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Facility-Based Maternal Death Review In Three Districts In The Central Region of Malawi : An Analysis of Causes and Characteristics of Maternal Deaths

Kongnyuy, Eugene J., Mlava, G. and Van Den Broek, Nynke ORCID: (2009) 'Facility-Based Maternal Death Review In Three Districts In The Central Region of Malawi : An Analysis of Causes and Characteristics of Maternal Deaths'. Womens Health Issues, Vol 19, Issue 1, pp. 14-20.

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Purpose. We sought to determine the causes and characteristics maternal deaths that occur in health facilities in Malawi. Methods. Forty-three maternal deaths were reviewed in 9 hospitals in 3 districts in Central Malawi over a 1-year period. Causes and avoidable factors of maternal deaths were identified during the review, and recommendations made and implemented. Main Findings. There were 28 (65.1%) direct obstetric deaths and 15 (34.9%) indirect obstetric deaths. The major causes of maternal deaths were postpartum hemorrhage (25.6%), postpartum sepsis (16.3%), HIV/AIDS (16.3%), ruptured uterus (7.0%), complications of abortion (7.0%), anemia (7.0%), antepartum hemorrhage (4.7), and eclampsia (4.7). Two thirds of the women were referred either from another health facility (51.2%) or by a traditional birth attendant (TBA; 11.6%), and up to 79.1% were critically ill on admission. Four groups of factors that contributed to maternal deaths were identified: 1) health worker factors, 2) administrative factors, 3) patient/family factors, and 4) TBA factors. The major health worker factors were inadequate resuscitation (69.8%), lack of obstetric life-saving skills (60.5%), inadequate monitoring (55.8%), initial assessment incomplete (46.5%), and delay in starting treatment (46.5%). The most common administrative factor was lack of blood for transfusion (20.9%). The major problems encountered include shortage of staff and other resources, difficulty in maintaining anonymity, poor quality of data, and difficulty in implementing recommendations. Conclusion. Adequate training on obstetric life-saving skills, addressing HIV/AIDS, and raising community awareness could be important factors for reducing maternal mortality in Malawi and countries with similar socioeconomic profiles.

Item Type: Article
Subjects: WQ Obstetrics > Labor > WQ 330 Complications of labor
WQ Obstetrics > Pregnancy Complications > WQ 240 Pregnancy complications (General)
WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare
Faculty: Department: Groups (2002 - 2012) > Child & Reproductive Health Group
Digital Object Identifer (DOI):
Depositing User: Users 19 not found.
Date Deposited: 14 Jun 2010 15:35
Last Modified: 17 Jul 2020 10:58


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