Verbal autopsy of preventable maternal deaths in Nigeria

Abstract

Introduction: Verbal autopsy is a method of finding out the medical causes of death and ascertaining the personal, family or community factors that may have contributed to the death in women who died outside of a medical facility. Objective: To determine the avoidable factors contributing to maternal deaths at the communities with Midwives Service Scheme (MSS) facilities in Northern Nigeria using verbal autopsy. Methodology: This was a 6 month confidential enquiry of all reported maternal deaths at the MSS facilities and the host communities in Northern Nigeria from 1 st July, 2011 to 31 st December, 2011 using verbal autopsy tools. Results: One or more avoidable factors were identified in 89% of the 141 maternal deaths. Socio cultural factors are the commonest avoidable cause of maternal mortality. TBAs, inadequate lifesaving skills, delay in referral and poor patient monitoring are the commonest avoidable factors seen in the health workers. Lack of transportation is a cross cutting avoidable factor contributing to all levels of delay in women with obstetric complications. Non availability of signal functions for a basic emergency obstetric care facility is responsible for 61% of administrative avoidable factors. Most (70%) maternal deaths occur postpartum. Most deliveries (56%) in these women were at home but most (52%) of them died at the health facility. TBAs conducted 50% of the deliveries. Out of the 73 that were alive at presentation in the health facility only 20(27%) were admitted in stable condition. Conclusion: Addressing preventable maternal mortality is key to achieving the SDG goal for Nigeria.