scholarly journals Estimating Maternal Mortality Level in Rural Northern Nigeria by the Sisterhood Method

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Henry V. Doctor ◽  
Sally E. Findley ◽  
Godwin Y. Afenyadu

Maternal mortality is one of the major challenges to health systems in sub Saharan Africa. This paper estimates the lifetime risk of maternal death and maternal mortality ratio (MMR) in four states of Northern Nigeria. Data from a household survey conducted in 2011 were utilized by applying the “sisterhood method” for estimating maternal mortality. Female respondents (15–49 years) were interviewed thereby creating a retrospective cohort of their sisters who reached the reproductive age of 15 years. A total of 3,080 respondents reported 7,731 maternal sisters of which 593 were reported dead and 298 of those dead were maternal-related deaths. This corresponded to a lifetime risk of maternal death of 9% (referring to a period about 10.5 years prior to the survey) and an MMR of 1,271 maternal deaths per 100,000 live births; 95% CI was 1,152–1,445 maternal deaths per 100,000 live births. The study calls for improvement of the health system focusing on strategies that will accelerate reduction in MMR such as availability of skilled birth attendants, access to emergency obstetrics care, promotion of facility delivery, availability of antenatal care, and family planning. An accelerated reduction in MMR in the region will contribute towards the attainment of the Millennium Development Goal of maternal mortality reduction in Nigeria.

2019 ◽  
Vol 7 (2) ◽  
pp. 235-241
Author(s):  
Hyacinthe Zamané ◽  
Hyacinthe Euvrard Sow ◽  
Dantola Paul Kain ◽  
Brice Wilfried Bicaba ◽  
Sibraogo Kiemtoré ◽  
...  

Background: Maternal mortality is of considerable magnitude. It is particularly relevant to developing countries, including those in Sub-Saharan Africa. The aim of this work was to study the cases of maternal deaths in the Dori Regional Hospital, Burkina Faso in the Sahel region, by analyzing the epidemiological aspects of these deaths in order to guide decision-making. Methods: This was a descriptive cross-sectional study which spanned the period from January 1, 2014 to December 31, 2016. Cases of maternal death and live births that occurred in the hospital during this period were collected by documentary review. Results: A total of 141 maternal deaths and 2,626 live births were recorded with a maternal mortality ratio of 5,369 for 100,000 live births. In 99 (72.20%) cases, death occurred in the postpartum. A home delivery had been reported in 33.70% of cases. Direct obstetric causes were found in 72.10% of cases. They were mainly represented by infections (32.40%) and hemorrhages (23%). Anemia was the indirect cause of death in 25 women (17.80%). The delay in health care access and the lack of blood products contributed to maternal deaths in 64.50% and 26.20% of cases. Conclusion and Global Health Implications: An intensification of awareness-raising messages about the importance of the rapid use of health care is necessary. Also, systematic audits of maternal deaths in the care environment and in the community would make it possible to clarify the determinants of maternal mortality in the Sahel region and to provide adequate solutions. Key words: Maternal Death • Maternal Mortality • Women’s Health • Burkin Faso • Dori Hospital • Sahel Region


Author(s):  
Janete Vettorazzi ◽  
Edimárlei Gonsales Valério ◽  
Maria Alexandrina Zanatta ◽  
Mariana Hollmann Scheffler ◽  
Sergio Hofmeister de Almeida Martins Costa ◽  
...  

Abstract Objective To determine the profile of maternal deaths occurred in the period between 2000 and 2019 in the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym) and to compare it with maternal deaths between 1980 and 1999 in the same institution. Methods Retrospective study that analyzed 2,481 medical records of women between 10 and 49 years old who died between 2000 and 2018. The present study was approved by the Ethics Committee (CAAE 78021417600005327). Results After reviewing 2,481 medical records of women who died in reproductive age, 43 deaths had occurred during pregnancy or in the postpartum period. Of these, 28 were considered maternal deaths. The maternal mortality ratio was 37.6 per 100,000 live births. Regarding causes, 16 deaths (57.1%) were directly associated with pregnancy, 10 (35.1%) were indirectly associated, and 2 (7.1%) were unrelated. The main cause of death was hypertension during pregnancy (31.2%) followed by acute liver steatosis during pregnancy (25%). In the previous study, published in 2003 in the same institution4, the mortality rate was 129 per 100,000 live births, and most deaths were related to direct obstetric causes (62%). The main causes of death in this period were due to hypertensive complications (17.2%), followed by postcesarean infection (16%). Conclusion Compared with data before the decade of 2000, there was an important reduction in maternal deaths due to infectious causes.


