Risk Factors for Maternal Mortality in Rural Tigray, Northern Ethiopia: A Case-Control Study

Abstract

BackgroundMaternal mortality continues to have devastating impacts in many societies, where it constitutes a leading cause of death, and thus remains a core issue in international development. Nevertheless, individual determinants of maternal mortality are often unclear and subject to local variation. This study aims to characterise individual risk factors for maternal mortality in Tigray, Ethiopia.MethodsA community-based case-control study was conducted, with 62 cases and 248 controls from six randomly-selected rural districts. All maternal deaths between May 2012 and September 2013 were recruited as cases and a random sample of mothers who delivered in the same communities within the same time period were taken as controls. Multiple logistic regression was used to identify independent determinants of maternal mortality.ResultsFour independent individual risk factors, significantly associated with maternal death, emerged. Women who were not members of the voluntary Women’s Development Army were more likely to experience maternal death (OR 2.07, 95% CI 1.04–4.11), as were women whose husbands or partners had below-median scores for involvement during pregnancy (OR 2.19, 95% CI 1.14–4.18). Women with a pre-existing history of other illness were also at increased risk (OR 5.58, 95% CI 2.17–14.30), as were those who had never used contraceptives (OR 2.58, 95% CI 1.37–4.85). Previous pregnancy complications, a below-median number of antenatal care visits and a woman’s lack of involvement in health care decision making were significant bivariable risks that were not significant in the multivariable model.ConclusionsThe findings suggest that interventions aimed at reducing maternal mortality need to focus on encouraging membership of the Women’s Development Army, enhancing husbands’ involvement in maternal health services, improving linkages between maternity care and other disease-specific programmes and ensuring that women with previous illnesses or non-users of contraceptive services are identified and followed-up as being at increased risk during pregnancy and childbirth.

Effect of pregnancy induced hypertension on adverse perinatal outcomes in Tigray regional state, Ethiopia: a prospective cohort study

“…Additionally, the available literature in Ethiopia showed a high burden of PIH which ranges from 2.23 to 18.25% (8)(9)(10)(11)(12)(13). Similarly, according to the finding of a study conducted in Tigray regional state, PIH was among the leading obstetric causes of maternal mortality in the region and the prevalence of PIH reported in this study was 8.1%, this was higher than the national pooled prevalence of PIH (6.29%) (14)(15)(16).…”

Reducing Maternal Deaths in Ethiopia: Results of an Intervention Programme in Southwest Ethiopia

“…Many studies have pointed to the lack of health-care seeking for ill mothers as risk factors for high mortality rates [35]. A recent meta-analysis documented that community-based interventions such as home visits and counselling can reduce foetal and neonatal mortality in low- and middle-income countries, whereas the effect on the reduction of maternal mortality was questionable [36].…”

Barriers of Maternal Health Seeking Behavior- A Bayesian Analysis

“…This will help the population to upgrade their knowledge and perception towards women reproductive health issues. Broad conclusions from the study can be strengthened with a survey which must be covering more districts and more participants [36][37][38][39][40][41][42].…”