A strategy for reducing maternal mortality in Migori, Kenya

Abstract

The aim of the study was to investigate the determinants of maternal mortality and develop a strategy for reducing the maternal mortality ratio (MMR) in Migori, Kenya. The objectives of the study were to describe the causes and the socio-economic determinants of maternal mortality, analyse the existing strategies that aim at reducing MMR, and develop a strategy to reduce MMR in Migori, Kenya. A sequential explanatory mixed methods study design was used to conduct the study. A checklist and in-depth interview guides were employed to collect the data. The quantitative data was analysed using the Statistical Package for Social Science (SPSS) version 23 and simple descriptive statistics. Thematic analysis was employed to analyse the qualitative data. The study revealed that the leading causes of maternal mortalities are haemorrhage (34.7%), eclampsia (20.8%) and sepsis (15.8%). Moreover, social and system factors which largely determined the deaths of mothers were found to be timely provision of and lack of drugs and blood, rural residence, and maternal ignorance of danger signs. The above-mentioned factors were exacerbated by the delays in accessing appropriate healthcare that could have saved the lives of mothers. Identified delays were theatre delays, resuscitation delays, competent care delays, referral delays, and the delays in decision-making by the mothers themselves. The study further established that the existing maternal improvement interventions such as the free maternal service policy, the haemorrhage prevention programmes, and family planning were poorly implemented with low coverage. The findings informed development of an alternative strategy that would reduce MMR in Migori, Kenya. The proposed strategy targets maternal care delays, which the study found to contribute to the persisting high levels of maternal deaths in Migori, Kenya. Increased focus on the identified determinants of maternal deaths by policy makers is recommended. The study further alerts stakeholders that hospital systems as well as community empowerment programmes are in dire need of quality improvement initiatives. The Kenyan government and non-profit organisations should be involved in the implementation of the proposed strategy.