Analysis of Factors Underlying Maternal Mortality at Victoria Chitepo Provincial Hospital 2017- 2022

Abstract

Globally, maternal mortality rate is unacceptably high, with a maternal death occurring almost every two minutes and close to 800 reported every day. Sub-Saharan Africa and Southern Asia have the highest burden, accounting for 87.0% of the estimated global maternal deaths in 2020. Sub-Saharan Africa alone accounts for around 70.0% while Southern Asia accounts for around 16%. Within Sub-Saharan Africa, the West African region has the highest MMR. In Zimbabwe, a decrease in MMR by 31.0% from 525 in 2012 to 363 in 2022 and 63.0% of all maternal deaths occur in Central and Provincial Hospitals according to Ministry of Health and Child Care, 2021. Victoria Chitepo Provincial Hospital had the highest institutional maternal mortality ratio consistently over the past 6-year period (2017-2022), among all the hospitals in the country. The purpose of this study was to investigate the factors underlying high institutional maternal mortality at Victoria Chitepo Provincial Hospital. The study was done in Manicaland Province at the Provincial Hospital. Victoria Chitepo is the biggest referral facility in Manicaland, and it caters for a population of 2,037,703 people from 7 districts. The study was a retrospective correlational study. 143 maternal death notification forms and the corresponding maternal death patient’s notes that occurred at the provincial hospital in the referred period were reviewed to identify the causes death (direct and indirect) and contribution of the 3 delays. Maternal death audit minutes were analysed and reviewed. The findings reveal that 90.9% (n = 130) of the individuals who died during childbirth were married, while 9.1% (n = 13) were single. In terms of education level, the highest percentage, 46.8% (n = 65), had completed secondary education, while the lowest percentage, 3.6% (n = 5), had reached tertiary education. Christianity accounted for the highest percentage at 46.4% (n = 77), followed by the Apostolic Sect with 23.5%. Regarding ANC visits, the average number of visits is 3, indicating that, on average, individuals made three antenatal care visits during their pregnancy. On causes of death PPH contributed 31.7%; eclampsia 16.9%; puerperal sepsis; cardiac disease and ruptured uterus contributed 7.7% to the cause of death. In this study 35.0% delivered by caesarean section and 44.3% had normal vaginal delivery. Pearson correlation between IMMR and CSR was conducted and a correlation coefficient of 0.818 was observed indicating a strong relationship between IMMR and CSSR. Chi-square test also examined the relationship between IMMR and CSR using a chi-square test at a significance level of 5.0% and maternal mortality occurred 22 times when caesarean was done and 68 times when caesarean section was not done.