Trends in health facility based maternal mortality in Central Region, Kenya: 2008-2012

Muchemi, Onesmus Maina; Gichogo, Agnes Wangechi; Mungai, Jane Githuku; Roka, Zeinab Gura

doi:10.11604/pamj.2016.23.259.8262

Cited by 13 publications

(13 citation statements)

References 4 publications

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“…Obstetric haemorrhage contributed to 38% of all maternal deaths in the study period. Similar findings were recorded in a retrospective analysis of causes of health facility maternal deaths in Ogun state, Nigeria, and central regions of Kenya where haemorrhage was the leading cause accounting for 40% and 43.3%, respectively [ 6 , 11 ]. A study conducted at Shinyanga Regional Referral Hospital, Tanzania, also correlates to the above findings that haemorrhage was the leading cause of maternal deaths by 50% [ 12 ].…”

Section: Discussionsupporting

confidence: 81%

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Maternal Deaths due to Obstetric Haemorrhage in Dodoma Regional Referral Hospital, Tanzania

Nassoro¹,

Chiwanga²,

Lilungulu

et al. 2020

Obstetrics and Gynecology International

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Background. Despite the availability of comprehensive emergency obstetric care at Dodoma Regional Referral Hospital, deaths due to obstetric haemorrhage are still high. This study was carried out to analyse the circumstances that had caused these deaths. Methods. A retrospective review of all files of women who had died of obstetric haemorrhage from January 2018 to December 2019 was made. Results. A total of 18,296 women gave birth at DRRH; out of these, 61 died of pregnancy-related complications of the deceased while 23 (38%) died of haemorrhage, with many of them 10 (44%) between the age of 30 and 34. Many were grand multiparous women 8 (35%) and almost half of them (11 (48%)) had stayed at DRRH for less than 24 hours. More than half (12 (52%)) had delivered by caesarean section followed by laparotomy due to ruptured uterus (8 (35%)). The leading contributing factors to the deaths of these women were late referral (6 (26%)), delays in managing postpartum haemorrhage due to uterine atony (4 (17%)), inadequate preparations in patients with the possibility of developing PPH (4 (17%)), and delay in performing caesarean section (3 (13%)). Conclusion. Maternal mortality due to obstetric haemorrhage is high at Dodoma Regional Referral Hospital where more than one-third of women died between 2018 and 2019. Almost all of these deaths were avoidable. The leading contributing factors were late referral from other health facilities, inadequate skills in managing PPH due to uterine atony, delays in performing caesarean section at DRRH, and inadequate preparation for managing PPH in patients with abruptio placentae and IUFD which are risk factors for the condition. There is a need of conducting supportive supervision, mentorship, and other modes of teaching programmes on the management of obstetric haemorrhage to health care workers of referring facilities as well as those at DRRH. Monitoring of labour by using partograph and identifying pregnant women at risk should also be emphasized in order to avoid uterine rupture.

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Section: Discussionsupporting

confidence: 81%

“…Moreover, in their study, Luis Alvarez et al found that 34% of maternal deaths in Africa were due to haemorrhage [ 5 ]. In East Africa, a study conducted in the central region of Kenya showed that haemorrhage contributed to 40% of all causes of maternal deaths and the majority of these women died within 24 hours after admission [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Maternal Deaths due to Obstetric Haemorrhage in Dodoma Regional Referral Hospital, Tanzania

Nassoro¹,

Chiwanga²,

Lilungulu

et al. 2020

Obstetrics and Gynecology International

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“…The distribution of included articles by country was as follows:, Algeria [60], Benin [78], Burkina Faso [122,143], Cameroon [99,133], Democratic Republic of Congo [55,82], Egypt [105], Eritrea [102], Ethiopia [57,62,71,72,74,86,130,131], Ghana [49,52,53,58,69,141], Guinea-Bissau [76], Kenya [63,91,110,123,142,145], Madagascar [79], Malawi [80,83,100,126,140], Morocco [44], Mozambique [59], Nigeria [42,43,45,47,48,54,56,65,67,89,…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Individual, health facility and wider health system factors contributing to maternal deaths in Africa: A scoping review