2016 ◽  
Vol 4 (2) ◽  
pp. 178-186
Author(s):  
Jose Campbell ◽  
Eliana Duarte Osis

Maternal mortality, as a largely avoidable cause of death and reduction in maternal mortality has been a top priority in Brazil, despite massive program efforts to avert maternal deaths, the maternal mortality ratio (MMR) in Brazil is still high especially in the poor area. Estimates of maternal mortality rates in Brazil are affected by underreporting of deaths, especially in less developed areas of the country where maternal mortality tends to be higher, and the absence of specific information indicating maternal death in reported deaths of women of reproductive age The objective of this study is to identify the true number of maternal deaths. We use data obtained from Ministry of Health information systems from the 2000 and 2012 Brazil Maternal Mortality Surveys to measure change in the maternal mortality ratio (MMR) and to measure changes in factors potentially related to such change. We estimate the changes in risk of maternal death between the two surveys using Poisson regression.


Author(s):  
Pradip Sarkar ◽  
Jahar Lal Baidya ◽  
Ashis Kumar Rakshit

Background: The objective of present study was to assess the proportion of maternal near miss and maternal death and the causes involved among patients attending obstetrics and gynaecology department of Agartala Govt. Medical College of North Eastern India.Methods: Potentially life-threatening conditions were diagnosed, and those cases which met WHO 2009 criteria for near miss were selected. Maternal mortality during the same period was also analyzed. Patient characteristics including age, parity, gestational age at admission, booked, mode of delivery, ICU admission, duration of ICU stay, total hospital stay and surgical intervention to save the life of mother were considered. Patients were categorized by final diagnosis with respect to hemorrhage, hypertension, sepsis, dystocia (direct causes) anemia, thrombocytopenia, and other medical disorders were considered as indirect causes contributing to maternal near miss and deaths.Results: The total number of live births during the study period (January 2017 to June, 2018) was 9378 and total maternal deaths were 37 with a maternal mortality ratio of 394.5/1 lakh live births. Total near miss cases were 96 with a maternal near miss ratio of 10.24/1000 live births. Maternal near miss to mortality ratio was 2.6. Of the 96 maternal near miss cases - importantly 20.8% were due to haemorrhage, 19.8% were due to hypertension, 13.5% were due to sepsis, and 11.5% were due to ruptured uterus. In maternal death group (n-37), most important causes were hypertensive (40.5%) followed by septicemia (21.6%), haemorrhage (10.8).Conclusions: Haemorrhage, hypertensive disorders and sepsis were the leading causes of near miss events as well as maternal deaths.


2021 ◽  
Vol 17 (3) ◽  
pp. 241-251
Author(s):  
Ashma Rana ◽  
Junu Shrestha ◽  
Suvana Maskey ◽  
Sudeep Kaudel ◽  
Prashant Shrestha ◽  
...  

