Abstract
BackgroundMaternal mortality ratio (MMR) has been on the decline in the Gambia since 1990. However, there has been no steady decline in maternal mortality ratio in the Edward Francis Small Teaching Hospital, the only tertiary health facility in the Gambia. The aim of the study is to determine the trend in maternal mortality over the last 8 years.A retrospective review of all maternal deaths occurring at the Edward Francis Small Teaching Hospital from 1st January 2007 to 31st December 2014 was done. Case abstraction was done with a pre-structured questionnaire using the WHO definition of maternal mortality.ResultsThere were 663 maternal deaths recorded during the study period. During the same period the total number of live births were 38,896. The annual MMR in each year varied with a range between 1461 and 2105 per 100,000 live births. The MMR in the hospital in on the rise compared to earlier studies. The causes of maternal mortality have not changed much in the hospital. However, the seasonal variation in maternal mortality in earlier studies attributed to the influence of malaria and anaemia was not seen in this study. We attribute this change to the widespread use of intermittent prophylactic treatment for malaria in the antenatal period.ConclusionWhile MMR was decreasing in the country, it was increasing in the only tertiary health facility in the country. This was attributed to increasing referrals from other health facilities. The influence of malaria and anemia as a cause of maternal mortality seems to be declining.
Highlights
Maternal mortality ratio (MMR) has been on the decline in the Gambia since 1990
While MMR was decreasing in the country, it was increasing in the only tertiary health facility in the country
The number of live births and maternal deaths were grouped into two periods to correspond to the malaria season (September– December) and non-malaria season (January–August) in the Gambia
Summary
There has been no steady decline in maternal mortality ratio in the Edward Francis Small Teaching Hospital, the only tertiary health facility in the Gambia. The death of a woman during pregnancy or childbirth is one of the most tragic, painful, unforgettable and often preventable tragedies that can befall a family and community in Africa. Such maternal mortality is one of the main indicators of the quality of health care including health system delivery in a country. In 2013, 289,000 women died during and following pregnancy and childbirth [1] Almost all of these deaths occurred in low-resource settings, and most could have been prevented [1].
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