Causes of maternal morbidity and mortality rate in Adansi West District of Ashanti Region

All over the world people celebrate the birth of a new baby. Societies expect women to bear children and honour women for their role as mothers. Yet in most of the world, pregnancy and childbirth is a perilous journey. In less developed countries, more than half a million mothers die each year from cause related to this life-giving event. Complications related to pregnancy and childbirth is among the leading causes of mortality for women of reproductive age in many parts of the developing world. At the global level, it has been estimated that about half a million women die each year of pregnancy-related causes. According to recent estimated, each year, more than 500,000 women between the ages of 15 and 49 die of causes related to pregnancy and childbirth, a leading cause of death among women in that age group (Hill et al, 2001) The most recent figures from the World Health Organisation which releases revised global maternal mortality estimates about every five years, estimate that 515,000 women die annually from maternal causes. Ninety-nine percent of these deaths occur in the less developed world making maternal mortality the health indicator that reveals the largest disparity between developing and developed countries. The situation is most dire for women in Sub-Saharan Africa, which Ghana is part, where one of every 13 women dies of pregnancy-related causes during her life time, compared with only one in 4,085 women in industrialised countries. Since the 1948 Universal Declaration of Human Rights, at least 14 international conventions and conferences have affirmed and reaffirmed safe motherhood as a right and identified the central role of safe motherhood interventions in women’s health. The study was a cross sectional descriptive type using both qualitative and quantitative methods. In all, 150 mothers and pregnant mothers of sixteen years and above from fifteen communities in the District were randomly interviewed and answered questionnaires to find out their socio-economic status and their assessment of the health facilities in the District. In depth interviews and questionnaires were conducted on fifty (50) health personnel and health providers to identify obstetric complications and causes of maternal deaths. Closed and open-ended structured interviews and questionnaires were used to elicit information from respondents. The findings of the study showed that maternal deaths in the District cut across all the fertility age groups, however, there seems to be more deaths in the 16-20 year group and above 35 year group than the other age groups. The finding indicated that 53% of the respondents were within the age group. Education level of the mothers seems to play an important role in reducing maternal deaths. Various study findings showed that maternal deaths occurred to mothers who either had no education or had up to primary level education. The study findings showed that 60% of those interviewed either had no education or had up to primary level education. Furthermore, it was revealed that antenatal clinic attendance plays a role in reducing maternal deaths. Important health issues like family planning are discussed during the session. A study demonstrated that the women who attended antenatal clinics had increased knowledge of how to recognize many of the major complications of pregnancy and childbirth including haemorrhage, obstructed labour and hypertensive disorders. The study revealed that 40% of the respondent went for their first antenatal visit within the first three months of pregnancy. It means that the remaining 60% had their first visit within the 2’ and 3 trimesters. The commonest reasons given by those mothers/respondents were lack of knowledge of services, not necessary, not customary, financial cost and others. The study further revealed that 53.3% of the mothers interviewed were found not to have used contraceptive prior to pregnancy. Fear of side effects of the oral contraceptive pill, and disapproval by the husbands emerged as two of the most important factors discouraging women from contraceptive use. The study showed that reasons for respondents not seeking for medical care when identify obstetric complications were given as lack of knowledge of complication, cultural beliefs, attitude of family members, unavailability of facilities, inaccessibility of facilities and lack of money. Findings revealed that 50% of the direct causes of maternal deaths in the District was haemorrhage. The findings showed that indirect causes were anaemia (33.3%), sickle cell (33.3%) and aspiratory pneumonia (33.3%). The study again revealed that the major obstetric complications were obstructed prolonged labour (12.8%), induced septic abortion (22.2%) and etopic pregnancy (17.3%). The research therefore, gave recommendations to enable the Ministry of Health, DHMT and other organisations design and implement appropriate and relevant maternal health programmes to reduce maternal deaths in the District.

Source: KNUST