Severe acute maternal morbidity and associated deaths in conflict and post-conflict settings in Africa
The objectives of this study were to report on the deliveries among five hospitals in four conflict and post-conflict countries (Democratic Republic of Congo, Somaliland, Sierra Leone and Burundi) with regard to: 1- the proportion of severe acute maternal morbidity (SAMM), 2- the pattern of SAMM, and 3- maternal deaths according to type of SAMM. An audit was conducted of data from a standardised database implemented in all the sites in the study. The results showed that of the 18 675 deliveries, there were 6314 (34%) known SAMM cases with 63 associated deaths, implying that for every 100 SAMM cases there was one maternal death. In descending order, the death-to-SAMM ratios per 1000 deliveries were: 1:7 for sepsis, 6 for haemorrhage 1:70 for hypertensive disorder and 1:398 for obstructed labour. A substantial proportion of deaths (38%) that occurred in hospitals could not be categorised into the standardised SAMM conditions available in the database. It was concluded that as this is the first study using multi-centre data from conflict and post-conflict countries, these findings are relevant to improving maternal health in such settings. Findings, implications and possible ways forward in addressing various challenges are discussed.
Tamura, M.; Hinderaker, S. G.; Manzi, M.; Van den Bergh, R.; Zachariah, R. Severe acute maternal morbidity and associated deaths in conflict and post-conflict settings in Africa. Public Health Action (2012) 2 (4) 122-125.