Maternal Mortality among Women Seeking Health Care Services in Kisii Level 5 Hospital

Osoro AA^1, , Ng’ang’a Z², Mutugi M³ and Wanzala P⁴

¹Kisii Medical Training College, P.O. Box 1165-40200, Kisii

²Jomo Kenyatta University of Agriculture and Technology, Institute of Tropical Medicine and Infectious Diseases

³Jomo Kenyatta University of Agriculture and Technology, Department of Zoology

⁴Kenya Medical Research Foundation (KEMRI), Nairobi

Cite this paper

Osoro AA, Ng’ang’a Z, Mutugi M and Wanzala P. Maternal Mortality among Women Seeking Health Care Services in Kisii Level 5 Hospital. American Journal of Public Health Research. 2014; 2(5):182-187. doi: 10.12691/AJPHR-2-5-1

Abstract

Background. Maternal mortality has continued to escalate in Kenya inspite of all the efforts being made by the government, non-governmental organization and the community. The purpose of the study was to establish the antecedent factors predisposing women to maternal death using the three delays model. Methodology: Retrospective 72 maternal death cases which occurred between January 01, 2009 and June 30, 2010 were reviewed by an independent gynecologist/obstetrician. Interviews were conducted with kins of the deceased women using a confidential questionnaire for female death based on distal as well as proximal factors that may have had a bearing on maternal death. Health care workers were likewise interviewed using a formulated questionnaire to assess the ability and readiness of the hospital to offer emergency obstetric care. Results: A record of 72 maternal deaths occurred during the study period thus between January 1, 2009 and June 30. 2010. Out of 72, 42 maternal deaths were as a result of direct obstetric complications which include hemorrhage, post-partum sepsis, pre-eclampsia and abortion. Post partum hemorrhage was the most common complication which contributed to maternal deaths. Again out of 72 maternal deaths, 33 were as a result of indirect causes with peritonitis, heart disease, HIV/AIDS, anemia, and convulsive disorder respectively. Delayed access to transport, lack of money for user fees, and hospital distance were challenges that led to delay in accessing care. Hospital experiences included; delay in service provision by staff, delayed quality emergency obstetric care and delayed care while at the hospital, unavailability of blood for transfusion, and lack of money for drugs, were reported as major challenges which attributed to maternal death. Conclusion: The study suggests maternal mortality occurs as a result of lack of access to quality healthcare facility poor health seeking behavior and poor socio-economic factors.

Keywords

maternal mortality, confidential female death questionnaire, verbal autopsy

Copyright

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References

[1]	WHO (2004). Beyond the Numbers: Reviewing Maternal Death and Complications to Make Pregnancy Safer, WHOPress, Geneva.
[2]	WHO; UNICEF and the World Bank (2012). Trends in maternal mortality 1990-2010, Geneva, WHO.
[3]	UNFPA, WHO, UNICEF and the World Bank. (2011). Trends in maternal mortality: 1990 to 2010. Released new report.
[4]	Kenya National Bureau of Statistics (KNBS) and ICF Macro. (2010). Kenya Demographic and Health Survey 2008-09. Calverton, Maryland: KNBS and ICF Macro.
[5]	Kenya Demographic and Health Survey (2008/9). Calverton, Maryland, CBS, MoH and ORC Macro, 2004.
[6]	Yumiko K. (2008). A Manual for partnership workshops. Samokike project: JapaneseInternational Co-operation Assistance – Kisii /Kericho Project.
[7]	Thaddeus S, Maine D. (1994).Too far to walk: maternal mortality in context. Social Science Medicine 38: 1091-1110.
[8]	van Dillon, J.S., Stekelenburg, J., Schutte, J., Walraven, G., van Roosmalen, J. (2007). The use of audit to identify maternal mortality in different settings: is it just a difference between the rich and the poor? Healthcare Quarterly 10, 131-137.
[9]	United Nations; WHO. (2000). World Bank Partner to combat Maternal Mortality the World Bank Group News Release No. 2000/080/S.
[10]	WHO; United Nations Millennium Project, UNDP (2005). WHO (2005). Defining Maternal Death: Africa Journal of Medical Practice, (2005) 12 (2) pp 33. Vol. 12 No. 2 April 2005. Accelerating Progress and Expanding efforts to improve Maternal Health. UN/UNDP 2005 Progress Report.
[11]	WHO (1996). Prenatal Mortality. Document FRH/MSM/96.7 Geneva: WHO, 1996.
[12]	Penney G.and Brace V., (2007). Near miss audit in obstetrics. Current Opinion in Obstetrics and Gynecology 19, 145-150.
[13]	United Nations (2009). Accelerating progress and expanding efforts to improve Maternal Health. UN/UNDP Progress Report.
[14]	Chandramohan D., Gillan H., Rodrigues L. (2001). Verbal autopsy for adults deaths: development and validation in a multicentre study. Tropical Medicine and International Health.8; 437-46.
[15]	UNFPA and UNICEF (2000). Situational Analysis of women and children in Kenya.
[16]	W.J. Graham (2010). Maternal Mortality: Evidence Gap and Measurement Traps. Journal of Obstetrics and Gynaecology.
[17]	Petros-Barvazian A. (1984). World Priorities and Targets in Maternal and Child Health for the Year 2000, International Journal of Gynaecology & Obstetrics. IJGOA 22 (6) 429-505.
[18]	Fillippi V, Ronsmans C, Gohou V, et al. (2005). Maternity wards or emergency Obstetric rooms? Incidence of near-miss events in African hospitals. Acta obstetrician et Gynecologica Scandinavica 84, 11-16.
[19]	WHO (1999). Maternal Mortality and Morbidity Report, World Health Organization. Geneva, Switzerland.
[20]	WHO (2001). WHO Bulletin: Managing Maternal Mortality: Special series. Geneva, Switzerland.
[21]	WHO (2008). “Why is giving special attention to adolescents important for achieving Millennium Development Goal 5?” Adolescent Pregnancy fact sheet. Geneva: department of making pregnancy safe, WHO.
[22]	Ashford L. (2001). Resource Flows for International Population Assistance and UNFPA.