Maternal Mortality in Addis Ababa, Ethiopia

Kwast, Barbara E.; Rochat, Roger W.; Kidane-Mariam, Widad

doi:10.2307/1966906

Cited by 77 publications

(45 citation statements)

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“…Indeed, such data from large, well-conducted, population-based studies anywhere in sub-Saharan Africa are sparse. Data from a large household survey in the capital of Ethiopia in 1981-3, of 9315 pregnant women, found an MMR of 566 per 100 000, 7 and this is likely to be lower than that in rural areas. A smaller study, of 5832 households, in another major urban area in south-west Ethiopia found an MMR of 402 per 100 000.…”

Section: Discussionmentioning

confidence: 92%

The role of a maternity waiting area (MWA) in reducing maternal mortality and stillbirths in high‐risk women in rural Ethiopia

Kelly

Kohls²,

Poovan³

et al. 2010

BJOG

118

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Objective To describe maternal mortality and stillbirth rates among women admitted via a maternity waiting area (MWA) and women admitted directly to the same hospital (non-MWA) over a 22-year period.Design Retrospective cohort study.Setting Hospital in rural Ethiopia, which provided comprehensive emergency obstetric care and has an established MWA.Population All women admitted for delivery between 1987 and 2008.Methods Data on maternal deaths, stillbirths, caesarean section and uterine rupture were abstracted from routine hospital records. Sociodemographic characteristics, antenatal care and other data were collected for 2008 only. Rates and 95% confidence intervals were calculated for maternal mortality and stillbirth.Main outcome measures Maternal mortality and stillbirth.Results There were 24 148 deliveries over the study period, 6805 admitted via MWA and 17 343 admitted directly. Maternal mortality was 89.9 per 100 000 live births (95% CI, 41.1-195.2) for MWA women and 1333.1 per 100 000 live births (95% CI, 1156.2-1536.7) for non-MWA women; stillbirth rates were 17.6 per 1000 births (95% CI, 14.8-21.0) and 191.2 per 1000 births (95% CI, 185.4-197.1), respectively; 38.5% of MWA women were delivered by caesarean section compared with 20.3% of non-MWA women, and none had uterine rupture, compared with 5.8% in the non-MWA group. For the 1714 women admitted in 2008, relatively small differences in sociodemographic characteristics, distance and antenatal care uptake were found between groups.Conclusions Maternal mortality and stillbirth rates were substantially lower in women admitted via MWA. It is likely that at least part of this difference is accounted for by the timely and appropriate obstetric management of women using this facility.

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Section: Discussionmentioning

confidence: 92%

The role of a maternity waiting area (MWA) in reducing maternal mortality and stillbirths in high‐risk women in rural Ethiopia

Kelly

Kohls²,

Poovan³

et al. 2010

BJOG

118

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“…Female mortality associated with child-bearing in Sweden was 7.4 deaths per 100,000 live births (Kwast, Rochat, & Kidane-Mariam, 1986) from 1980 to 1988. In contrast, maternal death in Ethiopia in 1983 was 566 deaths per 100,000 live births (Kwast et al, 1986). A direct comparison of mortality rates between pregnant and non-pregnant women in rural Malawi, found that pregnancy increased female mortality by 29 per 100,000 women (McDermott et al, 1996).…”

Section: The Risk Of Sexmentioning

confidence: 99%

Hormones and history: The evolution and development of primate female sexuality

Wallen¹,

Zehr

2004

Journal of Sex Research

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Sexual behavior is required for reproduction in internally fertilizing species but poses significant social and physical risks. Females in many nonprimate species have evolved physical and behavioral mechanisms restricting sexual behavior to when females are fertile. The same hormones producing female fertility also control these mechanisms, assuring that sex only occurs when reproduction is possible. In contrast to nonprimate mammals, hormones do not regulate the capacity to engage in sex in female anthropoid primates, uncoupling fertility and the physical capacity to mate. Instead, in primates, sexual motivation has become the primary coordinator between sexual behavior and fertility. This dependence upon psychological mechanisms to coordinate physiology with behavior is possibly unique to primates, including humans, and allows a variety of nonphysiological influences, particularly social context, to regulate sexual behavior. The independence between hormonal state and sexual behavior allows sex to be used for social purposes. This complex regulation of primate sexuality develops during adolescence, where female monkeys show both hormonally influenced sexual motivation and socially modulated sexual behavior. We present findings from rhesus monkeys illustrating how social context and hormonal state interact to modulate adolescent and adult sexuality. It is argued that this flexibility in sexual behavior, combined with a tight regulation of sexual motivational systems by reproductive hormones, allows sexual behavior to be used for nonreproductive purposes while still assuring its occurrence during periods of female fertility. The evolutionary pressures that produced such flexibility in sexual behavior remain puzzling, but may reflect the importance of sexuality to primate social attraction and cohesion.With respect to sexuality, I have often speculated on it, and have always concluded that we are too ignorant to speculate: no physiologist can conjecture why the two elements go to form a new being, and more than that, why nature strives at uniting the two elements from two individuals. (Darwin, 1861, in Darwin, 1903 In the preceding quote, Darwin's reference to "sexuality" was in the sense of sexual reproduction. We are, however, similarly ignorant about the behavior that accompanies sexual reproduction, the now conventional use of the term sexuality. What are the causes for engaging in sexual behavior? Why does sexual behavior vary across development and across species? What brings two individuals together so that their gametes can combine? We have partial answers to some of these questions, while answers for others remain elusive. However much of what is understood reflects the reality that sex is expensive, dangerous, and time consuming.

