Maternal mortality in the last triennium of the Millennium Development Goal Era at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria

Abstract

This article provides the contemporary maternal mortality data of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, during the last triennium of the Millennium Development Goal era. The findings from the study revealed that the average maternal mortality ratio (MMR) of the Hospital over the three years was 1640/100,000 live births, and that pregnancy-related infection is now the leading cause of maternal death, followed by obstetric haemorrhage. What the implications are for clinical practice: Improvement in aseptic techniques, evaluation of antimicrobial sensitivity patterns and efficient blood transfusion services, as well as Universal Health Insurance coverage and Skilled Birth Attendants will improve the maternal health indices of the hospital, and ultimately the country during the SDG execution period.

Applying the WHO ICD-MM classification system to maternal deaths in a tertiary hospital in Nigeria: A retrospective analysis from 2014–2018

“…Majority of these women died in their prime of life, are unbooked, and are educationally disadvantaged. This conforms with previous reports from Nigeria [9,[10][11][12][13]. Lack of maternal education has been reported to increase the risk of maternal deaths [14][15][16].…”

“…national MMR of 512 maternal deaths /100,000 live births [2], it is much lower than 1640/ 100,000 live births recorded in a similar hospital-based retrospective analysis of maternal deaths at Ife, South Western Nigeria [9] and 2,085/100,000 live births(range: 877-4,210 per 100,000 births) reported in a multicenter review of maternal deaths in eight secondary level hospitals across eight states in four geopolitical zones in Nigeria [10]. The high burden of maternal deaths in this study and in other tertiary health institutions in Nigeria underscores the need for sustained efforts at addressing the problem of maternal mortality towards realization of SDG3 target 3.1 (i.e., to reduce the global maternal mortality ratio to less than 70/ 100,000 live births).…”

Causes of maternal mortality in Sub-Saharan Africa: A systematic review of studies published from 2015 to 2020

“…The other studies were: case-control (n = 1) [ 38 ], Confidential Enquiries into Maternal Deaths (CEMD) or Maternal Death Surveillance and Response (MDSR) audits (n = 4) [ 39 - 42 ], cross-sectional facility and community surveys (n = 4) [ 43 - 46 ], prospective facility and community studies (n = 2) [ 47 , 48 ], Reproductive Age Mortality Study (RAMOS) (n = 2) [ 49 , 50 ], pre and post evaluation (n = 1) [ 51 ], and step-wedge randomised controlled trials (RCT) (n = 1) [ 52 ]. The methods of assigning the causes of death were: study expert panels (n = 21) [ 17 , 18 , 21 , 22 , 24 , 26 , 28 , 29 , 33 - 35 , 37 , 39 , 43 - 46 , 48 - 50 , 52 ], facility/MDSR audit teams (n = 8) [ 16 , 23 , 25 , 31 , 41 , 42 , 51 , 53 ], routine clinical assessments (n = 5) [ 19 , 20 , 27 , 30 , 32 ], physician verbal autopsy coders (n = 1) [ 47 ], and not stated (n = 3) [ 15 , 36 , 38 ]. South Africa contributed 21% of the deaths from 2 studies [ 22 , 41 ], Nigeria 18% from 13 studies [ 15 , 21 , 23 - 25 , 28 - 31 , 35 , 37 , 46 , 48 ], Tanzania 15% from 3 studies [ 16 , 18 , 39 ], and Zimbabwe 9% from 2 studies [ 20 , 42…”

“…The methods of assigning the causes of death were: study expert panels (n = 21) [ 17 , 18 , 21 , 22 , 24 , 26 , 28 , 29 , 33 - 35 , 37 , 39 , 43 - 46 , 48 - 50 , 52 ], facility/MDSR audit teams (n = 8) [ 16 , 23 , 25 , 31 , 41 , 42 , 51 , 53 ], routine clinical assessments (n = 5) [ 19 , 20 , 27 , 30 , 32 ], physician verbal autopsy coders (n = 1) [ 47 ], and not stated (n = 3) [ 15 , 36 , 38 ]. South Africa contributed 21% of the deaths from 2 studies [ 22 , 41 ], Nigeria 18% from 13 studies [ 15 , 21 , 23 - 25 , 28 - 31 , 35 , 37 , 46 , 48 ], Tanzania 15% from 3 studies [ 16 , 18 , 39 ], and Zimbabwe 9% from 2 studies [ 20 , 42 ] (See Table S4 in the Online Supplementary Document ). Risk of bias was rated as low in 20 studies and medium in 14 studies (Table S.2 in the Online Supplementary Document ).…”

Maternal near‐miss and death associated with abortive pregnancy outcome: a secondary analysis of the Nigeria Near‐miss and Maternal Death Survey

“…At present, there are few studies in Nigeria reporting maternal deaths from pregnancies with an abortive outcome, and none is nationally representative . Likewise, institutional‐based reports on maternal near‐miss and deaths from ectopic pregnancy in the country are random and scarce .…”