Introduction Maternal mortality reflects reproductive health status and availability of good health care facilities at different levels of the healthcare system at a given period, influenced by globally adopted safe motherhood policies. The leading causes of maternal death in Nepal mainly comprise of hemorrhage, eclampsia, abortion-related complications, gastroenteritis and anemia. Although a declining trend has been noted in Nepal it has yet to meet the target set by the Sustainable Development Goal (SDG) 3.1 of reducing the global MMR to less than 70 maternal deaths per 100,000 live births by 2030.  MethodsA cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Tribhuvan University Teaching Hospital (TUTH) from 1st Baisakh 2055- 30th Chaitra 2069 (15th April 1998- 14th April 2013). The study period of 15 years was divided into three parts, five years each: 2055-59 (14th April 1998-April 13th 2003) ; 2060-64 (14th April 2003- April 12th 2008) and 2065-69 (April 13th 2008 –April 12th 2013). MM was filled in Performa, discussed in morning conference and MM audit, computerized, analyzed, presented quarterly and yearly. Annual Maternal Mortality Ratio (MMR) expressed as MMR per 100,000 live births is calculated by dividing recorded (or estimated) maternal deaths by total recorded (or estimated) live births in the same period and multiplying by 100,000.  ResultsTotal MM/maternal mortality ratio (MMR) in the first, mid and last five years were 39 (270 %); 37 (212% ) and 37 (188%) respectively giving overall total MM/MMR 113 (223.5%) attributing to Direct: 55 ( 48.6%), Indirect: 44 (38.9%) and Non maternal deaths: 14 (12.3%). Predominating cause of MM in the first/mid/last five years were sepsis and infective hepatitis each (17.6%) and PPH (18.5 %). While SP/E were almost same over the years, in decreasing trend were hepatitis and puerperal sepsis but in rising trend was PPH and criminally induced abortion (10.6%). Thenumber of maternal death has not changed much, the median age in each five years is surprisingly similar, set at 25 years and the adolescents who died were not very different in every five years. It’s unfortunate that many primigravida died during this period which is a matter of concern.  ConclusionsMaternal mortality stresses the impact of timely health seeking behaviour and health providers making provision of prompt adequate services and referral to help so that all Nepalese mothers, especially the young and first-time pregnant thrive. Keywords: infective hepatitis, maternal mortality, maternal mortality ratio, PPH, sepsis.


Author(s):  
Shobha G. ◽  
Jayashree V. Kanavi ◽  
Veena B. Divater ◽  
Annamma Thomas

Background: The objectives of this study were to calculate the maternal mortality ratio, causes for maternal death in our institution and the duration of hospital admission to death interval.Methods: The study included collecting and analyzing the details of maternal death in women who were admitted to St. Johns Medical College Hospital, Bengaluru, from January 2007 to December 2016. Results: Total maternal deaths were 61 and live births were 26,001 during the study period. The maternal mortality ratio (MMR) was 234.6 per 100,000 live births. Majority of maternal deaths occurred in women aged 18 - 35 years 56 (91.80%) women, primipara 45 (73.77%) and referred cases to our institution from other hospitals 52 (85.24%).                      Most of the women died in the postnatal period 54 (88.52%). Direct obstetric causes accounted for 44 (72.13%) maternal deaths and indirect causes 17 (27.86%) deaths. Preeclampsia and eclampsia were the leading causes for death 13 (21.31%) followed by acute fatty liver of pregnancy 12 (19.67%), hemorrhage 7 (13.11%) and sepsis 6 (9.83%). Anemia was present in 77.04% of women at the time of admission to our hospital. Thirty six (59.01%) women died within a week of admission to the hospital, in which 13 (21.31%) women died in less than 24hours of admission. Twenty five (40.98%) women died after a week of admission to hospital.Conclusions: Apart from the triad of preeclampsia, obstetric haemorrhage and sepsis, acute fatty liver of pregnancy has emerged as an important cause of maternal death. Most of the maternal deaths are preventable. Early detection of complications and timely referral to tertiary care hospital in St. Johns Medical College Hospital, Bengaluru, Karnataka, India decreases maternal morbidity and mortality.


Author(s):  
Darshna M. Patel ◽  
Mahesh M. Patel ◽  
Vandita K. Salat

Background: According to the WHO, 80 of maternal deaths in developing countries are due to direct maternal causes such as haemorrhage, hypertensive disorders and sepsis. These deaths are largely preventable. Maternal mortality ratio (MMR) in India is 167/100,000 live births.Methods: This retrospective observational study was conducted at GMERS, Valsad. Data regarding maternal deaths from January 2016 to December 2017 were collected and analyzed with respect to epidemiological parameters. The number of live births in the same period was obtained from the labour ward ragister. Maternal mortality rate and Mean maternal mortality ratio for the study period was calculated.Results: The mean Maternal mortality rate in the study period was 413.3/100,000 births. The maternal mortality ratio (MMR) in India is 167/100,000 live births. More than half of maternal deaths were reported in multiparous patients. More maternal deaths were observed in women from rural areas (67.3%), unbooked patients (73.3%) and illiterate women (65.3%). Thirty six (69.3%) maternal death occurred during postpartum period. Most common delay was first delay (60.0%) followed by second delay (40.0%). Postpartum haemorrhage (28.8%), preeclampsia (17.3%), sepsis (13.46%) were the major direct causes of maternal deaths. Indirect causes accounted for one third of maternal deaths in our study. Anemia, hepatitis and heart disease were responsible for 13.4%, 5.7%, and 1.9% of maternal deaths, respectively.Conclusions: Majority of maternal deaths are observed in patients from rural areas, unbooked, and illiterate patients. Hemorrhage, eclampsia and sepsis are leading causes of maternal deaths. Most of these maternal deaths are preventable if patients are given appropriate treatment at periphery and timely referred to higher centers.


