Objective:

To estimate maternal mortality ratios (MMR) for the different sub-state regions in Mexico in order to identify those with highest maternal mortality, as well as the degree of inter-regional inequality.

Materials and methods:

Maternal mortality and registered live births data was taken from publicly available official data for the years 2005 to 2014. We regionalized the states based on political-administrative divisions within them and calculated MMR for these regions, and calculated Gini coefficients.

Results:

MMR for sub-state regions ranges from 16 (Non-Metropolitan Nuevo León State) to 160 (Sola de Vega, Oaxaca). We identified 13 regions of Very High or Extremely High maternal mortality. The national Gini coefficient is 0.175, with the states of Chihuahua, Nayarit, Oaxaca and Guerrero standing out for their unequal distribution of maternal mortality within their territory.

Conclusions:

Even state level averages of maternal mortality rates tend to hide important inequalities within states, which reflect multiple subjacent inequities.