Maternal Deaths in a Tertiary Health Institution in Southeast Nigeria: Two Decades after Safe Motherhood Initiative

Background: Decades after several concerted efforts were made to contain the scourge, maternal deaths continue to have a devastating effect in many developing countries. Strengthening the strategies to reduce these calamitous losses is necessary to achieve a palpable decline in the commonly affected regions.

Aim: This study was undertaken to determine the Maternal Mortality Rate (MMR) in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Southeast Nigeria and to compare with rates in other similar institutions.

Methods: A retrospective analysis of all maternal deaths over a five year period, January 2012 to December 2016. Data analysis was by means of descriptive and inferential statistics including means, frequencies and X2-tests at the 95% confidence level (CL).

Results: During the 5 year period (2012-2016), there were a total of 5057 live births and 13 maternal deaths. The overall MMR was 257 per 100,000 live births.

Maternal Mortality (MM) was highest amongst women age 40 years and above, 1429/100,000 live births (P=0.047).

Leading contributors to maternal deaths were grandmultiparity (33.3%) and unbooked mothers (75%). Mothers living in the rural area, unbooked and of lower socio-economic status were 4.7, 7.8 and 5.7 times more likely to be associated with maternal death.

Major direct causes of maternal deaths were sepsis (33.4%), haemorrhage (22.2%) and ectopic pregnancy (22.2%). HIV/AIDS (100%) was the major indirect cause of maternal deaths.

MMR increased gradually at the study hospital from zero in 2012 to the highest level, 588/100,000 live births in 2016.

Conclusion: MMR, though gradually increasing in COOUTH is still lower than the national average and outcome in similar health institutions in Nigeria.

The contributions of HIV/AIDS, unbooked mothers and low socio-economic status to maternal deaths stress the need for increased counselling and testing for HIV/AIDS, antenatal care services and empowerment of women respectively.