Maternal Mortality among Women Seeking Health Care Services in Kisii Level 5 Hospital

摘要

Background. Maternal mortality has continued to escalate in Kenya inspite of all the efforts being made by the government, non-governmental organization and the community. The purpose of the study was to establish the antecedent factors predisposing women to maternal death using the three delays model. Methodology: Retrospective 72 maternal death cases which occurred between January 01, 2009 and June 30, 2010 were reviewed by an independent gynecologist/obstetrician. Interviews were conducted with kins of the deceased women using a confidential questionnaire for female death based on distal as well as proximal factors that may have had a bearing on maternal death. Health care workers were likewise interviewed using a formulated questionnaire to assess the ability and readiness of the hospital to offer emergency obstetric care. Results: A record of 72 maternal deaths occurred during the study period thus between January 1, 2009 and June 30. 2010. Out of 72, 42 maternal deaths were as a result of direct obstetric complications which include hemorrhage, post-partum sepsis, pre-eclampsia and abortion. Post partum hemorrhage was the most common complication which contributed to maternal deaths. Again out of 72 maternal deaths, 33 were as a result of indirect causes with peritonitis, heart disease, HIV/AIDS, anemia, and convulsive disorder respectively. Delayed access to transport, lack of money for user fees, and hospital distance were challenges that led to delay in accessing care. Hospital experiences included; delay in service provision by staff, delayed quality emergency obstetric care and delayed care while at the hospital, unavailability of blood for transfusion, and lack of money for drugs, were reported as major challenges which attributed to maternal death. Conclusion: The study suggests maternal mortality occurs as a result of lack of access to quality healthcare facility poor health seeking behavior and poor socio-economic factors.