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“…Main contributing factors for this high death includes unsafe abortion, among others [5]. Several studies in Ethiopia indicated that unsafe abortion may account for up to 25-35% of the maternal deaths [6][7][8]. A recent nationwide study on abortion related complications has shown that an estimated number of 17 patients are seen in hospitals for post abortion complications in a month and complications due to abortion were also reported from low-level facilities, which do not provide post abortion care services [9].…”

Section: Introductionmentioning

confidence: 99%

Factors Influencing Utilization of Post Abortion Care in Selected Governmental Health Institutions, Addis Ababa, Ethiopia

Zemene¹,

Feleke²,

Alemu³

et al. 2014

Fam Med Med Sci Res

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IntroductionWorldwide, each year more than 500,000 women, 99% of them in developing countries, die from pregnancy and childbirth-related complications and an additional 15 to 20 million women suffer from debilitating consequences of pregnancy [1]. The major causes of maternal deaths are hemorrhage, infection, obstructed labor, hypertensive disorders in pregnancy, and complications of unsafe abortion [2].Maternal deaths due to unsafe abortion in developing countries fall within a narrow range from 9% to 17% of all maternal deaths [3]. Both the lowest and the highest figures are found in Africa (9% in Southern Africa and 17% in Eastern Africa), reflecting the combined impact of the legal abortion and health systems, with more liberal access to abortion and post abortion care in the health systems [3].Ethiopia is one of the counties with highest maternal mortality ratio which is currently estimated at 676/100,000 live births [4]. Main contributing factors for this high death includes unsafe abortion, among others [5]. Several studies in Ethiopia indicated that unsafe abortion may account for up to 25-35% of the maternal deaths [6][7][8]. A recent nationwide study on abortion related complications has shown that an estimated number of 17 patients are seen in hospitals for post abortion complications in a month and complications due to abortion were also reported from low-level facilities, which do not provide post abortion care services [9]. From a community based large-scale survey in Addis Ababa, Ethiopia, maternal mortality in the city was estimated to be 566 per 100,000 live births and abortion was major contributor to the deaths [4,8,10]. In addition, safe abortion service is a recent trend and a formal post abortion care (PAC) service in the country is not yet well expanded [3,11,12]. Thus this study assessed the influencing factors of PAC utilization in selected health institutions in Addis Ababa, Ethiopia. Methods Study design, area and periodAn institution-based cross sectional study was conducted among reproductive age women (15-49 years) who were attending maternal and child health (MCH) services using structured interviews. A total of 153 respondents were recruited from six MCH clinics in Addis Ababa, Ethiopia. Data were collected between February and April, 2012. There were 620 clients attending MCH services that obtained from monthly registration report of MCH clinics in these six MCH clinics. Respondents were recruited proportionally to the client flow from each MCH clinics. For the purpose of this study, we defined users of post abortion care as women of childbearing age who had received all components of post abortion care services, and non users of post abortion care as women of childbearing age who had not received all of the components. We used the inclusion criteria as all reproductive age women with at least one abortion history in the last one year, and exclusion criteria as all reproductive age women who had no any abortion history, women with hearing problem, and mentally incompetent women d...

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Maternal Mortality in Addis Ababa, Ethiopia

Cited by 77 publications

References 0 publications

The role of a maternity waiting area (MWA) in reducing maternal mortality and stillbirths in high‐risk women in rural Ethiopia

The role of a maternity waiting area (MWA) in reducing maternal mortality and stillbirths in high‐risk women in rural Ethiopia

Hormones and history: The evolution and development of primate female sexuality

Factors Influencing Utilization of Post Abortion Care in Selected Governmental Health Institutions, Addis Ababa, Ethiopia

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