Maternal mortality at the Queen Elizabeth Central Teaching Hospital, Blantyre, Malawi

Abstract

Background: Maternal mortality in Malawi continues to increase despite the global SMI and national safe motherhood programme's efforts to reduce it.

Objectives: To identify the social, demographic and reproductive profiles of women suffering a maternal death, the main immediate causes and the operational factors.

Design: A retrospective descriptive survey.

Setting: The Gogo-Chatinkha Maternity Unit, Queen Elizabeth Central Hospital, Blantyre, Malawi, from January 1, 1999 to December 31, 2000.

Subjects: All women who suffered a maternal death in the unit.

Results: There were a total of 204 maternal deaths and 19,859 live births, giving a Maternal mortality ratio (MMR) of 1027.2/100,000 live births. Their ages ranged from 16 to 40 years. Adolescents comprised 20.6%, while the majority, (56.4%), were aged 15 - 24 years. Almost half of the group, (43.4%), were para 1 and less, with a range of 0 to 12. The top five causes of death were puerperal sepsis, (29.4%); postabortal complications, (23.5%); other infectious conditions, (20.1%); obstetric haemorrhage, (10.6%), and eclampsia, (6.4%). Some of the identified operational factors included delay in accessing and receiving emergency obstetric care, poor quality services, HIV infection/ AIDS and unsafe induced abortion following unwanted pregnancy.

Conclusion and recommendations: Most of the causes and operational factors for maternal deaths are easily avoidable. The country needs to make more commitment and investments necessary to mitigate these deaths.