Factors Affecting Maternal Mortality

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A STUDY OF THE CAUSES OF MATERNAL MORTALITY IN RURAL AREAS IN UGANDA CASE STUDY: MITYANA HOSPITAL

BY

SEMPA FATUMAH
10/U/4724/BEK/PD

A RESEARCH PROPOSAL SUBMITTED TO THE DEPARTMENT OF ECONOMICS AND STATISTIC IN PARTIAL FULFILLMENT OF THE REQUIREMENTS OF THE AWARD OF THE DEGREE OF ECONOMICS AND STATISTICS OF KYAMBOGO UNIVERSITY.

FEBUARY 2012

List of acronyms
➢ MMR- Maternal Mortality Rate
➢ IMR - Infant Mortality Rate
➢ UBOS- Uganda Bureau of Statistics
➢ NPA- National Planning Authority
➢ HDI- Human Development Index
➢ MOH- Ministry of Health
➢ MOFPED- Ministry of Finance Planning and Economics Development ➢ MDG- Millennium Development Goal
➢ UNICEF- United Nations International Children’s Education Fund

INTRODUCTION
Background
Maternal mortality rate is the annual number of mothers who die per 100000 births from any cause related to or aggravated by pregnancy, management and delivery. This excludes accidental or incidental causes. The MMR includes deaths during pregnancy, childbirth or within 42 days of termination of the pregnancy, irrespective of the duration and the site of the pregnancy for a specified year (UNICEF, 2010). There exists a clear distinction between a direct maternal death that is as a result of a complication of the pregnancy or delivery and an indirect maternal death that is a pregnancy related death in a patient a pre-existing or newly developed health complication. However, in this study, both types of maternal deaths will be considered. According to a report , the MMR in Uganda was 435 deaths per 100000 births in 2006( UBOS,2008),down from 505 deaths per 100000 births in 2002 and Uganda has a millennium development goal target of reducing the maternal mortality rate by three quarters to 131deaths per 100000 births by 2015. However, a national study conducted by Mbonye 2000 at 97 health facilities, including 30 hospitals, found the institutional MMR to be as high as 846 per 100,000 live births . It is conceivable, however, that institutional mortality rates would be higher than national averages due to the fact that women will tend to seek institutional care when complications arise. High MMR are typical of many countries in sub Saharan Africa and this has further been worsened by the fact that very few pregnant women receive antenatal care and this exposes expectant mothers to the risk of death from pregnancy related causes (Ssengooba, 2004). A report by the population reference bureau indicated that in 2002 only 38% of the births are attended by a skilled personnel, the fertility rate stood at 6.9 children and that 66% of the women in Uganda had given birth by the age of 20(maternal and neonatal effort index, world population bureau,2002).according to the Uganda bureau of statistics, there has been a slight increase in the number of births attended by a skilled personnel to 41.1% in 2006 and the annual health sub sector performance report indicated a decline in the number of deliveries attended to by a skilled personnel from 40% in 2008 to 33% in 2010 and it is highly doubtable if the millennium development goal target of 90%births by 2015 will be attained. The report adds that only 45% of the health facilities in Uganda provided emergency obstetric care by 2007 and the report further notes that the high maternal mortality rates point to poor or lack of such services which unfortunately the government is giving a deaf ear to. Ssengooba, 2004, observes that the prevailing high rates of fertility (6.7 births per woman), in an environment of poor access to quality maternal and neonatal care, have continued to expose Ugandan mothers and infants to a high risk of death from pregnancy related causes , with an estimated 1 woman in 10 dying from maternal causes in Uganda (the lifetime risk) All pregnant women face some level...
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