A Review of Underlying Causes of Maternal Deaths in Benue North Central Nigeria

Abstract: Most maternal death reviews are on impact assessment rather than the underlying factors. Maternal death review that goes beyond the number has not been widely studied in Nigeria despite the high contribution of underlying factors to maternal deaths in the country. To determine the underlying causes of maternal death in the facility. This was a comprehensive facility-based maternal death review at Federal Medical Centre Makurdi from 1st January to 31st December 2012. Factors surrounding each maternal death were analyzed prospectively to learn a lesson from each death by exploring gaps at the levels of the hospital, patient and the community. The MMR was 1381/100000 live births. Hospital factors were implicated in 39.3% and they were predominantly lack of ICU 19.0%, poor management of the referral chain 19.0% inability to assess complications fully 15.5%, laboratories challenges 11.9% and lack of obstetric skills (inexperience) 8.3%. The patient’s factor occurred in 32.1% and they were non-booking (34.6%), nonuse of family planning (26.9%) and decision delays (32.7%). The Community factors occurred in 28.6% and they included transportation problems (28.6%), socio-cultural factors (28.6%), gender inequality (16.7%), inhibitory abortion laws 11.9% and illiteracy 9.5%. Maternal mortality was high in the facility because of the complex interaction of underlying factors with obstetric complications.  

 Key Words: Maternal mortality review, underlying factors, Benue state