A comparative Study of Maternal Mortality in Teritary and Secondary Health Care Centres in Enugu, Southeast Nigeria

Abstract

Aim: To compare the maternal mortality rates at the tertiary hospital (UNTH) and two secondary health institutions (Mother of Christ and Colliery Hospitals) in Enugu Metropolis for a five-year period 1995 – 1999. Patients and Methods: A retrospective study of 11,415 deliveries in the three hospitals was undertaken for the five-year review period. Maternal deaths as recorded in these hospitals were reviewed. Information sought included total number of deliveries for the period under review, booking status of patients, parity and mode of delivery as well as causes of maternal death. Doctor –patients ratio and Nurse –midwives/patient ratio in the three hospitals were equally included in information sought. Descriptive and parametric statistics were used where necessary to compare similarities and differences observed and explanations offered. Results: Maternal Mortality Rate (MMR) was found to be higher at UNTH, 1,738 per 100,000 births than the combined total from mother of Christ 407 and Colliery 560 (967 per 100,000 births). Higher maternal deaths were found among grand multiparous women (6 children and above) in the three hospitals. Similarly, there was also high maternal mortality among unbooked patients in the three hospitals. UNTH was better staffed in terms of doctor- patients ratio and nurse/midwives-patient ratio than the other two secondary level hospitals. Analysis of variance (ANOVA) of the maternal mortality ratio at 95% confidence level yielded a value of 0.086 as against a theoretical value of 3.88. Conclusion: It is therefore conclued that it is not the type of institutions that is the sole determinant of material outcome as parity, booking status, mode of delivery and the time and state at which the patient reaches the final referral centre are contributory factors. Key words: Comparative Study, Maternal Mortality, Hospital. [Jnl College of Medicine Vol.7(2) 2002: 111-114]