Submission ID 118193
| Issue/Objective | Maternal deaths are a global concern however, their burden is huge in low and middle income countries. Mangochi District Hospital in rural Malawi continues to experience increased maternal mortality rates despite implementing safe motherhood initiatives. This study was conducted to determine the association of Thaddeus and Maine's three delays model of care and Maternal deaths at Mangochi. |
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| Methodology/Approach | A quantitative retrospective case control design was employed. The population comprised reports of 33 cases and 169 maternal near misses as controls which occurred between January and December 2022. Convenience sampling was used to select a sample of 132 (33 maternal deaths and 99 maternal near misses matched on a ratio of 1:3. |
| Results | Bi-variable analysis revealed that age and gravidity were associated with maternal deaths (p<0.05). Type 3 delay contributed the most maternal deaths from inadequate midwifery skills (23.47%) distantly followed by shortage of essential obstetric drugs (15.15%) leading to incomplete initial assessment (41.70%) distantly followed by inadequate monitoring (23.70%). On multivariable analysis, age and gravidity were still associated with MDs. Women with delay 1, delay 2 and delay 3 had 4.72, 4.16 and 4.27 times chances of dying, respectively (p=<0.05). Women experiencing any delay at any level (OR=5.71, 95% CI: 1.62-20.05) had 5.71 times chances of dying. |
| Discussion/Conclusion | In 2022, maternal healthcare was overall suboptimal. Maternal deaths at Mangochi District Hospital predominantly resulted from delay 3 from health workers possessing inadequate midwifery skills and the hospital's not stocking adequate essential obstetric drugs. |
| Presenters and affiliations | Wyness Gondwe Kamuzu University of Health Sciences Wyness Gondwe Kamuzu University of Health Sciences Clophat Baleti Mangochi District Hospital Ruth Phiri Mangochi District Hospital Doris Kajanga Malawi College of Health Sciences |
