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Almost 9 in 10 maternal deaths could be prevented, Zimbabwe study shows.


 The University of Zimbabwe and two universities in Sweden conducted a study in Masvingo Province in Zimbabwe to examine maternal deaths. There were 168 and 85 maternal deaths per 100,000 live births in rural and urban areas, respectively. 90% and 85% of maternal deaths in rural and urban areas, respectively, were preventable. Mother-related preventable factors were no prenatal care, lack of social support, and delay in seeking help. Traditional birth attendant-related preventable factors were delay in referring mother to health care, inability to understand the severity of the complication, and administration of the wrong treatment. Local clinic-related preventable factors included inadequate resources, poor communication, and poor training of health care staff. Hospital-related preventable factors were delayed treatment, wrong diagnosis, wrong treatment, no supplies, and inadequate skills. Lack of prenatal care was common among many women who died from pregnancy- or childbirth-related complications. More than 33% of maternal deaths in rural areas occurred because there were no means for transport to the nearest clinic or hospital. Women who were single, divorced, separated, or self-supporting during pregnancy were more likely to die due to lack of social support. Other risk factors were high rate of unwanted pregnancies, age 35 or above, previous fetal death or miscarriage, and parity 7 or above. The leading causes of maternal death in rural areas included hemorrhage (25%), sepsis after unsafe abortion (15%), and puerperal sepsis (13%). In urban areas, they were eclampsia (26%), sepsis after unsafe abortion (23%), puerperal sepsis (15%), and hemorrhage (10%). 50% of the maternal deaths occurred outside of a health facility. More than 50% had already delivered 5 times. Recommendations to reduce maternal deaths were community-based health education on the risk factors of pregnancy and childbirth, improved health facilities, better training of health personnel, and improved family planning programs.
