Contributory Factors to In-hospital Maternal Mortality in a Governmental Hospital in Khartoum State in 2006

Case report
Case study: Contributory Factors to In-hospital Maternal Mortality in
a Governmental Hospital in Khartoum State in 2006

Christelle Evans1
, Mutasim El-Feel2. Abdelmageed Osman3*
1 School of Medicine, Southampton/England
2 Department of obstetrics and Gynaecology/International University of Africa – Faculty
of Medicine and Health Sciences, Khartoum, Sudan
3 Department of Community Medicine/International University of Africa Faculty of
Medicine and Health Sciences, Khartoum, Sudan
*Corresponding author: Dr. Abdelmageed Osman, Associate Professor, Department of
Community Medicine/International University of Africa Faculty of Medicine and Health
Sciences, Khartoum, Sudan. Email: majeed_osm@yahoo.com
Received: 30 August 2022
Accepted: 24 September 2022
Abstract
Background: In-hospital maternal mortality rates in Sudan are currently high, at 0.09%(1)
. According to World Health Organisation standards, in-hospital maternal
mortality should not exceed 0.025%(2) . Common contributory factors are numerous, both
in-hospital and in the community. This study aims to identify specific contributors to
maternal mortality and morbidity in a governmental hospital to make recommendations
to minimize them.
Materials and Methods: The study basis was an initial case study of maternal morbidity
in a governmental hospital with subsequent exploration of contributory factors. A
participatory rapid appraisal approach was used, employing observational checklists and
Napata scientific journal November 2022 Volume 1 (3) pp 316-328317
semi-structured interviews in order to identify problems at every level of the hospital
system, cross-checking information with different stakeholders.
Results: Results identified primary delays in seeking care and suboptimal care delivery
as the main contributors to in-hospital maternal mortality and morbidity. Interviews with
patients and staff also highlighted a need for more patient education and more
supervision and training opportunities for junior staff.
Conclusion: Important changes have been highlighted that may contribute to reducing in
hospital maternal mortality and morbidity. The main ones in the light of known cases of
maternal mortality and morbidity were; physical resources, human resources, maternity
information systems, good practice in labour, treatment of and communication with
patients and management of Obstetric Emergencies.

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