Comparative Analysis of Reported Cases of Maternal Deaths (A Case Study of Mater Misericordiae Hospital, Afikpo, Ebonyi State)
This work which featured the comparative analysis of reported cases of maternal deaths looked into the comparison between the mean deaths for each of the causes of maternal death using the Completely Randomized Design (CRD) and also tested to see if whether the number of deaths by causes has any dependent relationship within the years under consideration using Chi-Square (χ2). Nigeria has been mentioned by the United Nations as having one of the highest rate of maternal deaths in the world (WHO, 2008). Related literature revealed of the main factor affecting maternal deaths is the unavailability of skilled professional birth attendants who provide care during childbirth. A second important factor is the absence of formal education on health care of women under reproductive age. To solve this problem, we recommended that government should maintain and institute health programme unit which will help to enlighten the ignorant baby making parents on the better ways of managing pregnancy. Government is also advised to build more hospitals and health centres in all the rural and urban areas.
TABLE OF CONTENTS
Title page – – – – – – – – – i Approval page – – – – – – – – ii
Dedication – – – – – – – – – iii
Acknowledgement – – – – – – – iv
Abstract – – – – – – – – – v
Table of content – – – – – – – – vi-vii
List of Tables – – – – – – – – viii
Introduction – – – – – – – – 1
Background of the study – – – – – – 1
Statement of the study – – – – – – 2
Aims/Objectives of the study – – – – – 3
Significance of the study – – – – – – 3
Research Questions – – – – – – – 3
Hypotheses – – – – – – – – 4
Scope of the study – – – – – – – 4
Definition of terms – – – – – – – 5
LITERATURE REVIEW – – – – – – 6-10
3.0 Introduction – – – – – – – – 11
3.1 Population of Interest/Sample – – – – – 11
3.2 Source of Data – – – – – – – 11
3.3 Data Collection – – – – – – – 11
3.4 Data Presentation – – – – – – – 12
3.5 Data Analysis – – – – – – – – 12
Data Presentation and Analysis
4.0 Introduction – – – – – – – – 13
4.1 Data Presentation – – – – – – – 13
4.2 Data Analysis – – – – – – – – 13-15
CHAPTER FIVE-DISCUSSION AND RECOMENDATION
5.1 Discussion – – – – – – – – 16
5.2 Recommendation – – – – – – – 16
5.3 Limitations of the Study – – – – – – 17
REFRENCES – – – – – – – – 18-19
Appendix A-Working tables – – – – – – 20-22
Appendix B-Working Chart – – – – – – 23
Appendix C-Computations – – – – – – 24-30
Appendix D-Statistical tables – – – – – – 31-32
Maternal death, also known as maternal mortality, has become the major cause of death among women of reproductive age in many countries and remains a serious public health issues especially in developing countries. A maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration of the pregnancy, from any causes related to or aggravated by the pregnancy or its management but not from accidental causes.
The trend in maternal death rates in England and Wales between 1880 and 1980 was such that the rate of maternal death remained on a high rate through the mid 1930s, after which there was an abrupt and step decline. There were few reliable data on maternal death rates in the United States before 1915, but thereafter, the united state had the highest rate of maternal death compared to any developed country.
It is therefore, based on this information and problem that this chapter focuses on the background of study, statement of the problem. Aims and objectives of the study, significance of the study, research questions, hypothesis, scope of the study and definition of terms.
1.1 BACKGROUND OF STUDY
According to the WHO factsheet (2008), about 1500 women die from pregnancy or pregnancy related complications every day. Most of these deaths occur in developing countries and most are available. Of all the health statistics complied by the World Health Organization, the largest discrepancy between developed and developing countries can be seen in maternal mortality.
In 1935, a well-designed survey by Elizabeth Tandy of the children’s Bureau showed how the number of deaths in the United States exceeded the number of deaths in Britain.
Historical data also showed that maternal mortality rates were lowest from home deliveries undertaken by trained and supervised midwives with no exceptions.
