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Maternal Mortality Community-based Survey in Kassala State- Eastern Sudan. Abdalla Ali Mohammed Faculty of Medicine & Health Sciences University of Kassala Sudan. Kassala. Population: 1,767,603 70% rural. Objectives:. To determine MM rate and ratio in Kassala State
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Maternal Mortality Community-based Survey in Kassala State- Eastern Sudan. Abdalla Ali Mohammed Faculty of Medicine & Health Sciences University of Kassala Sudan
Kassala Population: 1,767,603 70% rural A.A. Mohammed Kassala Sudan
Objectives: • To determine MM rate and ratio in Kassala State • To determine the causes andcontributing factors • To compare rates and causes between different population sectors localities. • To put recommendations for lowering maternal mortality in the State. A.A. Mohammed Kassala Sudan
Materials and Methods • A retrospective cohort study of deaths of women of reproductive age (15-49 years) • 1stJan 2004 and 31st Dec 2006, • Four selected areas in four localities in Kassala State Eastern Sudan. A.A. Mohammed Kassala Sudan
Materials and Methods • Reproductive age Mortality Survey (RAMOS): • Two phases: • Identification of deaths of WRA • Verbal autopsy (WHO 1994) A.A. Mohammed Kassala Sudan
Materials and Methods • Multi-stage cluster sampling* • Purpose selection of area(Primary sampling Unit) • Systemic randomization of villages & Quarters (secondary sampling unit) *Bartlett et al (2005). Where giving birth is a forecast of death: maternal mortality in four districts of Afghanistan, 1999-2002. The Lancet, 35:864-870. A.A. Mohammed Kassala Sudan
First stage sample Population =335,394 (19%) Households = 67,079 Villages & quarters = 331 A.A. Mohammed Kassala Sudan
Second stage sample Population = 105,105Female of WRA=26,066 Expected live births = 2,943 Households = 21,450 Villages & quarters = 32 A.A. Mohammed Kassala Sudan
Results • Total deaths =168 • Total cases reviewed =148 (88.1%) • Maternal deaths = 64 (43.2%) • Annual maternal mortality =21 • MM ratio =713.6\100,000 LB A.A. Mohammed Kassala Sudan
Cause of death A.A. Mohammed Kassala Sudan
Time of death around pregnancy A.A. Mohammed Kassala Sudan
Contributing factors A.A. Mohammed Kassala Sudan
*70% of Kassala population live in rural area A.A. Mohammed Kassala Sudan
Maternal mortality in Sudan* National MM rate 1,107 94 161 166 1,414 609 1,056 1,581 2,054 *Sudan Household Health Survey 2006 A.A. Mohammed Kassala Sudan
Maternal Mortality in Kassala Rural 829 762 874 Urban 448 329 401 A.A. Mohammed Kassala Sudan
Conclusions • High MM in Kassala State, with wide variation between urban & rural population and between localities. • Poverty, illiteracy and poor health care are main contributing factors. A.A. Mohammed Kassala Sudan
Recommendations • Government to take more care in rural development. • Strengthening midwifery practice (training & coverage) • Existing Health facilities to cover effective emergency obstetric & newborn care. • Increase coverage of female education. A.A. Mohammed Kassala Sudan
Acknowledgement • Authors would like to thank: • Ministry of Higher Education & Scientific Research • University of Kassala • Kassala State Ministry of Health • UNFPA – Kassala Office • For funding this study A.A. Mohammed Kassala Sudan
Thank you A.A. Mohammed Kassala Sudan