STATISTICAL ANALYSIS ON FACTORS AFFECTING MATERNAL MORTALITY (A CASE STUDY OF DUTSE GENERAL HOSPITAL) JIGAWA STATE

CHAPTER ONE

 1.1 INTRODUCTION

Maternal mortality remains alarmingly high in Nigeria, especially in the northern region and in the rural south. In 2005, the estimated total of global maternal deaths recorded was 536,000; developing countries, such as Nigeria, accounted for over 99 percent or 533,000 of the recorded deaths (WHO, 2007). While having only 2 percent of the world's total population, Nigeria accounted for 10 percent of the world's total maternal deaths in 2010. Nigeria's maternal mortality rate exceeds 1000 deaths per 100,000 live births and is much higher than the African continent average of 800 deaths per 100,000 live births (Zozulya).                                                                                           

High Maternal Mortality Rate (MMR) poses a serious danger to Nigeria, especially in the northern region and in the rural south. In 2013, there were an estimated 293,000 maternal deaths worldwide, with 99% of these occurring in low income countries like Nigeria.

While having only 2 percent of the world's total population, Nigeria accounted for 10 percent of the world's total maternal deaths in 2010. Nigeria's maternal mortality rate exceeds 1000 deaths per 100,000 live births and is much higher than the African continent average of 800 deaths per 100,000 live births [2].As defined by [3], MMR is a death of a woman during pregnancy or within 42 days after birth, remains a major global health problem. Nigeria is one of the six countries that together contribute more than 50% of the total maternal deaths worldwide, reductions in the maternal mortality ratio has always been incompatible. The most recent national data estimates the MMR for Nigeria to be 576 deaths per 100,000 live births (95% CI: 500–652) [4]. Previous estimates of MMR in Nigeria ranged from 608 deaths per 100,000 live births (95% CI: 372–946) in 2008, to 473 deaths per 100,000 live births (95% CI: 360–608) in 1990 [4]

Jigawa state is a northwestern state in Nigeria with 4.3 million inhabitants during the 2006 Census [5], it is situated between the latitudes 11.00N to 13.00N and longitudes 8.00E to 10.15E. Jigawa state in particular, also records high number of maternal mortality rate (MMR) in the Nigeria.

1.2 HISTORICAL BACKGROUND OF THE STUDY AREA       

The Hospital was established in 1972 as Dutse comprehensive Health Centre by old kano state. The CHC was on 8^th August, 1985 converted to Dutse General Hospital and commissioned by military government of kano state. Dutse general hospital located in Dutse metropolitan along kiyawa road, Dutse. It covers an area of 500m 800m and it currently has 200 bed capacities, secondary Health facility serving as referral centre of all PHCs in Dutse and kiyawa local government areas.

It also provide avenue for other neighbouring settlement in kano and Bauchi.Thus, the Hospital centre for the health care access 58.58 total catchment population consisting of 2.343 under 1year children, 11.716 children less than 5years, 2.929 pregnant women and 12.888 of child bearing age.

Human resource for Health of the General Hospital is made up of 76 Nurses, 5 Jchews, 23 Chews, 5 Midwives, 3 Combew, 5 Health Information Technicians, 4 Health Information Officers, 2 Pharmacist, 7 Pharmacy Technicians Radio Legists, 4 Xray technicians, 3 Physiotherapist Laboratory scientist, 15 Medical Technicians, 5 Medical Laboratory assistant, 1 Dental Therapist, 6 Dental Technicians, 3 Environmental officers, 10 Medical Doctors, 103 Health attendants and 93 casual staffs including NYSC.

General out patient accident and emergency, medical Laboratory, TB DOTS, Routine Immunization, Ultra sound scanning, Gynaecology X ray Censing and Testing of HIV/AIDS, Health Information and record keeping dental, Environmental sanitation welfare, Laundry, accounting and General Administration registry.

1.3 STATEMENT OF THE RESEARCH PROBLEMS

 Jigawa state is among the states hit by high maternal mortality and inadequate data on maternal mortality rate has posed a set back to the level of interventions on maternal mortality in the state. according to 2006 population census, the north western states which includes Jigawa, Katsina, Kebbi, Sokoto, Zamfara and Kano states in Nigeria had generally poor maternal and child health indicators for example a maternal mortality ratio (MMR) of over 1000 deaths per 100,000 live births which is significantly higher than the national average. this has not significantly improved according to a study by Henry, (2012) which puts the ratio at 1271 maternal deaths per 100,000 live birth.

High Maternal Mortality Rate (MMR) poses a serious danger to Nigeria, especially in the northern region and in the rural south. In 2013, there were an estimated 293,000 maternal deaths worldwide, with 99% of these occurring in low income countries like Nigeria. There is not much improvement towards curving the MMR, despite several efforts made by the government and many more interventions by international and national NGOs. The problems facing the health sectors includes are; low income, high rate of poverty, low literacy level leading to unhealthy life style and inappropriate health seeking behavior, shortage and mal distributions of health, professionals and socio –cultural beliefs. This research tends to identify the most significant factors associated to maternal mortality in particularly in Dutse Local Government Jigawa state.

1.4 AIM AND OBJECTIVES OF THE STUDY

The aim of this research is to analyze the factors affecting maternal mortality in Dutse General Hospital Jigawa state.

The objectives are;

1.      To determine whether there is significant different of education level on maternal mortality cases.

2.      To determine whether there is significant different of level of age on maternal mortality cases.

3.      To identify the impact of level of education, age and anti natal care attendance on maternal mortality cases.

1.5 SIGNIFICANCE OF THE STUDY

This study gives an insight into to the Government, individuals, organizations and the public in general with information on the impact of maternal education, maternal age at birth and antenatal care attendance on maternal mortality.

organizations to understand the causes and risk factors of maternal mortality rates in Dutse Local The research findings would be used by the communities, governments and non-governmental Government. This knowledge will enable them to device mechanisms of mitigating through financial facilitations, policies that address the problem and any other forms of support.

1.6 SCOPE AND LIMITATION OF THE STUDY        

This specifies the boundaries of the research work as follows:

The study restricted to the General Hospital Dutse and the data collection was carried out from 2015 – 2020 on monthly basis.

The issues covered in the research work is the risk factor model of maternal mortality through which maternal education, maternal age at birth and antenatal care are considered and to see if there is relationship between them.

Factors considered in the research work are maternal mortality, maternal age at birth, maternal education, and antenatal care attendance.

1.7 HYPOTHESIS

H_o: There is no significant relationship between maternal mortality and maternal education.

Hi: There is significant relationship between maternal mortality and maternal education.

H_o: There is no significant impact between maternal mortality and maternal age at birth.

Hi: There is significant impact maternal mortality and maternal age at birth.

H_o: There is no significant influence between maternal mortality and antenatal care attendance.

Hi: There is significant influence between maternal mortality and ante natal care attendance.

1.8 DEFINITION OF TERMS

Maternal mortality: refers to the deaths due to complications from pregnancy or childbirth.

Multiple regression: is a set of statistical processes for estimating the relationship between a dependant (outcome variable) variable and one or more independent variables (predictors).

Antenatal care: Antenatal or pregnancy care is the Healthcare and support you have while you are pregnant.

Maternal education: Maternal education directly corresponded with the number of years mothers spent in school.

Dummy variable: A dummy variable is a numerical variable used in regression analysis to represent subgroups of the sample in the study.

Maternal age at birth: Maternal age is the instance of woman being an older age at a stage of reproduction.

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