ABSTRACT
UNFPA estimated that 303,000 women died of pregnancy or childbirth related causes in 2015.causes’ ranges from severe bleeding to obstructed labor for which there are highly effective interventions. This study aims to find out the factors responsible for high rate of maternal mortality in study area, the study adopted a descriptive designed, based on finding of this research work, it was observed that obstructed labor 37.5% and anemia 28% where the major contributing to maternal mortality in the facility and then followed by eclampsia 18.8% followed by sepsis and postpartum hemorrhage 6.3% which has the lowest percentage of total maternal death. Moreover, mothers between the range of 15-25 years have the highest percentage of 56% followed by those between the 36-49 years with 25% appeared to be age group, low percentage based on parity, grand multigravida had the highest percentage (40.6%) followed by primigravida with 37.5% and then multigravida 21.9% have the low percentage of total maternal death. However, based on the result of the study the researcher suggested that government should intensify and enlighten campaign on the importance of antenatal visit, the government should also establish and encourage premarital test and counselling unit for intending couples as well as provision of adequate manpower in health facilities of the state. In view of the findings of this research work the following recommendations are proposed; a) Government should create basic obstetric and emergency unit in some of the primary health care settings, b) to establish and encourage premarital test and counselling unit for intending couples in the area, c) government should provide adequate man power in the facilities of the states and d) government should review and support poverty alleviation programs as well as a roll back malaria programs as to curtail the occurrence of malaria disease especially in pregnant mothers.
TABLE
OF CONTENT
PRELIMNARY
PAGES
TITLE
PAGE…………………………………………………………………………………. I
CERTIFCATION PAGE…………………………………………………………...…………
II
APPROVAL PAGE……………………………………………………………………...……III
DEDICATION
PAGE……………………………………………….………………………. IV
ACKNOLEDGEMENT
PAGE………………………………………………………………. V
TABLE
OF CONTETENT…………………………………………………………………. VI
ABSTRACT
……………………………………………………………………………….. VII
CHAPTER
ONE
INTRODUCTION
1.1BACKGRAUND
OF THE STUDY ………………………………………………………… 1
1.2
STATEMENT OF THE PROBLEMS………………………………………………………. 2
1.3
OBJECTIVES OF THE STUDY…………………………………………………………… 3
1.4
RESEARCH QUESTIONS…………………………………………………………………
3
1.5
SIGNIFICANT OF THE STUDY…………………………………………………………… 4
1.6
SCOPE/DELIMITATION OF THE STUDY ………………………………………………...5
1.7
OPERATIONAL DEFINITIONS OF TERMS ……………………………………...……… 5
CHAPTER
TWO
LITERATURE
REVIEW
2.2
CONCEPTUAL REVIEW. ………………………………………………………………… 11
2.2.1 THE MAJOR FACTORS MATERNAL MORTALITY ……………...…………………12
2.2.2MATERNAL
SEPSIS ………...…………………………………………………………... 13
2..2.3
UNNSAFE ABORTION………………………………………………………………….14
2.2.4
OBSTRUCTED LABOR …………………………………………….………………… 15
2.2.5
ECLAMPSIA…………………………………………………………………………… 16
2.2.6
POVERTY ………………………………………………………………………………17
2.2.7
THREER DELAYS MODEL…………………………………………………………... 20
2.4
THEORITICAL REVIEW………………………………………………………….……. 22
2.5
EMPIRICAL REVIEW ……………………………………………………………………25
CHAPTER
THREE
RESEARCH
METHODOLOGY
3.1RESEARCH
DESIGN……………………………………………………………………... 26
3.2
RESEARCH SETTING…………………………………………………………………… 28
3.3
TARGET POPULATION…………………………………………………………………..28
3.4
SAMPLING SIZE DETERMINATION……………………………………………………29
3.5
SAMPLING TECHNIQUE…………………………………………………………………30
3.6
INSTRUMENT FOR DATA COLLECTION…………………………………………….. 31
3.7
VALIDITY OF INSTRUMENT………………………………………………………..….. 31
3.8
RELIABILITY OF INSTRUMENT……………………………………………………….. 32
3.9
METHOD OF DATA COLLECTIN………………………………………………….…… 33
3.10
METHOD OF DATA ANALYSIS………………………………………………………. 34
3.11ETHICAL
CONSIDERATION…………………………………………………………… 35
CHAPTER
FOUR
DATA
ANALYSIS AND RESULTS PRESENTATIONS
4.1
DISCUSSION…...………………………………………………………………………… 36
4.2
TABLE SHOWING……………………………………………………………………….. 37
4.3.
