Pregnancy Outcomes of the Internally Displaced Women in Juba, South Sudan

Abstract

Background: Conflict and displacement substantially affect maternal reproductive health by increasing the risks formorbidity and mortality. However, most literature on pregnancy outcomes is from cross-border refugees and migrants. To date, scanty literature is available on pregnancy outcomes of internally displaced women. South Sudan, with 16 women dying daily is badly affected by internal conflicts of which by the end of December 2013 about 2.2 million people were internally displaced. The aim of this study was to determine pregnancy outcomes of women living in the United Nations House Internally Displaced People (UN IDP) camp and factors associated with poor outcomes. The study was ethically cleared by MUHAS and the Ministry of Health in South Sudan. Methods: A cross sectional study was conducted in UN House IDP Camp in Juba among internally displaced women who attended antenatal services in the camp, from September to November 2016. Among them, women who became pregnant in last 3 years, excluding the index, were interviewed about their immediate past pregnancy experiences. Additionally, the women were interviewed on reproductive health and gender violence matters. Interviews were guided by a structured questionnaire. Data were analyzed using SPSS software version 20. Descriptive and multivariate logistic regression analyses were computed for associations with poor pregnancy outcome. Results: A total of 300 internally displaced women participated in the study. Data for 289 participants were analyzed for poor pregnancy outcome. More than half of the women, 157 (54.3%), had poor pregnancy outcome. Poor Maternal outcome was established in 47% of the women and poor fetal outcome in 27.7%. Delivery in IDP camp compared with outside the camp, was independently associated with a 3-fold increase in risk for poor pregnancy outcome, OR = 2.9 (95% CI: 1.47 - 5.56). Conclusion: The prevalence of poor pregnancy outcome is unacceptably high among internally displaced women seeking antenatal services in the IDP camp in Juba and delivery in the camp seems to increase the risk.