Document Detail


Maternal mortality and related factors in Ejisu District, Ghana.
MedLine Citation:
PMID:  7821246     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A community-based survey on maternal mortality was carried out in the Ejisu health district of Ghana in January and February 1990 to identify all women who died in pregnancy, delivery or the puerperium from January 1985 to December 1989, determine their characteristics, the presumptive causes of death and related factors. Forty-four women who died in pregnancy, delivery or the puerperium were identified over the stated period. 59% were aged between 20 and 34 years. Eighty-two percent were married and sixty-six percent had at least primary education. Based on an average crude birth rate of 40 per 1000 population for the district over the period, the lowest maternal mortality rate occurred in 1988, 120 per 100,000 total births and the highest occurred a year later, 235 per 100,000 total births. The main presumptive causes of maternal mortality in the district were postpartum haemorrhage 45.5%, jaundice in pregnancy 22.7%, obstructed labour 6.8%, eclampsia 6.8% and fever 4.6%. 59% of them died in a hospital, 2% died at a Government Maternity Home and 7% died during referral from health facilities in the district. Thirty-four percent of the women who died did not attend any antenatal clinic. The actual number of deaths may be underestimated due to the sampling method used and the difficulties encountered in linking survey data with hospital records. Based on the survey findings and other related PMM research, plans have been developed to reduce maternal mortality in the district as outline in the conclusion.
A community-based survey was conducted among 1200 reproductive age women living in 80 out of 160 communities in Ejisu health district in Ghana during January-February 1990. Retrospective data was collected for the period January 1985-December 1989. Data was analyzed in order to determine maternal mortality, causes of death, and the characteristics of the mothers who died. The sample community was comprised of 223,632 persons in 1990. 44 women were identified as having died in pregnancy, delivery, or postpartum. 59% were 20-34 years old, and 41% were in high-risk age groups. 65.9% had at least some primary education, and 81.8% were married at the time of death. 27.3% were childless at the time of death. Maternal deaths were distributed by year as follows: 9 deaths in 1985, 10 in 1986, 7 in 1987, 6 in 1988, and 12 in 1989. The estimated maternal mortality was 211 per 100,000 live births in 1986 and 235 per 100,000 in 1989. The 4-year average was 181 per 100,000. 34% of deaths were to women who had not received any prenatal care in the last pregnancy. Almost 75% died during delivery. 59% died in a hospital, 7% during a referral to a hospital, and 2% at a Government Maternity Home. Over 66% died after reaching a health facility. 27% died at home. 2% died while under the care of a local traditional birth attendant. Causes of maternal death were postpartum hemorrhage (45.5%), jaundice in pregnancy (22.7%), obstructed labor (6.8%), eclampsia (6.8%), and fever (4.6%). 2.3% of deaths were attributed to antepartum hemorrhage, ectopic pregnancy, and septic abortion. Prenatal care alone is not sufficient to prevent some deaths. The high mortality rate during delivery is a justification to improve the quality of care during delivery at all levels of the district health system. Listed are 9 potential interventions to reduce maternal mortality, including: establishing operating facilities at local health centers and maintaining a resident doctor for obstetric emergencies.
Authors:
J O Martey; J O Djan; S Twum; E N Browne; S A Opoku
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  East African medical journal     Volume:  71     ISSN:  0012-835X     ISO Abbreviation:  East Afr Med J     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1995-02-16     Completed Date:  1995-02-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372766     Medline TA:  East Afr Med J     Country:  KENYA    
Other Details:
Languages:  eng     Pagination:  656-60     Citation Subset:  IM; J    
Affiliation:
School of Medical Sciences, University of Science and Technology, Kumasi, Ghana.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Birth Rate
Cause of Death
Delivery, Obstetric / statistics & numerical data
Developing Countries
Eclampsia / mortality
Educational Status
Female
Fever / mortality
Ghana / epidemiology
Hospital Mortality
Humans
Jaundice / mortality
Marriage
Maternal Mortality*
Middle Aged
Obstetric Labor Complications / mortality
Postpartum Hemorrhage / mortality
Postpartum Period
Pregnancy
Pregnancy Complications / mortality
Prenatal Care / statistics & numerical data
Referral and Consultation / statistics & numerical data

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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