Introduction: According to WHO, globally an estimated 585,000 women die each year from complications of pregnancy and childbirth. One of the targets of Millennium Development Goal 5 (MDG 5) is to reduce maternal morta...Introduction: According to WHO, globally an estimated 585,000 women die each year from complications of pregnancy and childbirth. One of the targets of Millennium Development Goal 5 (MDG 5) is to reduce maternal mortality by three quarters of the 1999 value by the year 2015. However, three years to 2015, very little is known on the trends in maternal mortality ratio, causes of maternal deaths and their associated factors in the Tiko Cottage Hospital (TCH) and Limbe Regional Hospital (LRH) in the South-West Region, Cameroon. Methods: This was a retrospective, analytical cross-sectional study that was carried out from 1st January 2000 to December 2012. After obtaining ethical clearance, the records of cases of maternal deaths and a reference group of women who survived after a pregnancy during the same period were carefully reviewed. The data were analyzed with SPSS 10 and EPI 3.5.1. Results: There were 14,480 live births and 132 maternal deaths during the study period, giving an adjusted Maternal Mortality Ratio (MMR) of 892/100,000 live births. Patients’ age ranged from 15 - 40 years (SD 2.3). We observed a downwards trend of Maternal Mortality Ratio (MMR). Seventy-eight percent of the maternal deaths were due to direct causes. The triad of hemorrhage (54.5%), abortions (17.4%), and eclampsia (10.6%) was the leading cause of death. HIV-related complications and hepatitis constituted the main indirect causes of maternal death. In 85.4% of cases, maternal deaths were avoidable. Lack of blood for transfusion and late referral of cases were the main avoidable factors. Patients less than 35 years (p = 0.01), no antenatal care (ANC) (p = 0.001), unemployment [OR = 1.52;95% CI: (1.38 - 48.28);p = 0.02] were significantly associated with maternal deaths while grand multiparity [OR = 1.20;95% CI (0.30 - 4.86);p = 0.79], marital status [OR = 1.20;95% CI: (0.70 - 2.07);p = 0.51] and education level were not significantly associated with maternal deaths. Conclusion: The trend shows that there was no appreciable decline in maternal mortality, implying that attaining the objectives of MDG 5 is very unlikely. Therefore, to meet the MDG 5 target, we recommend that, there should be amelioration towards obstetric emergencies care and health education by health care providers.展开更多
The Millennium Development Goal (MDG) 5 advocated the reduction of maternal mortality rates significantly by 2015, however, maternal mortality rates continue to rise. Here, we modelled maternal mortality data for the ...The Millennium Development Goal (MDG) 5 advocated the reduction of maternal mortality rates significantly by 2015, however, maternal mortality rates continue to rise. Here, we modelled maternal mortality data for the years 2000 to 2013 obtained from a public hospital in Kumasi, Ghana. We applied the Box-Jenkins approach of univariate form of time series autoregressive integrated moving average (ARIMA). The output revealed that the ARIMA (1, 1, 1) model was most appropriate to model and predict monthly maternal cases with Akaike information criterion (AIC) value of 117.02 and Bayesian information criterion (BIC) value of 125.91. The Shapiro-Wilk normality test confirmed normality of the residuals. The Ljung-Box test on the residuals showed no serial correlation. The model was then validated based on the measures of accuracy. The results showed that the maternal mortality cases for the years 2000 to 2011 are high: minimum 3, median 11, mean 12 and maximum cases of 26 per month. The predicted mortality cases were 10 to 11 monthly for years 2012 to 2013, indicating that the target of MDG 5 could not be achieved by 2015. Fresh and perceptive strategies are urgently needed to arrest the unacceptably high death rates.展开更多
文摘Introduction: According to WHO, globally an estimated 585,000 women die each year from complications of pregnancy and childbirth. One of the targets of Millennium Development Goal 5 (MDG 5) is to reduce maternal mortality by three quarters of the 1999 value by the year 2015. However, three years to 2015, very little is known on the trends in maternal mortality ratio, causes of maternal deaths and their associated factors in the Tiko Cottage Hospital (TCH) and Limbe Regional Hospital (LRH) in the South-West Region, Cameroon. Methods: This was a retrospective, analytical cross-sectional study that was carried out from 1st January 2000 to December 2012. After obtaining ethical clearance, the records of cases of maternal deaths and a reference group of women who survived after a pregnancy during the same period were carefully reviewed. The data were analyzed with SPSS 10 and EPI 3.5.1. Results: There were 14,480 live births and 132 maternal deaths during the study period, giving an adjusted Maternal Mortality Ratio (MMR) of 892/100,000 live births. Patients’ age ranged from 15 - 40 years (SD 2.3). We observed a downwards trend of Maternal Mortality Ratio (MMR). Seventy-eight percent of the maternal deaths were due to direct causes. The triad of hemorrhage (54.5%), abortions (17.4%), and eclampsia (10.6%) was the leading cause of death. HIV-related complications and hepatitis constituted the main indirect causes of maternal death. In 85.4% of cases, maternal deaths were avoidable. Lack of blood for transfusion and late referral of cases were the main avoidable factors. Patients less than 35 years (p = 0.01), no antenatal care (ANC) (p = 0.001), unemployment [OR = 1.52;95% CI: (1.38 - 48.28);p = 0.02] were significantly associated with maternal deaths while grand multiparity [OR = 1.20;95% CI (0.30 - 4.86);p = 0.79], marital status [OR = 1.20;95% CI: (0.70 - 2.07);p = 0.51] and education level were not significantly associated with maternal deaths. Conclusion: The trend shows that there was no appreciable decline in maternal mortality, implying that attaining the objectives of MDG 5 is very unlikely. Therefore, to meet the MDG 5 target, we recommend that, there should be amelioration towards obstetric emergencies care and health education by health care providers.
文摘The Millennium Development Goal (MDG) 5 advocated the reduction of maternal mortality rates significantly by 2015, however, maternal mortality rates continue to rise. Here, we modelled maternal mortality data for the years 2000 to 2013 obtained from a public hospital in Kumasi, Ghana. We applied the Box-Jenkins approach of univariate form of time series autoregressive integrated moving average (ARIMA). The output revealed that the ARIMA (1, 1, 1) model was most appropriate to model and predict monthly maternal cases with Akaike information criterion (AIC) value of 117.02 and Bayesian information criterion (BIC) value of 125.91. The Shapiro-Wilk normality test confirmed normality of the residuals. The Ljung-Box test on the residuals showed no serial correlation. The model was then validated based on the measures of accuracy. The results showed that the maternal mortality cases for the years 2000 to 2011 are high: minimum 3, median 11, mean 12 and maximum cases of 26 per month. The predicted mortality cases were 10 to 11 monthly for years 2012 to 2013, indicating that the target of MDG 5 could not be achieved by 2015. Fresh and perceptive strategies are urgently needed to arrest the unacceptably high death rates.
