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Attainment of the Fifth Millennium Development Goal: Utopia or Reality Based on Trends in Maternal Mortality in 12 Years in Two Regional Hospitals in Fako Division, Cameroon? A Retrospective Study

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DOI: 10.4236/ojog.2014.413107    2,528 Downloads   3,006 Views   Citations

ABSTRACT

Introduction: According to WHO, globally an estimated 585,000 women die each year from complications of pregnancy and childbirth. One of the targets of Millennium Development Goal 5 (MDG 5) is to reduce maternal mortality by three quarters of the 1999 value by the year 2015. However, three years to 2015, very little is known on the trends in maternal mortality ratio, causes of maternal deaths and their associated factors in the Tiko Cottage Hospital (TCH) and Limbe Regional Hospital (LRH) in the South-West Region, Cameroon. Methods: This was a retrospective, analytical cross-sectional study that was carried out from 1st January 2000 to December 2012. After obtaining ethical clearance, the records of cases of maternal deaths and a reference group of women who survived after a pregnancy during the same period were carefully reviewed. The data were analyzed with SPSS 10 and EPI 3.5.1. Results: There were 14,480 live births and 132 maternal deaths during the study period, giving an adjusted Maternal Mortality Ratio (MMR) of 892/100,000 live births. Patients’ age ranged from 15 - 40 years (SD 2.3). We observed a downwards trend of Maternal Mortality Ratio (MMR). Seventy-eight percent of the maternal deaths were due to direct causes. The triad of hemorrhage (54.5%), abortions (17.4%), and eclampsia (10.6%) was the leading cause of death. HIV-related complications and hepatitis constituted the main indirect causes of maternal death. In 85.4% of cases, maternal deaths were avoidable. Lack of blood for transfusion and late referral of cases were the main avoidable factors. Patients less than 35 years (p = 0.01), no antenatal care (ANC) (p = 0.001), unemployment [OR = 1.52; 95% CI: (1.38 - 48.28); p = 0.02] were significantly associated with maternal deaths while grand multiparity [OR = 1.20; 95% CI (0.30 - 4.86); p = 0.79], marital status [OR = 1.20; 95% CI: (0.70 - 2.07); p = 0.51] and education level were not significantly associated with maternal deaths. Conclusion: The trend shows that there was no appreciable decline in maternal mortality, implying that attaining the objectives of MDG 5 is very unlikely. Therefore, to meet the MDG 5 target, we recommend that, there should be amelioration towards obstetric emergencies care and health education by health care providers.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Ekane, G. , Obinchemti, T. , Tchente, C. , Fokunang, L. , Njamen, T. , Bechem, N. , Njie, M. and Latum, D. (2014) Attainment of the Fifth Millennium Development Goal: Utopia or Reality Based on Trends in Maternal Mortality in 12 Years in Two Regional Hospitals in Fako Division, Cameroon? A Retrospective Study. Open Journal of Obstetrics and Gynecology, 4, 771-781. doi: 10.4236/ojog.2014.413107.

