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Quality of maternal health in Sudan

Quality of maternal health in Sudan. Ensaf Hassan Ahmed MSC in Nursing Ph D – Student Alneelain University School of Nursing. Objectives. Magnitude of M.M in Sudan . Causes. Interventions. Design. Retrospective analysis of surveys. Resources.

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Quality of maternal health in Sudan

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  1. Quality of maternal health in Sudan Ensaf Hassan Ahmed MSC in Nursing Ph D – Student Alneelain University School of Nursing

  2. Objectives • Magnitude of M.M in Sudan . • Causes. • Interventions.

  3. Design • Retrospective analysis of surveys .

  4. Resources • Sudan Household Health Survey (SHHS) 2006 - 2007. • Previous Studies. • WHO reports.

  5. Background • Sudan is the largest country in Africa, about 2.5 million Km2. • Population 39,154,000 (2008 Census) • Decentralization policy,25 states (15 Northern +10 Southern ) and 152localities.

  6. Health Indicators • The national maternal mortality ratio is estimated at 1,107per 100,000 live births and represents one of the highest in WHO.

  7. Table 1:Maternal mortality ratio per 100,000 by SHHS 2007

  8. cont,health indicators: • Juba (2007) rates of pregnancy – related deaths in South Sudan are the highest 2.030 per 100,000 live birth in compared to North –638 ( United Nation Population Funds ) . • In South Sudanfertility rate is high 6.7and couple with high rate of early marriage and pregnancy with blood donor 7- 9 percent HIV positive.

  9. cont,health indicators: • Contraceptive prevalence rate stands at 7.6%(8.5%,N.Sudan)with a surprisingly low unmet need for contraceptive service (5.7%), probably explained by the poor knowledge and high illiteracy rate (SHHS)

  10. Table 2:Safe motherhood mortality and service indicators, 1999

  11. Factors influencing maternal health • Prolonged war( migration). • Cultures and behaviors (circumcision). • Poverty (low – income). • Lack of education (ignorance ). • Lack of transportation . • Lack of maternal health services (health policy). • Lack of trained staff (midwifes) .

  12. Hospital – based surveys Kasala Hospital ( 1997-1998)(A. Naser 2006). • Maternal deaths: 72 • Causes: direct 41.7% indirect 58.3% • Malaria is the main cause followed by anaemia • 8.3% arrived dead. • 54.2% died within 6 hours from arrival to • hospital. • 59 out 72 cases needed blood Transfusion • only 20 (34%) received blood

  13. Hospital – based surveys Umdorman and Saudi Maternity Hospitals Survey period 1998- 2001(A.Naser 2006). Maternal deaths: 199 • Causes: direct 61.8% indirect 38.2% . • Malaria and eclampsia are the main causes each constitutes 18.1%. • 46.2% of deaths occurred within the first 24 hours.

  14. WadMedani Hospital SurveyHospital SurveyPeriod :1998 - 2002 No. of maternal deaths 118. • Sepsis is the main cause followed by hemorrhage and malaria. • Two third of maternal deaths followed C/S. • Two third of maternal deaths from rural area .

  15. Conclusion Commonestcauses of maternal deaths: • Malaria • Anemia • Eclampsia • Hemorrhage • Sepsis • Obstructive labor

  16. Interventions • WHO and Sudan ministry of health put strategies to establish national policy and standards for maternal care and develop measures to support the policy. • Recently, Federal Ministry of Health put strategies of Sudan Rood Map for MMR 2010 – 2015, which include : - Midwifery strategy, focus on revision and upgrading of midwifery curriculum Sudan Declaration. - Policy of infection control. - Raise awareness towards related health issue among individuals, families and community

  17. Cont. interventions • Ensure availability of adequate facilities for all women who are pregnant or delivering, wherever they are, including women in complex emergency situations. • Support free institutional deliveries and essential obstetric care.

  18. Screening pregnant women for risk factors. • Mobilize communities to support transport and communication to improve access to care for women when they are in danger.

  19. Thank You

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