Title: A community-based investigation of avoidable factors for maternal mortality in Zimbabwe.

POPLINE Document Number: 121063

Author(s):

Fawcus S
Mbizvo M
Lindmark G
Nystrom L

Source citation:

STUDIES IN FAMILY PLANNING, 1996 Nov-Dec;27(6):319-27.

Abstract:

A community-based survey of maternal deaths in a rural province (Masvingo) and urban area (Harare) of Zimbabwe in 1989-90 revealed a high incidence of avoidable factors, both within and outside the health sector. During the 2-year study period, 109 maternal deaths were identified in Masvingo (168/100,000 live births) and 66 in Harare (85/100,000 live births). In Masvingo, the three leading causes of death were hemorrhage (25%), postabortion sepsis (15%), and puerperal sepsis (13%); in Harare, these causes were eclampsia (26%), postabortion sepsis (23%), and puerperal sepsis (15%). In Masvingo, the locations of maternal deaths included rural hospitals (50%), provincial hospitals (13%), home (13%), and travelling to or between health facilities (11%); all deaths in Harare occurred in central hospitals. One or more avoidable factors were identified for 90% of maternal deaths in Masvingo and 85% of those in Harare; these factors occurred at the community level in 47% and 38% of deaths, respectively. Among patient-related factors, delay in the decision to seek care for symptoms was most widespread (32% of deaths in Masvingo and 28% of those in Harare). Problems of access to transportation from home to health facility were implicated in 28% of deaths in Masvingo and 3% in Harare. Avoidable factors within the health sector were identifiable in 67% of Masvingo deaths and in 70% of Harare deaths. Notable was failure of health personnel to assess the severity of postabortion conditions and puerperal sepsis and initiate aggressive treatment. Recommended, to reduce maternal mortality in Zimbabwe, are community awareness of risk factors for pregnancy and delivery, collective emergency transportation mechanisms, maternity waiting shelters, appropriate obstetric management protocols, more effective identification and treatment of emergency conditions, and liberalization of existing abortion legislation.

Keywords:

Zimbabwe
Surveys
Maternal Mortality
Mortality Determinants
Causes of Death
Urban Population
Rural Population
Women
Africa, Southern
Africa, Sub Saharan
Africa
Developing Countries
Sampling Studies
Studies
Research Methodology
Mortality
Population Dynamics
Demographic Factors
Population
Population Characteristics