INDIRECT ESTIMATES OF MATERNAL MORTALITY IN MOKOLA AREA, IBADAN

Abstract

Most developing countries including Nigeria do not have effective systems for complete registration of births, deaths and other vital events from which data can be generated for the direct estimates of maternal mortality. Therefore, alternative and complementary methods for generating information on maternal mortality need to be explored. An indirect technique was therefore used in this study to estimate maternal mortality in Mokola, an urban settlement in lbadan North Local Government Area. The study was cross-sectional in design. A cluster sampling technique was employed in a household survey conducted at Mokola area. The first stage of sampling was a random sampling of 30 clusters from the already exiting 50 clusters in the community. The second stage was the selection of respondents from the households of selected clusters and all individuals in each households, (30 clusters) were listed. Individuals aged 15-49 years, were administered the questionnaires. In the selected clusters, a total of 1357 individual were thus selected for the study. The sisterhood, method which allows the surviving sibling to give report about survival of their reproductive-aged sisters and whether they had a female sibling, whose circumstances of death is maternity related was used. Both female and male respondents were asked retrospective questions about their sisters who died during pregnancy, childbirth and within six weeks of childbirth. The Brass indirect techniques were used to estimate maternal mortality from questions on the survivorship of respondents' sisters. Male respondents (28.0%) had mean age 31.0 ± 9.6years while female respondents (72.0%) had mean age of 30.0 ± 8.7years. A total of 96.9% women respondent, have had at least one live birth. Forty five percent of all respondents were married and the total number of births by the women surveyed was 1,902. The result showed that 1.7% of male and 2.8% female respondents reportedly had a sister who had died during pregnancy, childbirth or within six weeks of birth. The observed and adjusted reported total fertility rates were 3.1 and 3.9 respectively. The number of reported maternal deaths was 57 and this yields a maternal mortality ratio of 1523 per 100,000 live births. The analysis shows that estimate of maternal deaths occurred at a time period of 10-12 years prior to the survey. The lifetime risk of maternal death was 1.52%. There is direct association between low level of education and maternal mortality. A higher proportion (44.4%) of those with secondary education compared with 15.6% of those with tertiary education died during pregnancy (OR=4.32; 95% CI 1.14-16.06). The reported level of maternal mortality was high and low level of education appeared to be associated with maternal death. Therefore effort should be targeted towards health education of the women in reproductive age. The method of estimation should be refined to enable it establish current status of maternal mortality as this will help for development of appropriate intervention strategies.