Author(s):  
Jayasree Hansda ◽  
Debobroto Roy ◽  
Krishnapada Das ◽  
Manojit Sarkar ◽  
Rumpa Das ◽  
...  

Background: Maternal mortality is a tragic event as family revolves around a mother. The deadly obstetrical triad of hemorrhage, preeclampsia and infection has accounted for a third of all deaths. This study was conducted to assess maternal mortality ratio, demographic profile and causes of maternal death.Methods: This retrospective longitudinal study was conducted in the department of obstetrics and gynecology for a period of three years from 1st January 2018-31st December, 2020. Total no of death during this period was 134.Records of deaths and demographic profiles were retrieved from the medical record library of aforesaid hospital.Results: There were 134 maternal deaths amongst 56815 live births with MMR 235.85. The majority of deaths were in 20-29 year of age group and most of the deaths seen in multigravida. The 91.79% death was observed within the 24 hours and after 72 hours. Eclampsia, preeclampsia and hemorrhage were leading cause of maternal death seen in the study.Conclusions: Maternal mortality is higher than national MMR. Majority of maternal death were preventable by proper antenatal care, early detection of high-risk pregnancies and their timely referral to tertiary care centre.


2009 ◽  
Vol 16 (01) ◽  
pp. 135-138
Author(s):  
TASNIM TAHIRA REHMAN ◽  
MAHNAZ ROOHI

Objective: To find out maternal mortality ratio (MMR) and to determine major causes of maternal death. S t u d y d e s i g n:A descriptive study. Setting: Department of Obstetric and Gynaecology, Allied Hospital, Faisalabad. S t u d y period: From 01.01.2008 to31.12.2008. Materials a n d m e t h o d s : All cases of maternal death during this study periods were included except accidental deaths. Results:There were 58 maternal deaths during this period. Total No. of live births were 5975. MMR was 58/5975 x 100,000 = 970/100,000 live births.The most common cause of maternal death was hemorrhage (34.5%) followed by hypertensive disorders/eclampsia (31%). Most of thepatients (75.86%) were referred from primary & secondary care level. C o n c l u s i o n : Maternal mortality is still very high in underdevelopedcountries including Pakistan. We must enhance emergency obstetric care (EOC) to achieve the goal of reduction in MMR.


Author(s):  
Vrinda Patil ◽  
Vidya Kamath ◽  
Rathnamala M. Desai

Background: Maternal mortality is one of the important indicators of maternal health. Objectives of present study were to determine the frequency of maternal near miss, maternal near miss incidence ratio, maternal near miss to mortality ratio and mortality index and to study the risk factors associated with near miss events.Methods: A retrospective analysis of severe maternal morbidity from January 2015 to December 2015 was studied. Data was collected from women with pregnancy related life-threatening complications, near miss cases and maternal deaths.Results: The total number of deliveries were 5247. The numbers of maternal deaths were 12. Maternal mortality ratio was 228 per one lakh deliveries. There were 5.3 near miss events for every 1 maternal death. The nature and course of near miss cases were analysed. Severe maternal odds ratio was 14.48. Mortality index was 15.78%. Maternal near miss incidence ratio was 12.19.Conclusions: Near Miss Mortality indicator is helpful in identifying the life-threatening conditions and thus aiming to prevent maternal mortality. Hypertensive disorders and its complications are the leading causes of near miss events. Sepsis is the main cause of maternal death.


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