Determinants of Perinatal Mortality at Luisa Guidotti Hospital, Mutoko District, Mashonaland East Province 2021

Abstract

Stunting is a public health problem affecting millions of children globally. Stunting has persisted in Chimanimani over the years from 35% in 2014 to 35.8% in 2018 during the National Nutrition Survey and the problem is attributed to factors such as inadequate access to food, poor feeding patterns and or low household socioeconomic status. It results in individuals having low cognition, low wages in adults and poor reproductive outcomes. This study aimed to establish the predictors of stunting in Chimanimani and its prevalence. The study followed an analytical cross sectional study design and enrolled 357 caregivers while 351 under-fives were measured for length/height. The study had 99.2% female respondents as caregivers and 0.8% males. Chimanimani has a low-birth-weight rate of 6.5%. The prevalence of stunting in children below 5years was 25.1%. A total of 72.2% boys and 77.2% girls were of normal height for age in the study. Two tailed bivariate analysis was done on all variables and age of child [rs = -0.123 (p-value= 0.021< 0.05)] had an effect on stunting. Month of first ANC visit had a small to moderate negative significant association with stunting at 0.05% confidence level (rs = -0.105, p = 0.049). Type of residence had a spearman’s correlation coefficient of -0.196 at 95% CI (p = 0.022). Household main source of income and treating of drinking of water both had a small to moderate significant correlation with stunting at 0.05 confidence level [ rs = 0.110 (p= 0.039)]. The spearman’s rho correlation coefficient (rs = -0.122) was significant at 95% CI (p= 0.023). Breastfeeding children under 2years had a small to moderate significant positive association at 0.05 confidence interval [rs = 0.125 (p= 0.125)]. Stepwise multiple regression was performed for confounding in the significant variables. On performing the ordered logistic regression, type of residence was found to have significant independent association with stunting. There is high prevalence of stunting in Chimanimani in children below the age of 5years. A multi-sectorial approach is needed to address the issue as factors range from socioeconomic factors, WASH, infant and young child feeding patterns and food security.

Luisa Guidotti Hospital experienced a perinatal ratio of 22/1000 live births and 41/1000 live births in 2019 and 2020 respectively. These ratios were higher than that of the national average which was 29/1000 live births in 2020. This research determines the factors contributing to perinatal mortality at Luisa Guidotti Hospital in Mutoko District in 2021. A sequential mixed method was used comprising a descriptive qualitative design and a quantitative survey. For the qualitative phase, 10 women who had lost their babies and six Midwives were purposively selected. Quantitative complete sampling was done on all women who attended ANC at Luisa from18 October to 30 November 2021. Data was presented in tables, graphs and pie charts for Quantitative and as was also analysed by thematic approach for qualitative. The researcher scheduled 10 interviews with mothers who had lost their babies and all of them were successful to achieve a 100% response rate. 46 questionnaires were distributed to all women who attended ANC from 18 October to 30 November 2021. Only 40 were returned to achieve an 87% response rate. Major findings proved that there was a significant association between the knowledge of women of child bearing age and perinatal mortality (p=0.001). The study concludes that the determinants of perinatal mortality at Luisa Guidotti included, cultural issues, knowledge deficit regarding pregnancy processes, attitudes of health care workers and shortage of resources. From the study it is recommended that nurses at LGH should intensify health education to all communities on the importance of early booking and hospital delivery. The DMO of Mutoko District should liase with the PMD, reproductive department to source food for pregnant mothers staying in the waiting mother’s homes.