References

[1] Rosenfield, A. and Maine, D. (1987) Maternal Health in Third World. Lancet, 1, 691-197.
http://dx.doi.org/10.1016/S0140-6736(87)90461-2
[2] Hill, K., AbouZahr, C. and Wardlaw, T. (2001) Estimates of Maternal Mortality for 1995. Bulletin of World Health Organization, 79, 182-193.
[3] Priya, A. and Van Den Broek, N. (2009) Priorities in Obstetrics and Gynaecology in the Developing World Obstetrics. Gynaecology and Reproductive Medicine, 19, 197-200.
http://dx.doi.org/10.1016/j.ogrm.2009.03.006
[4] Carine, R., Wendy, J. and Graham, D. (2006) Maternal Mortality: Who, When, Where, and Why. The Lancet, 368, 1189-1200. http://dx.doi.org/10.1016/S0140-6736(06)69380-X
[5] United Nations (2010) United Nations Millennium Development Goal Report. United Nations, New York.
[6] FMSB (1997) Nkigoum. Mortalite Maternelle au CHU de Yaounde: Etude Retrospective de 1988-1997. These de Doctorat en Medecine, FMSB, Yaounde.
[7] Tebeu, P.M., Ngassa, P., Kouam, L., Major, A.L. and Fomulu, J.N. (2007) Maternal Mortality in Maroua Provincial Hospital, Cameroon (2003-2005). West Indian Medical Journal, 56, 502.
[8] United Nations (2011) Millennium Development Goal Report. United Nations, New York.
[9] United Nations Children Fund (UNICEF) (2010) The State of World Children: Maternal and New Born Health. United Nations, New York.
[10] World Health Organization (1993) International Statistical Classification of Diseases and Related Health Problems. 10th Revision, WHO, Geneva.
[11] Mafany, N., Mati, J.K.G. and Nasah, B.T. (1990) Maternal Mortality in South West Region Cameroon (1982-1987). Annales Universitaire de Sante, CUSS Yaounde, 7, 52-59.
[12] Fomulu, J.N., Tchana, T.M., Nana, N.P., Mbu, R. and Kasia, J.M. (2008) Mortalité maternelle à l’h?pital général de Yaoundé: Etude rétrospective sur 5 années (2002-2006). Health Sciences and Disease, 10, 86-92.
[13] Doh, A.S., Nasah, B.T. and Kamdom-Moyo, J. (1991) The Outcome of Labor at the University Teaching Hospital (CHU), Yaoundé, Cameroon. International Journal of Gynecology and Obstetrics, 36, 195-201.
[14] Fomulu, J.N., Tiyou, K.C., Mbu, R.E., Nana, N.P. and Leke, R.J. (2009) Mortalité maternelle à la Maternité Principale de Yaoundé: Etude rétrospective de 2001 à 2006. Health Sciences and Disease, 9, 5-10.
[15] Agan, T.U., Archibong, E.I., Ekabua, J.E., Ekanem, E.I., Abeshi, S.E., Edentekhe, T.A. and Bassey, E. (2010) Tends in Maternal Mortality in the Calabar Teaching Hospital, Nigeria 1999-2009. International Journal of Women’s Health, 2, 249-245.
[16] Nasah, B.T., Leke, R.J., Doh, A.S., Moyo, J.K., Fomulu, J. and Njikam, O.M. (1999) The Risk Approach for Reducing Maternal Mortality: The Yaoundé Experience. International Journal of Gynecology & Obstetrics, 13, 195-201.
[17] Ministry of Public Health (2006) Advocacy for Education of Maternal Mortality in Cameroon. UNFPA, Yaounde.
[18] Zakariah, A.Y., Alexander, S., Van Roosmalen, J., Buekens, P., Kwawukume, E.Y. and Frimpong, P. (2009) Reproductive Age Mortality Survey (RAMOS) in Accra, Ghana. Reproductive Health, 6, 7.
[19] Gabriel, Y.K., Ganyaglo, M.G. and Hill, W.C. (2012) A 6-Year (2004-2009) Review of Maternal Mortality at the Eastern Regional Hospital, Koforidua, Ghana. Seminars in Perinatology, 36, 79-83.
http://dx.doi.org/10.1053/j.semperi.2011.09.015
[20] Tita, A.T., Selwyn, B.J., Waller, D.K., Kapadia, A.S. and Dongmo, S. (2005) Evidence-Based Reproductive Health Care in Cameroon: Population-Based Study of Awareness, Use and Barriers. Bulletin of the World Health Organization, 83, 895-903.
[21] Wagaarachchi, P.T. and Fernando, L. (2002) Trends in Maternal Mortality and Assessment of Sub Standard Care in a Tertiary Care Hospital. European Journal of Gynecology and Obstetrics, 58, 36-40.
[22] Ujah, I.A., Aisien, O.A., Mutihir, J.T., Vanderjagt, D.J., Glew, R.H. and Uguru, V.E. (2005) Factors Contributing to Maternal Mortality in North-Central Nigeria: A Seventeen-Year Review. African Journal of Reproductive Health, 9, 24-27. http://dx.doi.org/10.2307/3583409
[23] Tebeu, P.M., Foumane, P., Mbu, R., Fosso, G., Biyaga, P.T. and Fomulu, J.N. (2011) Risk Factors for Hypertensive Disorders in Pregnancy: A Report from the Maroua Regional Hospital, Cameroon. Journal of Reproduction and Infertility, 12, 227-234.
[24] Abe, E. and Omo-Aghoja, L.O. (2008) Maternal Mortality at the Central Hospital, Benin City Nigeria: A Ten Year Review. African Journal of Reproductive Health, 12, 17-26.
[25] Nkwabong, E., Fomulu, J.N., Hamida, V., Onana, A., Tjek, V., Kouam, V. and Ngassa, P. (2011) The Risk of Adverse Maternal and Neonatal Outcomes in Cameroonian Primiparous Women Aged More than 26 Years. Clinics in Mother and Child Health, 8, 1-4.
[26] Loudon, I. (1992) Death in Childbirth: An International Study of Maternal Care and Maternal Mortality 1800-1950. Oxford University Press, Oxford.
[27] Mbola Mbassi, S., Mbu, R. and Bouvier-Colle, M.H. (2009) Delay in the Management of Obstetric Complications: Study in 7 Maternity Units in Cameroon. Medicine Tropical, 69, 480-484.
[28] Fomulu, J.N., Ngassa, P.N., Nong, T., Nana, P. and Nkwabong, E. (2009) Mortalité maternelle à la Maternité du Centre Hospitalier et Universitaire de Yaoundé, Cameroun: Etude rétrospective de 5 ans (2002 à 2006). Health Sciences and Disease, 10, 11-16.
[29] Tiomela, P. (2003) Apprecier la Mortalite Maternelle a la Maternite Principale de Yaounde 5 ans apres sa Reorganisation. Sujet de Recherche d’obstetrique, Memoire de fin d’etudes speciales de Gynecologie et d’obstetrique, Yaounde.

  
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