Abstract:
Approximately 600,000 women die each year from complications related to pregnancy and childbirth, 99% of them in developing countries. Kenya has a record of 488 deaths per 100,000 live births while in Kisii region has a maternal mortality of 500 per 100,000 live births. The objective of the study was to establish the determinants of maternal mortality among women seeking obstetric care in Kisii Level 5 Hospital. In this case control study, factors specifically studied were those that contributed to maternal mortality. A confidential female death questionnaire (CFDQ) was used to collect data from relatives of the 230 subjects with 72 subjects on the deceased arm. Study findings revealed that among those who died, 43 (60%) ranged between 15-25 years. Fifty-one (70.8%) of the deceased did not go to hospital promptly due to lack of money and delayed decision making process. Thirty-nine pregnancies (54%) were unplanned and the expectant mothers did not have a birth plan. Complications which led to maternal mortality were mainly bleeding /hemorrhage, swelling of hands, hypertension, heart diseases, and post-partum sepsis/infections. The women with a less than primary level of education were 7.46 times less likely to report bleeding as a complication that occurs to them as a result of abortion compared to females with a secondary and above level of education and mothers who were in business/formal employment are 7.25 times less likely to experience bleeding in early pregnancy before 22 weeks compared to those who are farmers/housewives. The study concludes that young women (15-30 years) of reproductive age either married or single are prone to maternal mortality. Unplanned pregnancies, abortion, home deliveries, delay in being attended while in hospital and preterm deliveries were the main contributory factors to maternal mortality. This study recommends that health education on antenatal care and birth-plan should be intensified targeting young women of reproductive age (15-30 years), single or married women. They should also be empowered economically. Again, scaling-up family planning and skilled deliveries should be encouraged. This will reduce maternal mortality and make significant progress towards achievement of Millennium Development Goal number 5. Again the study has revealed that verbal autopsy is a suitable method that can be used to collect useful data for research.
