Factorial Analysis of Maternal Mortality Audits: A Case of Migori County Referral Hospital, Kenya

Background: Maternal mortality is a global health concern especially in developing countries with 99% of all maternal deaths. Kenya reports a mortality rate of 342/100000 with majority of these occurring in northern and western parts of the country with Migoricounty recording annual maternal mortality rate of 673/100000. As part of Sustainable Development Goals, the target is to reduce the global maternal mortality ratio to below 70 per 100 000 live births. Maternal death reviews are globally accepted as a means of mitigating against avoidable maternal deaths. Kenya adopted and rolled this in 2004. The efficiency of this intervention in major referral facilities remain unmonitored and undocumented.

Objectives: Major goal of this study was to examine the effect of maternal death review on maternal outcomes with specific aims being: To determine the prevalence and compare the trends of maternal mortality over two years, identify factors contributing to maternal mortality and to examine and compare the trends of factors leading to maternal mortality between the two years in the referral hospital..

Methodology: Data on all audited maternal deaths that occurred in Migori County Referral hospital between 2018-19 were abstracted from District Health Information system and analyzed using excel version 2007. Both descriptive and inferential statistics were used. We used both chi-square test and test of difference for proportions with CI interval set at 95% p=0.05 to test our null hypotheses.

Results: Total of 36 maternal deaths were recorded during the study period with 16 (329/100000) and 20 (469/100000) occurring in 2018 and 2019 respectively.  We found a significant association between parity and maternal mortality, p-value=0.0027 and a significant association between gestation and maternal deaths, p-value =0.0006.

Conclusion: Maternal death reviews has not led to reduction of maternal mortality in the referral hospital.