Muriithi

Banke-Thomas

Gakuo

et al. 2022

PLOS Glob Public Health

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The number of women dying during pregnancy and after childbirth remains unacceptably high, with African countries showing the slowest decline. The leading causes of maternal deaths in Africa are preventable direct obstetric causes such as haemorrhage, infection, hypertension, unsafe abortion, and obstructed labour. There is an information gap on factors contributing to maternal deaths in Africa. Our objective was to identify these contributing factors and assess the frequency of their reporting in published literature. We followed the Arksey and O’Malley methodological framework for scoping reviews. We searched six electronic bibliographic databases: MEDLINE, SCOPUS, African Index Medicus, African Journals Online (AJOL), French humanities and social sciences databases, and Web of Science. We included articles published between 1987 and 2021 without language restriction. Our conceptual framework was informed by a combination of the socio-ecological model, the three delays conceptual framework for analysing the determinants of maternal mortality and the signal functions of emergency obstetric care. We included 104 articles from 27 African countries. The most frequently reported contributory factors by level were: (1) Individual—level: Delay in deciding to seek help and in recognition of danger signs (37.5% of articles), (2) Health facility—level: Suboptimal service delivery relating to triage, monitoring, and referral (80.8% of articles) and (3) Wider health system—level: Transport to and between health facilities (84.6% of articles). Our findings indicate that health facility—level factors were the most frequently reported contributing factors to maternal deaths in Africa. There is a lack of data from some African countries, especially those countries with armed conflict currently or in the recent past. Information gaps exist in the following areas: Statistical significance of each contributing factor and whether contributing factors alone adequately explain the variations in maternal mortality ratios (MMR) seen between countries and at sub-national levels.

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“…Maternal mortality has decreased in Africa, especially in southern and high-income countries. The most important long-term factors are health policies and the accessibility of health services, which are influenced by the quality of care and road building construction that facilitates transportation to health facilities [41,42].…”

Section: Discussionmentioning

confidence: 99%

“…In future research, maternal mortality may be adjusted for potential risk factors, including income and education level, comorbidities, medical assistance, and environmental sanitation, to estimate maternal mortality trends [42][43][44][45] accurately.…”

Section: Discussionmentioning

confidence: 99%

Maternal Mortality in Africa (Part I), Regional Trends (1990-2015)

Onambele¹,

Ortega-Leon²,

Guillen-Aguinaga³

et al. 2022

Preprint

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Background: United Nations Sustainable Development Goals state that by 2030, the Global maternal mortality rate (MMR) should be lower than 70 per 100,000 live births. MMR is still one of Africa's leading causes of death among women. This research aims to study regional trends in maternal mortality in Africa. Methods: We extracted data for Maternal mortality rates per 100,000 births from the World Bank database from 1990-2015. Joinpoint regression was used to study the trends and estimate the annual percent change (APC). Results: Maternal mortality has decreased in Africa over the study period by an average APC of -2.6%. All regions showed significant downward trends, with the sharpest decreases in East Africa. Only the North African region is close to the United Nations' sustainable development goals for Maternal mortality. The remaining sub-Saharan African regions are still far from achieving the goals. Conclusions: maternal mortality has decreased in Africa, especially in East Africa. The only region closed to the United Nations target is North Africa. The remaining sub-Saharan African regions are still far from achieving the goals. These results could be used for the development of Regional Policies.

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Trends in health facility based maternal mortality in Central Region, Kenya: 2008-2012

Cited by 13 publications

References 4 publications

Maternal Deaths due to Obstetric Haemorrhage in Dodoma Regional Referral Hospital, Tanzania

Maternal Deaths due to Obstetric Haemorrhage in Dodoma Regional Referral Hospital, Tanzania

Individual, health facility and wider health system factors contributing to maternal deaths in Africa: A scoping review

Maternal Mortality in Africa (Part I), Regional Trends (1990-2015)

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