Age Related Factors and Other Social Determinants That Influence Maternal Deaths at Two Expansive Slums in Nairobi Kenya
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Background; Approximately 830 women die every day from complications related to child birth or pregnancy globally. It is projected that 99% of these deaths mostly occur in low-resource settings. In Kenya, according to the Population Reference Bureau 2015, maternal mortality ratio was estimated at 362 per 100,000 live births. The causes of maternal mortality in Kenya are well comprehended but there is little information as to whether the patterns or trends for causes of maternal deaths among older women are the same as for adolescence girls. Objective; This particular study sought to determine the influence of mothers’ age and other social determinants on the occurrence of adverse pregnancy outcomes (maternal deaths) at the two expansive slums in Nairobi (Viwandani and Korogocho). Study Methodology; The study employed a retrospective study design to identify cases of mothers who had died as a result of maternal deaths from the Nairobi Urban Health and Demographic Surveillance System (NUDHSS) program database run by African Population and Health Research Center (APHRC). A study approval was obtained from KHN-UoN Research Ethics and Research Committee and APHRC as an institution. A sample size of 80 maternal deaths was retrieved using simple random sampling from the secondary data obtained from the NUDSS project between the years 2003 – 2015. The extracted data was the entered into Microsoft Excel, coded using standard coding system, processed and analyzed using IBM SPSS V 25.0 Statistical software. The quantitative data were then analyzed using the descriptive statistics and logistic regression models Results; Several causes of maternal deaths were identified, the leading cause was delivery complication (38.8%), pre-term delivery (15.0%), HIV (12.5%), abortion (10.0%), post-partum delivery (8.8%) and the least was puerperal sepsis (5.0%). In terms of cause by age there was a significant association between age and pre term delivery as a cause of maternal mortality. Participants who were aged between 15-19 years were about 6 times more likely to die due to preterm birth as compared to those aged 20-44 years (O.R=5.92; 95% C.I. 1.62-21.67; p=0.007). No significant associations were observed in terms of age with other causes. Participants who had pre-existing conditions were 12.571 times more likely to die of post-partum hemorrhage as compared to those without pre-existing conditions (57.1% vs 9.6%); (O.R. 12.571, 95% C.I. 2.325-67.964; p=0.003). Conclusions; The conclusion is that possible causes of maternal deaths affects women of all age groups but some are more prominent amongst certain age groups. More sensitization therefore needs to be done to the women and girls of reproductive age on the possible causes of maternal deaths and how they can work round to combat them. The health facilities also need to be supported with enough medical personnel to assist the mothers during their pregnancy phase and post natally.
University of Nairobi
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