Tag Archives: Sub-Saharan Africa

Maternal mortality in Zimbabwe: evidence, costs and implications

This issue paper published in 2013 by the United Nations in Zimbabwe provides an overview of the country’s situation with regard to maternal mortality, as well as highlighting the need for better tracking, monitoring and reporting of maternal deaths as a key strategy.

The paper shows that Zimbabwe has an unacceptably high maternal mortality ratio (MMR) which has worsened by 28% from 1990 to 2010. Recent data shows that the MMR now stands at 960 deaths per 100,000 live births according to the Demographic Health Survey 2010-11. According to WHO 2004 estimates, about 2,593 disability-adjusted life years per 100,000 females are lost per year in Zimbabwe due to maternal causes.

The Ministry of Health and Child Welfare (MoHCW), implemented a national Maternal Death Notification System (complementing the national Health Management Information System) aimed at strengthening tracking, monitoring and reporting of maternal mortality in the country, but the system is reported to be inadequate. The system reports deaths at facilities but not those in the community and not attended to by professional health care staff. Continue reading

Easier said than done: methodological challenges with conducting maternal death review research in Malawi

This 2014 paper critically reflects on a facility-based maternal death review study in Lilongwe, Malawi, using the five step mortality surveillance cycle framework that was used for the study, and highlights the methodological challenges faced while doing such reviews.

Although studies using maternal death audit methodologies are widely available, few discuss the challenges in their implementation. This study was conducted at comprehensive emergency obstetric care units of a secondary hospital and a tertiary hospital. It found that there were gaps in identifying and reporting on maternal deaths that may have happened in units/wards other than the maternity unit, which may have led to under-reporting.

Data was also found to be as being poorly maintained, missing or incomplete in many cases, as there was no system in place for health information collection and storage in cases of maternal mortality. Whilst language barriers and cultural norms were thought to have potentially influenced data from the communities, busy schedules and fear of blame were some of the issues faced at the facility level. Continue reading