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Authors:
Oyeniyi S.O., Afolabi K A, Tunau K. A., Ahmad M.M., Ango I. G., Amina A.G., Nigeria
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Abstract:
Background
In Nigeria
Maternal Mortality ratio 512/100000 live birth and Perinatal Mortality rate
39/1000 live births are unacceptably high and is on the increase with
Post-partum haemorrhage and Birth Asphyxia as the leading cause respectively.
Aim: To develop key evidence based intervention strategies for prevention and
management of causes of maternal and perinatal mortality in Sokoto state to
promote well-being at personal, community and workplace to reduce mortality.
Materials and Methods: A retrospective study of 320 secondary data
analysis of maternal and perinatal deaths records in 34 public health
facilities over 12 months, 1 July 2017 to 30th June 2018, prior to survey in
Sokoto state, was conducted using purposeful sampling technique, a
semi-structured questionnaire; maternal deaths, perinatal deaths, causes of
deaths, notification of deaths, review of deaths, recommendations made for each
review and if action was taken. Data was analyzed using descriptive statistics
in excel.
Result: Total number of deliveries of 11343. Total deaths of 320 with Maternal
(80) and Perinatal deaths (214) mean age were 20.0±5.0 years and 3.5±2days
respectively. About 59% of maternal deaths were in the age group 15-24 years
with mean age 20.0±5.0 years with a range of 15 - 49 years. About 79% of deaths
were in the age group 1-6 days with mean age 3.5±2days a range of 1 to 7 days.
126(64%) of perinatal deaths were male while 88(36%) were females. 73 (92.1%)
direct and 6 (7.8%) indirect cause of maternal deaths respectively. 34(42.4%)
Eclampsia, 22(28.0%) post-partum haemorrhage, 11(14%) prolong obstructed labour,
5 (6.5%) antepartum haemorrhage, 1(1.3%) unsafe abortion 1 (1.3%) severe
malaria and 5(6.5%) anaemia. No documented congenital abnormalities. 13(59%)
maternal and 9(41%) perinatal deaths were notified. 4(31%) maternal deaths
2(22%) perinatal deaths notified were reviewed. Health facility Obstetrics case
fatality rate Post-Partum Haemorrhage (12.2%), Eclampsia(14.1%), Antepartum
haemorrhage (4.9%), Prolong obstructed labour (6.4%),Unsafe
abortion(0.7%),Sepsis(1.1%) and Indirect causes(0.2%). Health facility
Perinatal case fatality rate Birth Asphyxia (21%),Tetanus (100%),Prematurity
(11%), Sepsis (1.6%), Congenital Abnormality (0%) , Indirect (3.2%). Maternal Mortality ratio 705/100000 live
birth and Perinatal Mortality rate 19/1000 live birth per year projected.
Conclusion: Maternal and Perinatal
mortality abound as public health importance level among study area; continuous
deaths surveillance, deaths notification, data analysis, deaths reviews and
strategic implementation will accelerate reduction of maternal and perinatal
deaths in Sokoto State.
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