1.2 STATEMENT OF THE PROBLEM
In spite of all the policies, declarations, conferences and other efforts aimed at reducing the scourge of maternal death across the globe, only modest gains in maternal mortality reduction appeared to have been achieved in many countries in the past 20 years (Shah et al, 2007). Countries in Africa may have actually lost ground while many developing countries have fallen far short of the standards set by the World Health Organization’s initiative on Safe Motherhood.
In Nigeria, the federal ministry of Health did set year 2006 as the target year that maternal mortality would have been reduced by 50 percent. However, not only were these targets not achieved, but also the maternal health situation in Nigeria is now much worse than the previous years (Ujah et al, 2005).
Past efforts to reduce maternal mortality death ratio in Nigeria were concentrated on making direct improvements to the health system. These efforts have not involved enough resources to successfully reduced maternal death in the country. Young women have the highest risk of complication and heath during pregnancy and childbirth, especially those whose bodies are not developed due to chronic malnutrition.
The aforesaid are the problems of maternal deaths and therefore becomes the statement of the problem of this research work.
1.3 AIMS/OBJECTIVES OF THE STUDY
The study will be looking into the comparison between the mean deaths for each of the causes of maternal deaths over the years under consideration.
The research will also test whether the number of deaths by causes has any dependent relationship within the years under consideration.
1.4 SIGNIFICANCE OF THE STUDY
The identification of the difference in the mean deaths for each of the causes of maternal death and relationship that exists between the causes of maternal deaths in Mater Misericordiae hospital; will greatly help to reduce the rate at which women die during pregnancy and childbirth.
Since children are the leaders of tomorrow, one needs a good knowledge of what causes of maternal deaths, the relationship that exists between these causes and how to prevent them from occurring.
1.5 RESEARCH QUESTIONS
This research work will attempt to supply answer to the following questions:
Which of the causes of maternal death has the highest incidence of death?
Is there any dependent relationship between the causes of maternal deaths?
The research hypothesis will be in two folds: To address the first question, which of the causes of maternal death has the highest incidence of death? This will be addresses using analysis of variance – comparison of multiple means that are more than two.
Ho: µAPH =µPPH = µSVD = µC/S = µUA
H1: µi ≠ µì’
APH: Ante – Post patum Haemorrage
PPH: Post patum Haemorrage
SVA: Safe virginal Delivery
C/S: Caesarean Section
UA: Unsafe Abortion
i: stand for the different causes of death
ì: stands for the different causes of death from causes i
Ho: The number of deaths by causes is independent of the year
H1: The number of deaths by causes is not independent of the year
1.7 SCOPE OF THE STUDY
This research work focuses on the comparative analysis of reported cases on maternal deaths and their causes in Mater Misericodiae hospital, Afikpo North L.G.A., for the period spanning 2008-2012 (five years).
1.8 DEFINITION OF TERMS
DEATH: This can be defined as the power that destroys life. According to the Oxford Advanced Learner’s Dictionary (7th Edition), death is the permanent end or destruction of something.
MORTALITY: mortality is the state of being human and not living forever. It can also be said to be the number of deaths in a particular situation or period of time.
MATERNAL: Maternal simply means having feelings that are typical of a caring mother towards a child.
MATERNAL MORTALITY RATE: This is the rate number of maternal deaths per 1000 live birth (WHO).
MATERNAL DEATH RATE: This is the frequencies of maternal death with a given population conventionally calculated as annual number of maternal death per 1000 population or inhabitant.
MATERNITY: This is defined as the state of becoming a mother, relatively to pregnancy or giving birth.
ENTOPIC PREGNANCY: This is a pregnancy that is abnormal position (Taber Medical Dictionary)
Ho: Null Hypothesis
H1: Alternative Hypothesis
ANOVA: Analysis of variance
Fcal: F- calculated
Fα(v1v2): F- tabulated
χ2cal: Chi-Square calculated
χ2αvdf Chi-Square tabulated
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