ( ) become lower that
√❑
minimizes the errors and produces more exact results in the data set. In short, the greater sample
size we have, the more accurately it is expected.

V – OVERALL CONCLUSION
In conclusion, the report indicates how the maternal mortality rate links with a statistical factor
(GNI) and exemplifies its current and future trends. In the second part, the probability and
descriptive measures are applied to affirm the relationship between GNI and the maternal death
ratio. Specifically, via the performance of probability, the rate presented by wealthier countries
seems to be lower than poor nations’. This correlation is also strengthened by the best measures
of box-plot, central tendency (median), and variation (interquartile range). Then, these statistical
measures can imply the status of maternal death succinctly in each state category. In part III and
IV, confidence intervals and hypothesis testing are implemented to examine the average maternal
deaths in the globe and its tendency in the future. In particular, the future global average

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maternal mortality ratio is forecasted to decelerate that associates well with the first target in the
third SDG of the United Nations because of the false null hypothesis. Additionally, some
assumptions are considered in those parts to find other solutions to have more accurate
outcomes.

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VI – REFERENCES
Demographic and Health Surveys Program n.d, Chapter 12 – Maternal Mortality, viewed 20
April 2020, <https://dhsprogram.com/pubs/pdf/FR183/12Chapter12.pdf>.
United Nations n.d, Goal 3: Good health and well-being, United Nations, viewed 20 April 2020,
<https://www.un.org/sustainabledevelopment/health/>.
United Nations n.d, Goal 3: Sustainabe Development Knowledge Platform, United Nations,
viewed 20 April 2020, <https://sustainabledevelopment.un.org/sdg3>.
World Health Organization n.d, Maternal mortality ratio (per 100,000 live births), World Health
Organization, viewed 20 April 2020, <https://www.who.int/data/gho/indicator-metadata-
registry/imr-details/26>.

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VII – APPENDICES
Appendix 1: The global maternal mortality ratio from 2000 to 2017.

Figure 6 – The global maternal mortality ratio (modeled estimate, per 100,000 live births) from
2000 to 2017 (The World Bank, 2019)
Appendix 2: Maternal mortality ratio in countries in 2017.

Figure 7 – Maternal mortality ratio in countries in 2017 (The World Bank, 2019)
Appendix 3: Maternal deaths by income group from 1990 to 2015.

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 Figure 8 – Maternal deaths by income group from 1990 to 2015 (OurWordInData, n.d)
Appendix 4: Summary statistics of maternal mortality rate by each countries’ income group.

LI countries MI countries HI countries

Mean 400.5 93.2727272 5.33333333

Standard Error 4.5 Mean 7 Mean 3
Median 400.5 Standard Error 26.694697 Standard Error 0.76011695
Mode #N/A Median 52.5 Median 5
Standard 6.36396103 Mode 44 Mode 5
Deviation 1 Standard 125.209227 Standard 1.86189867
Sample Deviation 5 Deviation 3
Variance 40.5 Sample 15677.3506 Sample 3.46666666
Kurtosis #DIV/0! Variance 5 Variance 7
Skewness #DIV/0! 13.9057305 -
Range 9 Kurtosis 7 0.94304733
Minimum 396 3.47113111 Kurtosis 7
Maximum 405 Skewness 1 0.39248603
Sum 801 Range 595 Skewness 7
Count 2 Minimum 7 Range 5
Maximum 602 Minimum 3
Sum 2052 Maximum 8
Count 22 Sum 32

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 Count 6
Figure 9 – Summary statistics of maternal mortality rate by each countries’ income category

VIII - ACRONYMS AND ABBREVIATIONS

WHO World Health Organization
UN United Nations
SDGs Sustainable Development Goals
DHS Program Demographic and Health Surveys Program
GNI Gross National Income
CLT Central Limit Theorem
d.f Degrees of freedom

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