Maternal mortality at the Queen Elizabeth Central Teaching Hospital, Blantyre, Malawi.

BACKGROUND

Maternal mortality in Malawi continues to increase despite the global SMI and national safe motherhood programme's efforts to reduce it.

OBJECTIVES

To identify the social, demographic and reproductive profiles of women suffering a maternal death, the main immediate causes and the operational factors.

DESIGN

A retrospective descriptive survey.

SETTING

The Gogo-Chatinkha Maternity Unit, Queen Elizabeth Central Hospital, Blantyre, Malawi, from January 1, 1999 to December 31, 2000.

SUBJECTS

All women who suffered a maternal death in the unit.

RESULTS

There were a total of 204 maternal deaths and 19,859 live births, giving a Maternal mortality ratio (MMR) of 1027.2/100,000 live births. Their ages ranged from 16 to 40 years. Adolescents comprised 20.6%, while the majority, (56.4%), were aged 15 - 24 years. Almost half of the group, (43.4%), were para 1 and less, with a range of 0 to 12. The top five causes of death were puerperal sepsis, (29.4%); postabortal complications, (23.5%); other infectious conditions, (20.1%); obstetric haemorrhage, (10.6%), and eclampsia, (6.4%). Some of the identified operational factors included delay in accessing and receiving emergency obstetric care, poor quality services, HIV infection/ AIDS and unsafe induced abortion following unwanted pregnancy.

CONCLUSION AND RECOMMENDATIONS

Most of the causes and operational factors for maternal deaths are easily avoidable. The country needs to make more commitment and investments necessary to mitigate these deaths.