Medical And Social Determinants Of Maternal Death In Uttarakhand State

Abstract

ABSTRACT newlineIntroduction: newlineMaternal death mostly happens as a result of a host of medical factors which are often directly or newlineindirectly affected by various socio-demographic, economic and cultural issues. Delays in newlinedecision making, arranging transport services and receiving requisite treatment at a health care newlinefacility independently or in combination contribute to maternal mortality in developing countries. newlineThe present study was conducted to identify various medical and socio-cultural factors newlinethat lead to occurrence of maternal deaths. The study also assessed the functioning of maternal newlinedeath reporting and review system. newlineMethods: newlineA retrospective mixed method study was undertaken in four High Priority Districts of newlineUttarakhand State by conducting verbal autopsy of all 178 maternal deaths reported from April newline2017 to March 2019. Household member from the deceased family, District Nodal Officers and newlineFacility In-charges engaged in reporting and reviewing maternal deaths were interviewed using newlinepeer evaluated questionnaire. newlineResults: newlineApproximately one third (31.46%) deceased women had received three or more ANC services. newlineAlmost half of maternal deaths (47%) occurred at health facilities. The clinical causes reported newlinewere Postpartum haemorrhage (42.17%), sepsis (7.23%), prolonged labour (7.23%) and newlinePregnancy induced hypertension (6.02%). There were delays in decision making, reaching health newlinecare facilities on time and initiation of treatment. Most common risk behavioural sociocultural newlinepractices include avoiding dark green leafy vegetables, pulses, grams during pregnancy newline(54.49%), placing the pregnant women in Gaushala (Cowshed) during and before three days of newlinedelivery (35.39 %) etc. newlineApplication of and#967;² test has shown significant relationship between the socio-demographic factors newlineand maternal death, socioeconomic status and Delay 1 and 2. Maternal Death Review Team for newlineHousehold Verbal Autopsy was constituted only in 61.54 % Level-III Delivery Points. Both newlineFacility and Community Based Maternal Death Reviews w