Determinants of maternal mortality in south-western Nigeria: Midwives’ perceptions

Article


Olawade, D. B., Wada, O. Z., Ojo, I. O., Odetayo, A., Joel-Medewase, V. I. and David-Olawade, A. C. 2023. Determinants of maternal mortality in south-western Nigeria: Midwives’ perceptions. Midwifery. 127 (Art. 103840). https://doi.org/10.1016/j.midw.2023.103840
AuthorsOlawade, D. B., Wada, O. Z., Ojo, I. O., Odetayo, A., Joel-Medewase, V. I. and David-Olawade, A. C.
Abstract

Background
Maternal mortality remains one of Nigeria's most significant public health challenges. In order to address this issue sustainably, it is necessary to consider the perceptions of all stakeholders involved, including midwives.

Objectives
To examine the determinants of maternal mortality in south-western Nigeria from the midwife's perspective.

Design
A cross-sectional study was employed using mixed methods with a semi-structured questionnaire and an in-depth interview guide.

Participants
Quantitative data were obtained from 215 midwives using a convenience sampling technique. Qualitative data were obtained from 25 midwives from five government health centres, selected using a stratified sampling technique.

Methods
Quantitative data were analysed using SPSS Version 20 using descriptive and inferential statistics with 95 % confidence intervals, while qualitative data were analysed using thematic analyses.

Findings
The mean age and work experience of the participants were 35.2 ± 9.3 years and 8.4 ± 7.0 years, respectively. The midwives perceived that the main determinants of maternal mortality were postpartum haemorrhage (86.5 %), hypertensive disorder in pregnancy (80.9 %), mismanagement at mission homes/traditional birth attendant centres (MH/TBAs) (79.1 %) and sepsis (70.1 %). Some of the priority target areas to improve the well-being of pregnant women as identified by the midwives, were increased awareness of pregnancy danger signs (97 %), destigmatising caesarean section (CS) (96 %), regulation of MH/TBAs (92 %), and increased accessibility of hospitals (84 %). Findings from the qualitative data also affirmed that regulating MH/TBAs, destigmatising CS and subsidising healthcare expenses were prerequisites to curbing maternal mortality. Inferential analysis revealed that determinants such as unsafe abortion (p < 0.001), ectopic pregnancy (p = 0.001), domestic violence (p = 0.023), malaria (p = 0.029), short interbirth interval (p = 0.03), and patients’ negative perceptions of CS delivery (p = 0.036) were more commonly perceived to be associated with maternal mortality by younger midwives (age 17–34 years) compared with older midwives.

JournalMidwifery
Journal citation127 (Art. 103840)
ISSN0266-6138
Year2023
Publisher's version
License
File Access Level
Anyone
Digital Object Identifier (DOI)https://doi.org/10.1016/j.midw.2023.103840
Publication dates
Online14 Oct 2023
PrintDec 2023
Publication process dates
Accepted08 Oct 2023
Deposited02 Feb 2024
Copyright holder© 2023, The Authors
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