Facility Based Maternal Death Review in Selected Hospitals of SNNPR from 2007/2008- 2009/2010
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Date
2011-05
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Addis Ababa University
Abstract
Introduction: Maternal mortality has high public health importance because of its magnitude in Ethiopia. Reduction of this high magnitude is possible. However, evidence on magnitude and factors affecting maternal mortality at different administrative level in Ethiopia are not sufficient. Objective: This study aims at identifying cause, magnitude and contributing factors for maternal death in selected health facilities in SNNPR between 2007/2008 and 2009/20010. Method: A retrospective register based study using quantitative and qualitative method was conducted in SNNPR in purposively selected three hospitals. All maternal deaths that occurred in the selected hospitals and recorded during the study period were included. Data were collected by reviewing records using check list in the selected hospitals. Additionally FGD using four groups was conducted using semi structured questionnaire. Midwives data collectors from nearby health center were selected for record review; whereas for FGD principal investigator and one note taker participated. Data quality was assured by training data collectors and supervisor, by conducting pre test. Data was entered and cleaned using EPI version 3.5.2.The cleaned data was exported to SPSS version 16, for descriptive statistical analysis. For qualitative method after transcription of data, content analysis was employed. Result: In the three years of study period in the three selected hospitals 127 maternal deaths were recorded & maternal mortality ratio on average was 1360/100,000 live births. Direct obstetric causes of death accounted for 88%, out of which 31%, 23 % and15% obstructed labour, hemorrhage and eclampsia were the leading causes of death, respectively. Concerning patient factors low level of ANC follow up 3.1%, delay in health seeking behavior by mothers who were in labour for 2-3 days at home 70% and 48.4% the deceased mothers died on the day of admission. About care provision in the facility also delay was seen in patients who were in need of resuscitation, 90%, 84% and 79% of APH, PPH and ruptured uterus cases respectively, died without receiving blood transfusion.
Conclusion: obstructed labour was the leading cause of death. Delay in health seeking behavior as patient factor and delay at health facility as provider factor have contributed to maternal death. High maternal mortality ratio was observed. Based on this finding regional health office was recommended to make the comprehensive emergency obstetric care service accessible to the rural society in which the majority lives
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Maternal Death