Bounds Test Cointegration Approach to Examine Factors Contributing to Declining Maternal Mortality Ratio in Sudan (1969-2015)

Abstract Unlike other studies in the field of maternal health, the objective of this study is to examine the contribution of some socioeconomic, demographic and health care factors to the declining trend of maternal mortality ratio MMR in Sudan over the period 1969-2015. The study employs econometric techniques including the OLS, Cointegration methods of Johansen and autoregressive distributed lag ARDL bounds tests and Granger causality analysis. The OLS shows that economic growth measured by GDP has significant bad affect on MRR but it has more significant good effect when measured by GDP per capita GDPP. Declining fertility rates lead to declines in MMR. Health expenditure has no effect on MMR. The ARDL bounds test shows existence of a long-run equilibrium relationship between MMR and its explanatory variables. In both the short run and long run, declines in MMR are explained by GDPP and fertility but badly affected by GDP. In contrast, health care factors have no effects on MMR. Granger causality test shows a unidirectional relationship running from economic growth measured by GDP and GDPP to MMR with no sign of feedback effect. Bidirectional relationships between MMR and fertility rate, MMR and health expenditure, as well as between MMR and the number of physicians per 100,000 people have been established. The study recommends that the government should ensure stable and inclusive economic growth. There is a need to increase resources to maternal and reproductive health with emphasis on the number of physicians per 100,000 people in order to move forward to the SDGs.