THE PREVALENCE OF MATERNAL MORTALITY …………………………………. 38
4.4
ANSWERING RESEARCH QUESTION ………………………………………………….39
CHAPTER
FIVE
SUMMARY,
CONCLUSION AND RECOMMENDATION
5.3
LIMITATION OF THE STUDY…………………………………………………………… 41
5.4 SUMMARY …………………………………………….…………………………………..41
5.5
RECOMMENDATION…………………………………………………………………….. 42
5.6
SUGGESTIONS FOR FURTHER ………………………………………………………….42
5.7
QUESTIONS NEAR……………………………………………………………………….. 42
5.8
REFERENCE……….……………………………………………………………………… 43
CHAPTER ONE
INTRODUCTION
1.1 Background of The Study
According to World Health Organization [WHO] maternal mortality
is the death of a woman while pregnant or within 42 days of termination of pregnancy,
irrespective of the duration and the site of the pregnancy from any cause related
to or aggravated by the pregnancy or its management but not from accidental or in
incidental causes.
By 2017 the world maternal mortality rate had declined
to 44% since 1990, but still every day 830 women die from pregnancy or child birth
related causes. According to the United Nation Population Funds Association (UNPFA)
2017 report, this is equivalent to one Woman every 2 minutes and for every Woman
who dies 20 or 30 encounters complications with series or long-lasting consequences,
most of these injuries and deaths are preventable.
UNFPA estimated that 303,000 women died of pregnancy or
childbirth related causes in 2015.causes’ ranges from severe bleeding to obstructed
labor for which there are highly effective interventions. As women have gained access
to family planning and skilled birth attendants with backup emergency obstetric
care, the global maternal mortality ratio has fallen from 385 maternal deaths per
100,000 live births in 2015 and many countries halved their maternal mortality death
rates in the last 10 years.
Although attempts
have been made in reducing maternal mortality there is much room for improvement
particularly in impoverished regions. Over 85% of the maternal deaths are from impoverished
communities in Africa and Asia. The effect of the mothers’ deaths results to vulnerable
families.
According to WHO (2017) maternal mortality is unacceptably
high, about 295,000 women died during and following pregnancy and child birth in
2017. The vast majority of these deaths (94%) occurred in low resources setting
and must be prevented. Sub Saharan Africa and Southern Asia accounted for approximately
86% (254,000) of the estimated global maternal deaths in 2017. Sub Saharan Africa
alone accounted for roughly two thirds (196,000) 0f maternal deaths while Southern
Asia accounted for nearly one fifth (58000), the study shows that, Africa has the
highest maternal mortality ratio with an estimate average of 800 dies per every
100,000 births. Africa alone accounted for roughly two thirds [196,000] of maternal
deaths.
In 2017 according
to the fragile states index 15 countries were considered to be “very high alert”
or “high alert” being a fragile state. (South Africa, Somalia, Central Republic,
Yemen, Syria, Sudan, the Democratic republic in Congo, Chad, Afghanistan, Iraq,
Halti, Guinea Zimbabwe, Nigeria and Ethiopia) are among the 15 high alert countries.
Maternal mortality rate in Nigeria however is 1000 for
every 100,000 births, but this figure varies according to regions of the country.
Maternal mortality is higher in the northern region of the country accounting for
75% of the country`s maternal death compared to the South East and South West regions.
After India Nigeria has the second highest maternal death in the world, 52,000 women
die every year. Unsafe practices of the child birth causes an average death of 144
Nigerian women; this means that every 10minutes one of the Nigerian women dies due
to child birth and pregnancy related causes. This means that out of 25millions of
women of child bearing age or reproductive age about 2millions of women will not
survive either pregnancy or child birth. Maternal mortality persists in Nigeria
despite strategies like the promotion of institutional deliveries, training and
deploying new skilled health workers in the year 1987, the world bank in collaboration
with WHO and UNFPA sponsored a conference on safe motherhood initiative which issued
an international call to action in the reduction of maternal mortality. In 1990
safe motherhood initiative was adopted in Nigeria Abuja.
