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Lessons learned from maternal deaths at an East African health center

  • Willibald Zeck , Ingrid Kelters , Uwe Lang and Edgar Petru
Published/Copyright: December 1, 2006
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 34 Issue 6

Abstract

Aims: To analyze maternal deaths occurring at the Mikumi Health Center in Tanzania, East Africa, to discuss causes for the high maternal mortality rate at the Health Center, and to define possible strategies for the reduction of maternal deaths.

Methods: Between 2002 and 2003, a total of nine maternal deaths were identified and analyzed from hospital records of the East-African Mikumi Health Center.

Results: During the two-year period, the total number of deliveries was 977 including two maternal deaths during pregnancy and seven deaths during labor or postpartum (0.7% of total deliveries). The maternal mortality ratio (MMR) was 921 per 100,000 live births. The maternal average age was 27 years (range 18–37). The average interval between the first contact with the Health Center and maternal death was 3.5 days.

Conclusion: The main cause for maternal complications and subsequent deaths might have been the patient's delayed presentation at the Health Center. Aggravating circumstances such as long distance from the health services and hospital fees hinder patients from a timely and eventually life-saving presentation. The womens' low educational level affects their health as well as their nutritional state and thus increases the maternal death rate. Strategies to prevent maternal deaths at the Mikumi Health Center include measures to raise awareness about consequences of poor maternal health, to improve general education especially for young women, to increase the number of professional birth attendants in the region, to improve family planning services and sexual education with special reference to HIV/AIDS. Additionally, improvement of the first referral facilities around the Mikumi Health Center according to the “essential obstetric functions” recommended by the WHO seems crucial.

Keywords: East Africa; maternal mortality ratio; maternal obstetric deaths; obstetric complications; women's education
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Corresponding author: Dr Willibald Zeck Department of Obstetrics and Gynecology Medical University Graz Auenbruggerplatz 14 A 8036 Graz/Austria Tel.: +43 316 - 385 81070 Fax: +43 316 - 385 3199

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Published Online: 2006-12-01
Published in Print: 2006-12-01

©2006 by Walter de Gruyter Berlin New York

Articles in the same Issue

  1. WAPM-Newsletter No 2/2006 ACTIVITIES OF THE “INTERNATIONAL ACADEMY OF PERINATAL MEDICINE”
  2. Editorial
  3. Neurosonography in the second half of fetal life: a neonatologist's point of view
  4. Normal and abnormal transformation of the spiral arteries during pregnancy
  5. Lessons learned from maternal deaths at an East African health center
  6. Maternal venous procalcitonin levels do not correlate with umbilical cord blood and venous blood concentrations in the neonate
  7. Increased cortisol concentrations in the cord blood of newborns whose mothers smoked during pregnancy
  8. The assessment of fetal behavior of growth restricted fetuses by 4D sonography
  9. Impact of fetal blood sampling on vaginal delivery and neonatal outcome in deliveries complicated by pathologic fetal heart rate: a population based cohort study
  10. Postnatal growth failure in preterm infants: ascertainment and relation to long-term outcome
  11. Impact of breast-feeding on psychomotor and neuropsychological development in children of diabetic mothers: role of the late neonatal period
  12. Factors associated with hypospadias in Asian newborn babies
  13. Spontaneous dichorionic triamniotic triplet pregnancy affected by TTTS: follow-up from diagnosis to three months of extrauterine life
  14. Antibiotic therapy for preterm premature rupture of membranes
  15. Reply
  16. Delivery of a healthy child 30 weeks after resuscitation for thromboembolism and treatment with danaparoid: 5-year follow up
  17. Seasonality of birth and acute lymphoblastic leukemia
  18. Errata
  19. Congress Calendar
  20. Index Volume 34 (2006)
  21. Index - Subjects
  22. Index - Authors
  23. Acknowledgement
https://doi.org/10.1515/JPM.2006.090
Keywords for this article
East Africa; maternal mortality ratio; maternal obstetric deaths; obstetric complications; women's education

Articles in the same Issue

  1. WAPM-Newsletter No 2/2006 ACTIVITIES OF THE “INTERNATIONAL ACADEMY OF PERINATAL MEDICINE”
  2. Editorial
  3. Neurosonography in the second half of fetal life: a neonatologist's point of view
  4. Normal and abnormal transformation of the spiral arteries during pregnancy
  5. Lessons learned from maternal deaths at an East African health center
  6. Maternal venous procalcitonin levels do not correlate with umbilical cord blood and venous blood concentrations in the neonate
  7. Increased cortisol concentrations in the cord blood of newborns whose mothers smoked during pregnancy
  8. The assessment of fetal behavior of growth restricted fetuses by 4D sonography
  9. Impact of fetal blood sampling on vaginal delivery and neonatal outcome in deliveries complicated by pathologic fetal heart rate: a population based cohort study
  10. Postnatal growth failure in preterm infants: ascertainment and relation to long-term outcome
  11. Impact of breast-feeding on psychomotor and neuropsychological development in children of diabetic mothers: role of the late neonatal period
  12. Factors associated with hypospadias in Asian newborn babies
  13. Spontaneous dichorionic triamniotic triplet pregnancy affected by TTTS: follow-up from diagnosis to three months of extrauterine life
  14. Antibiotic therapy for preterm premature rupture of membranes
  15. Reply
  16. Delivery of a healthy child 30 weeks after resuscitation for thromboembolism and treatment with danaparoid: 5-year follow up
  17. Seasonality of birth and acute lymphoblastic leukemia
  18. Errata
  19. Congress Calendar
  20. Index Volume 34 (2006)
  21. Index - Subjects
  22. Index - Authors
  23. Acknowledgement
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