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. 2019 Jan-Mar;44(1):26-30.
doi: 10.4103/ijcm.IJCM_170_18.

Maternal Mortality in Rural Varanasi: Delays, Causes, and Contributing Factors

Kalpana Kumari  1 , Ratan Kumar Srivastava  2 , Manushi Srivastava  2 , Neeti Purwar  2
Affiliations

Maternal Mortality in Rural Varanasi: Delays, Causes, and Contributing Factors

Kalpana Kumari et al. Indian J Community Med. 2019 Jan-Mar.

Abstract

Background: Pregnancy and motherhood are natural processes and considered to be full of positive experiences. However, for various reasons many women end up dying during pregnancy, childbirth, and the postpartum period. Improving maternal health and reducing maternal mortality have been prioritized in several international declarations and national policies.

Objectives: The objective of the study is to assess delays, cause, and its contributing factors related to maternal deaths in rural Varanasi.

Methodology: Verbal and Social Autopsy have been done for each maternal death occurred between April 2015 and March 2016 in four randomly selected blocks of rural Varanasi. The "3 Delay Model" and "Pathway analysis" concept was used in collection and analysis of data through in-depth interview of three people (family member, neighbor, and a health worker) for each maternal death. Cause of death and delays was identified by two reviewers (obstetrician) independently.

Results: In almost half of the autopsied cases two different delays were found, and in one-third case, only one delay was found. Direct obstetric cause found in more than half (54%) cases. Hemorrhage and anemia were found major direct and indirect obstetric cause, respectively. Other causes identified were sepsis (direct), jaundice, and meningitis. A number of social, behavioral, and cultural factors were identified, that had been contributed to different delays related to the maternal deaths.

Conclusions: First delay was present in most of (90%) cases. Nonbiological (social, behavioral, and cultural) and health service factors were also identified in this study.

Keywords: Delay; maternal mortality; social autopsy; verbal autopsy.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Venn diagram (Maternal death autopsied)
Figure 2
Figure 2
Distribution of cause (proportion) of maternal death with respect to different levels of delay in four blocks of Varanasi (April 1, 2015–March 31, 2016)
Figure 3
Figure 3
Pathway analysis of 22 identified maternal death in four blocks of rural Varanasi (April 01, 2015–March 31, 2016)
See this image and copyright information in PMC

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