Jigawa state has an extremely high maternal mortality ratio;
study was done to estimate the lifetime risk [LTR] of maternal death and the maternal
mortality ratio [MMR] in Jigawa state Northern Nigeria using the sisterhood method,
through interview with 7,069 women aged 15-49 in 96 randomly selected clusters of
communities in 27 local government areas (LGA) across Jigawa state were conducted.
A retrospective cohort of their sisters of reproductive age was constructed to calculate
the lifetime risk of maternal mortality using the most recent estimate of total
facility for the state the MMR was estimated. The result was; 7,069 respondents
reported 10,957 sisters who reached reproductive age, of the 1,026 deaths in these
sisters 300 (29.2%) occurred during pregnancy, childbirth or within 42 days of termination
of pregnancy [Nigeria Demographic and Health Survey, 2013].
Therefore, Jigawa state has an extremely high maternal
mortality ratio undergoing the urgent need for health systems improvement and intervention
to accelerate reductions in MMR, [NPC and NDHS 2014].
Birnin Kudu is one of the local government areas of Jigawa
state that has high maternal mortality rate of 19 [33.9%] therefore there is need
for health systems improvements and interventions to decrease MMR (NPC 2014).
1.2 Statement of the Problem
Combating maternal mortality is a global problem that demands
policies, commitment, strategy formulation and implementation and improvement of
health care service delivery. [WHO 2013]
It has been observed that the prevalence of maternal mortality
remains high in Nigeria especially in northern state and Jigawa being one of them.
It also has a ravaging effect among resident of Kantoga Village of Birnin Kudu local
Government, Jigawa State. This may be due to lack of understanding of factors contributing
to maternal mortality (I.H MIGA 2018).
The researcher sets to find out the factors influencing
death of women during pregnancy, child birth and puerperium that occurred in the
Kantoga health facility.
1.3 Objectives
of the Study
- To find out the factors
contributing maternal mortality in Kantoga health facility
- To find out the prevalence
of maternal mortality among age group, religions, occupation, parity and ethnics
groups.
- To find out the age groups
mostly affected with maternal mortality at Kantoga health facility.
1.3 Research Questions
1. What are the factors influencing maternal mortality
in Kantoga community?
2. What is the prevalence of maternal mortality among age
group, religious, occupation, parity and ethnics groups?
3. What are the ways of reducing factors contributing to
maternal mortality
1.5 Significances
of the Study
The findings of this research work will
specially benefit pregnant mothers attending ante natal services in primary
health care Kantoga, Birnin Kudu Local Government Jigawa State.
The result of this study would serve as an eye
opener to workers of the community in their process of health education during
antenatal services and home visit to guide these mothers on early recognition
of anemia and the prevention of complication of such condition.
Furthermore, this research will be of immense
benefit to other researchers in same field in obtaining information and review
literature
1.6 Scope of the Study
The scope of the study is limited to find out the factors
that contributed to maternal mortality among women in Kantoga health facility,and
the study will be limited to woman of child bearing age with pregnancy related complications.
1.7 Operational Definition of the Terms
1. Antenatal Care: is a care provided by the health professionals
during pregnancy to ensure fetal and maternal health satisfactory.
2. Maternal: Relating
to the mother.
3. Mortality: The state of been susceptible to death.
4. Obstetric: Is a branch of medicine that deals with the
birth of the children and with the care of women before, during and after they give
birth to children.
5. Postpartum Hemorrhage:
This is excessive bleeding from vagina at any time following the birth of the baby
up to 6 weeks after delivery.
6. Pregnancy: Is a physiological change that occurs in
a woman from conception to birth.
7. Puerperium: Refers
to the six weeks periods following childbirth, in which reproductive organs returns
to pre-pregnancy size.
8. Gynecology: Is a branch of medicine that deals with
the diseases and routine physical care of the reproductive system of women.
9. Incidence: The number of particular new event which
occurs in population at a given period of time.
10. Maternal Hemorrhage: Is a bleeding through the genital
erect by a mother which encompasses before delivering during delivery and after
delivery.
11. Postinatal Care: Is a care provided by health professional
to a woman after birth.
12.Factor:is anything that
contribute to result.
13.Assessment:is the process
of reviewing something
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