Abstract
BackgroundNigeria still ranks second globally in the number of maternal deaths. Most maternal death reviews in Nigeria are isolated research based reports from a single health facility. This study determined causes and contributory factors of maternal mortality in Ogun statefollowing a periodic State-widematernal and perinatal deaths surveillance and response (MPDSR) review.MethodsWe carried out a retrospective analysis of cases of maternal deaths notified (n = 77) and reviewed (n = 45) in health facilities in Ogun State from 2015 to 2016selected using total sampling method. Using the national MPDSR structured and validated data collection tools or questionnaire, collected data was extracted from existing MPDSR data base, andanalyzed using the Statistical Package for Social Sciences (SPSS) software 20.0. We obtained approval from the State Ministry of Health for this study.ResultsAverage age at maternal death was 30.8 ± 5.7 years. Haemorrhageand pre-eclampsia or eclampsia account for 43.4 and 36.9% of causes respectively. Leading contributory factors ofmaternal deaths include inadequate human resource for health, delay in seeking care, inadequate equipment, lack of ambulance transportation, and delay in referrals services. 51.1%of the women had antenatal care while a significant proportion of the women were referred from Traditional Births Attendants (TBAs) and mission houses.ConclusionWe concluded that many of the contributory factors of maternal mortality could be avoided if preventive measures were taken and adequate care available. MPDSR provides a platform for critical evidence of where the main problems lie, and can provide valuable information on strategies which maternal mortality prevention programs should focus on. The implementation and institutionalization of MPDSR programme is on course in Ogun State. MPDSR is feasible and should be institutionalized in all states of Nigeria. A commitment to act upon the findings of MPDSR is a key prerequisite for success.
Highlights
Nigeria still ranks second globally in the number of maternal deaths
When a pregnant woman is not booked for antenatal care or does not deliver in a health facility, she misses all the opportunities offered by antenatal care, benefits of active management of labour, Emergency Obstetrics Care (EOC) and management of the puerperal period, thereby having a higher risk of maternal death [10]
We concluded thatthe majority of causes and contributory factors to reported maternal deaths are preventable through combined safe motherhood strategies of focused antenatal care, prompt referral, active management of labour and immediate post-partum period and access to family planning
Summary
Nigeria still ranks second globally in the number of maternal deaths. Globally,thousands of women die annually from complications during pregnancy, childbirth, or postpartum period, with most deaths occurring in developing countries [1]. These trends over the past decades had been adjudged as unacceptable, as it remained a problem of public health importance necessitating the attention of all stakeholders in maternal and child health care. According to the World Health Organization (WHO), Nigeria had the second highest number of annual maternal deaths in the world in 2010 and contributed 14% of all maternal deaths globally [2].
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