Review of Maternal Deaths Audit in Effia Nkwanta Regional Hospital in the Western Region

Abstract

Review of maternal mortality is one of the most effective methods to improve the performance of health workers and it could bring about changes to reduce maternal mortality. Ghana recorded 3,100 maternal deaths in 2013.The Western Region recorded 85 maternal deaths per 100,000 live births and Effia Nkwanta Regional Hospital recorded 24 maternal deaths out of 2,788 deliveries in 2013 giving a maternal mortality ratio of 717/ 100,000 live births. The hospital also recorded 32 maternal deaths at the end of 2014 showing an increasing trend in maternal mortality. The study was aimed at determining the factors that contributed to the 24 avoidable maternal deaths in the Effia Nkwanta Regional Hospital and to identify challenges associated with the use of maternal death audit guideline forms by health care providers. Data was collected from existing hospital record system using a data extraction sheet. Interviews were also conducted with health care workers who manage cases of maternal deaths from January to December 2013 using a questionnaire. Data was analyzed using SPSS Version 20. The descriptive variables of interest were computed and chi square test was used to ascertain whether there was a significant level of dependency between the variables of interest. A logistic regression was performed to ascertain the effect of place of residence, age of mother, parity, avoidable factors, antenatal care and education in the likelihood that the cause of death will be either direct or indirect. The logistic regression model was statistically significant for p value < 0.05. The findings of this review showed that most of the maternal deaths resulted from direct causes occurring in rural setups. From the direct causes of maternal deaths, eclampsia was the leading cause of death 9 (37.5%), followed by haemorrage 4 (16.7%), uterine rapture 3 (12.5%), unsafe abortion 2 (8.3%), and ectopic pregnancies 2 (8.3%) and 4 (16.7%) constituted indirect causes of death. Place of residence, parity, level of education and age were associated with cause of maternal deaths. The study also indicated that the main challenge in the use of maternal audit forms by health providers was due to busy work schedules. There is therefore a need to intensified Health promotion and education activities in the region and maternal audit guidelines forms should be reviewed and made simpler for health care providers.