A Comparative study of maternal mortalitybetween Al-Abasia Tagali and Juba
by
Mahasin Hamed HajElsiddig
Introduction:
Maternal Mortality:
Is defined by United Nation Population FundAction (UNFPA) as the death of a womenduring pregnancy or within 42 days aftertermination of pregnancy from any causesrelated to, or aggravated by the pregnancy orits management. This includes death as acomplication of abortion at any stage ofpregnancy (UNFPA, WHO, 2006).
Study justification:
Nearly half of all pregnant women inSudan deliver their children without thehelp of skilled birth attendants and as aresult many of them die in childbirthUNFPA (2004). The mortality andmorbidity rates among women in Sudanis among the highest in the region,UNFPA (2004).
•26000 women die every year in Sudanwhile giving birth. 13300 of them in thesouth and 12700 in the north. Thismeans about 71 women die everydaywhile giving birth UNICEF(2009). Ratesof pregnancy related deaths in southSudan are the highest in the world; it'sactually at 2.030 per 100.000 births.
According to Sudan health facilities,hemorrhage accounted for 25 percentof all maternal deaths.
In north Sudan, rates of maternalmortality are 509 deaths per 100.000birth UN (2007).
The importance of the problem is notalways evident from official statistic. Inarea where the problem is greatest,most maternal death go unregistered,therefore been subject to underestimation which aggravates thesituation.
Maternal mortality affects not onlywomen but also their families andcommunities. The risk of an infantdying increases significantly with themother's death.
The death of a woman of reproductiveage brings significant economiclosses and setbacks to communitydevelopment.(WHO/UNICEF/UNFPA,1995)
Objectives:
The aim of this paper is to determine thecauses of maternal mortality among Al-Abasia Tageli women compared withmaternal mortality at Juba Teaching Hospital.It focus on the demographic and socio-economic status of the deceased women inthese areas, and evaluating the maternityhealth care facilities in the study areas.
Materials and methods
Primary data: Obtained throughquestionnaire and personal interviewsof families who had maternal deathbeside information from healthproviders and retrospective healthservices attendants' records.
Secondary data: Obtained fromtextbooks, published articles, andjournals and internet sources.
Study areas
Al-Abasia Tagli and Juba Teaching Hospital.
Al- Abasia Tagali, is situated in the easternpart of South Kordofan state
Juba Teaching Hospital:
Established back in the early 1920, as theCentral Hospital in the southern Sudan.Maternity Unit:
It is established following theComprehensive Peace Agreement byUNFPA agency. It has 6 wards plus thetheater room.
The unit lack access to basic emergencyobstetric services, provision for health care islow ,about 25% of the population in southernSudan had access to health care which areorganized predominantly by NGOs.
The grater part of this health care isprovided by unqualified personal who aretrained by the NGOs to diagnose and treatcases according to protocols.
Target group:
Families whom had maternal deathsduring the last10 year taken as sample.
Sample Size:
Hundred questionnaires were distributed .Fifty of these questionnaires in Al-AbasiaTagali, 30 were collected from families basedinformation who had maternal deaths, and 20from health centers selected purposively. InJuba 30 were from Juba Teaching Hospitaland the other 20 questionnaires from healthcenters in the area purposively selected.
Data Analysis:
The data were analyzed using the SPSSand the results are presented in the form oftables and figures using frequency andpercentage.
Study period:
5 May 2009 – 29 September 2009.
Result and discussion
Fig, 1: Percentage of the maternal mortality cases according todemographic data in Juba and Al-Abasia Tagali respectively.
1 - Age
Juba Al-Abasia Tagali
Juba Al-Abasia Tagali
2- Education
Juba Al-Abasia Tagali
3- Marital status
Juba Al-Abasia Tagali
4- Economic status
Fig. 2: Percentage of the maternal mortality cases according to birthnumber and birth status at time of death in Juba and Al-Abasia Tagalirespectively .
Birth number
Juba Al-Abasia Tagali
Birth status
Fig. 3: Percentage of the maternal mortality cases according tohealth care factors in the area in Juba and Al-Abasia Tagalirespectively.
Juba Al-Abasia Tagali
1- Availability of healthcare in the area
2- Availability ofmaternity unit
Juba Al-Abasia Tagali
Juba Al-Abasia Tagali
3- Maternity unitstatus
Fig. 4: Percentage of the maternal mortality cases according tofactors during and post pregnancy, at time of delivery and afterdelivery in Juba and Al-Abasia Tagali respectively.
1- Pregnancycomplications
2- Delivery time span
Juba Al-Abasia Tagali
3- Complications afterdelivery
Juba Al-Abasia Tagali
Fig. 5: Percentage of the maternal mortality cases according toprobable maternal death factors Juba (column 1) and Al-AbasiaTagali respectively (column 2).
1- Place of delivery
Juba Al-Abasia Tagali
2- Way of delivery
Juba Al-Abasia Tagali
3- Causes ofmaternal death
Juba Al-Abasia Tagali
4- Maternal death time
Juba Al-Abasia Tagali
Fig. 6: The correlation between the demographic variables and theprobable maternal death factors in both areas.
Fig. 7: Mean of pregnancy and delivery complications variables visavailability of health services in the both areas.
Conclusion:
The present study revealed that most casesof maternal mortality deliver at home by TBA,midwives or alone.
Delivery complications were highly noticed inhome delivered cases where heavy bleedingand retained placenta were well noticed.Death from hemorrhage was thepredominant cause of maternal mortalityamong the study cases.
The result of the study explained that thedemographic data of the cases areuncorrelated to the medical factors. Whilethe health services in the two areas althoughdifferent but contribute directly to the highdelivery complications and thus elevatedmaternal mortality rate.
Thank you
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