Maternal Mortality in Dodoma Regional Referral Hospital, Tanzania

Abstract

Background. Maternal mortality has remained a challenge in Tanzania. The Tanzania Demographic and Health Survey 2015-16 has shown that the problem has been increasing despite various strategies instituted to curb it. It has been shown that most of the maternal deaths occurring in health facilities, whether direct or indirect, have other contributing factors. The objective of this study was to analyse causes and associated factors for maternal deaths in Dodoma Regional Referral Hospital (DRRH). Methods. A retrospective review of all files of the women who died in 2018 and were classified as maternal deaths. Results. A total of 8722 women gave birth in DRRH, out of which 35 died and were confirmed as maternal deaths. The number of live births was 8404 making the maternal mortality ratio of 417 per 100,000 live births. The leading causes of maternal death were eclampsia (9), sepsis (6), ruptured uterus (5), and haemorrhage (5). The third-phase delay was the leading contributing factor to 19 maternal deaths. This includes delays in referral from another facility as well as delays in getting treatment at DRRH and inadequate skills of providers at both the referring facilities and DRRH. The first-phase and second-phase delays contributed to 7 and 6 deaths, respectively. Furthermore, poor antenatal care contributed to 2 deaths. Conclusion. Maternal mortality is still high in Dodoma Regional Referral Hospital. Eclampsia was the leading cause of maternal deaths in 2018 followed by sepsis and obstetric haemorrhage. Delays associated with health system factors (third-phase delay) contributed much more to maternal mortality than the first-phase delay. Mentorship programmes on management of obstetric complications need to be instituted in order to reduce maternal deaths in Dodoma Regional Referral Hospital.

Quality of Maternal Death Documentation in Afghanistan: A Retrospective Health Facility Record Review

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Puerperal sepsis-related knowledge and reported self-care practices among postpartum women in Dar es salaam, Tanzania

“…The sample size was calculated using the formula for quantitative studies ( n = Z 2 P (1 − P )/ d 2 ) 18 with the following assumptions: n is the required sample size, P is the proportion (33.5%) of knowledge and hygienic practices for postpartum women, 11 d is the margin of error to the desired level of precision to the true value (5%), and Z is the constant standard normal variation (1.96 for 95% confidence level). Proportionate sampling method was adapted to handpick the number of study participants from each selected facility using the following formula: n i = N i / N t * n , whereas n i is the required number of respondents per each facility, N i is the total number of deliveries per each facility per day, N t is the total number of deliveries in all selected facilities, and n is the total sample size.…”

“… 10 Another study which was conducted in Dodoma region indicated that among 35 maternal deaths, 12 were due to puerperal sepsis. 11 …”

Understanding barriers to implementing referral procedures in the rural and semi-urban district hospitals in Tanzania: Experiences of healthcare providers working in maternity units

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