Maternal health epidemiology in Rwanda

Abstract

Maternal Health is the health of women during pregnancy, childbirth and the postpartum period. The study objective was to assess maternal health epidemiology in Rwanda for 2014 and in the beginning of 2015. All 47 hospitals in Rwanda were visited by the researcher. The researcher worked with maternity services, data management services and community health services to reach the required documents. The used documents were verbal autopsies filled after each death of a mother due to the complication of pregnancy, delivery and in postpartum period within 42 days. An extensive desk review of hospital level documents and reports was conducted for the period of 4 quarters of 2014 (the whole year 2014) and 1 quarter of 2015(January-March 2015) in order to capture the required data. Data were analyzed using computer software Ms Excel. The study reveal that 306 mothers were died at health facilities and 32 women died in community during the year 2014. Among those deaths around the half (44.9%) happened in referral hospitals. Also the prevalence is high in urban hospital than l in rural hospital. The most frequented associated factor in maternal death was the delay in seeking health care followed by intoxication. The period of complication is high in post-partum with the prevalence of 53% followed by 30% in pregnancy and 16% in delivery. The main cause of maternal death in 2014 was post-partum hemorrhage (PPH) with 26% followed by other unspecified caused which takes 22% and 40% of maternal death happened in less than 24 hours in post-partum, 24% in period of post-partum between 7-42days, 13% occurred between 1-7 days in post-partum and 23% occurred in period not ranged in post-partum period. At the time of death, 69% of mothers died had a post-partum status of pregnancy against 12% of ante-partum, 10% of post-abortion and 9% of intra-partum. However, the results of the study showed that although much has been achieved in reducing maternal mortality and Rwanda is on track for MDGs targets, Rwanda needs to do much more so that no woman can die from maternal complications. Rwanda is still facing a heavy burden of maternal mortality. It is in this regard that the researcher proposed different recommendations at different levels.