Abstract
BackgroundAccess factors associated with maternal death are important to understand because they are considered to be an essential measure of women’s health and indicative of the performance of health care systems in any community globally. This study aimed to analyse the access risk factors linked to maternal deaths in Lundazi district of the Eastern Province of Zambia using secondary data obtained from maternal death reviews and delivery registers.MethodsThis was a case-control study with cases being recorded maternal deaths for Lundazi district (n = 100) while controls were randomly selected Lundazi District Hospital deliveries (n = 300) for the period 2010 to 2015. STATA™ (Stata Corporation, Texas, TX, USA) version 12.0 was used to analyse data. Odds ratio and 95% confidence intervals with associated p-values were used to analyse disparities between cases and controls while bivariate and multivariate regression analyses were done to show associations.ResultsThe likelihood of experiencing maternal death was 94% less among women who completed their scheduled antenatal care visits than those who did not (OR 0.06, 95% CI = 0.01–0.27, p = < 0.001). Delayed referral associated with maternal deaths and complications were 30% (30) for cases, 12% (37) for controls and 17% (67) for both cases and controls. Long distances, unskilled deliveries were 3%, (15) for both cases and controls with 13% (13) for cases and 1% (2) for controls only.ConclusionAntenatal care is important in screening for pre-existing risk conditions as well as complications in early stages of pregnancy that could impact adversely during pregnancy and childbirth. Delay in seeking health care during pregnancy could be minimised if health services are brought closer to the communities to reduce on distances covered by pregnant women in Lundazi. Maternal education appears to influence antenatal health care utilisation because greater knowledge and understanding of the importance of antenatal care might increase the ability to select most appropriate service. Therefore, there is need for Lundazi District Health Office to scale up interventions that motivate women to make at least four scheduled antenatal care visits during pregnancy as recommended by the World Health Organization.
Highlights
Access factors associated with maternal death are important to understand because they are considered to be an essential measure of women’s health and indicative of the performance of health care systems in any community globally
The outcome that cases had more than four times the odds of having delayed to access maternal health services than the controls is comparable to the findings by Cham et al (2005) who established that women who died of maternal cause were more likely to have delayed to receive prompt and adequate obstetric care at the hospital level [14]
Inadequate antenatal care, delay in accessing obstetric care and low literacy levels were established to be important factors contributing to maternal deaths in Lundazi district
Summary
Access factors associated with maternal death are important to understand because they are considered to be an essential measure of women’s health and indicative of the performance of health care systems in any community globally. This study aimed to analyse the access risk factors linked to maternal deaths in Lundazi district of the Eastern Province of Zambia using secondary data obtained from maternal death reviews and delivery registers. Lundazi is one of the districts with high mortality rates because together with Nyimba district of Eastern Province of Zambia, maternal mortality ratio of 410 maternal deaths per 100,000 live births was estimated [3]. This is more than the national level maternal mortality ratio of 398 per 100,000 reported in the 2013/2014 ZDHS. There has been no study conducted in the district to establish risk factors which are associated with maternal death yet such information is valuable in implementing and evaluating maternal health interventions
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