Abstract
BACKGROUND: Limited population data exist on mortality and causes of death among women of reproductive age, including maternal mortality. OBJECTIVE: To present trends from 1995 to 2022 in mortality, cause of death, maternal mortality ratio and place of death from the rural Magu health and demographic surveillance site in north-west Tanzania. METHODS: Data on residency, fertility, and verbal autopsy were analysed to compute trends in all-cause and cause-specific mortality for women 15-49 years, using InSilicoVA, a Bayesian probabilistic model. Maternal mortality was estimated for three periods: 1995-2002, 2005-2011 and 2015-2022. We described place of death and healthcare utilization leading up to death by calendar time and broad cause of death. RESULTS: All-cause mortality among women 15-49 declined from a peak of 9.0 deaths per 1000 person-years in the late 1990s to 3.5 in 2020. HIV/TB contributed 61% of this reduction. During 1995-2022, infectious diseases were the leading cause (54%), followed by NCD (29%). Maternal mortality declined but stagnated from approximately 2010 at 281 per 100,000 live births in 2015-2022 and remained a leading cause of death (12%). Comparing 2009-2015 and 2016-2022, more deaths occurred in health facilities (37.3%-45.9%), and more women sought care during terminal illness or maternity (85%-93%). CONCLUSION: Despite a major reduction in all-cause mortality among women 15-49 years, mainly due to decreased HIV/AIDS deaths, infectious diseases remain the leading cause alongside a much-increased share of NCD. While maternal mortality levels have decreased, its share of total deaths has remained unchanged compared to 25 years ago.