Causes of maternal deaths in Sierra Leone from 2016 to 2019: analysis of districts’ maternal death surveillance and response data
Introduction Sierra Leone is among the top countries with the highest maternal mortality rates. Although progress has been made in reducing maternal mortality, challenges remain, including limited access to skilled care and regional disparities in accessing quality care. This paper presents the firs...
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2024-01-01
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| author | Francesco Barone-Adesi Francesca Tognon Fabio Manenti Marta Caviglia Yasir Shafiq Zainab Juheh Bah Michele Orsi Abibatu K. Kamara Caracciolo Claudia Francis Moses Tom Sessay |
| author_facet | Francesco Barone-Adesi Francesca Tognon Fabio Manenti Marta Caviglia Yasir Shafiq Zainab Juheh Bah Michele Orsi Abibatu K. Kamara Caracciolo Claudia Francis Moses Tom Sessay |
| author_sort | Francesco Barone-Adesi |
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| description | Introduction Sierra Leone is among the top countries with the highest maternal mortality rates. Although progress has been made in reducing maternal mortality, challenges remain, including limited access to skilled care and regional disparities in accessing quality care. This paper presents the first comprehensive analysis of the burden of different causes of maternal deaths reported in the Maternal Death Surveillance and Response (MDSR) system at the district level from 2016 to 2019.Methods The MDSR data are accessed from the Ministry of Health and Sanitation, and the secondary data analysis was done to determine the causes of maternal death in Sierra Leone. The proportions of each leading cause of maternal deaths were estimated by districts. A subgroup analysis of the selected causes of death was also performed.Results Overall, obstetric haemorrhage was the leading cause of maternal death (39.4%), followed by hypertensive disorders (15.8%) and pregnancy-related infections (10.1%). Within obstetric haemorrhage, postpartum haemorrhage was the leading cause in each district. The burden of death due to obstetric haemorrhage slightly increased over the study period, while hypertensive disorders showed a slightly decreasing trend. Disparities were found among districts for all causes of maternal death, but no clear geographical pattern emerged. Non-obstetric complications were reported in 11.5% of cases.Conclusion The MDSR database provides an opportunity for shared learning and can be used to improve the quality of maternal health services. To improve the accuracy and availability of data, under-reporting must be addressed, and frontline community staff must be trained to accurately capture and report death events. |
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| language | English |
| publishDate | 2024-01-01 |
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| spelling | doaj-art-7af44aaf3b224e02a761e8c6fe6e2b642025-08-20T03:12:36ZengBMJ Publishing GroupBMJ Open2044-60552024-01-0114110.1136/bmjopen-2023-076256Causes of maternal deaths in Sierra Leone from 2016 to 2019: analysis of districts’ maternal death surveillance and response dataFrancesco Barone-Adesi0Francesca Tognon1Fabio Manenti2Marta Caviglia3Yasir Shafiq4Zainab Juheh Bah5Michele Orsi6Abibatu K. Kamara7Caracciolo Claudia8Francis Moses9Tom Sessay10CRIMEDIM – Research Center in Emergency and Disaster Medicine, Università degli Studi del Piemonte Orientale Amedeo Avogadro Scuola di Medicina, Novara, Piemonte, ItalyDoctors with Africa CUAMM, Padua, ItalyDoctors with Africa CUAMM, Padova, ItalyUniversità degli Studi del Piemonte Orientale Amedeo Avogadro Scuola di Medicina, Novara, ItalyDepartment of Translational Medicine and Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università degli Studi del Piemonte Orientale Amedeo Avogadro Scuola di Medicina, Novara, Piemonte, ItalyGovernment of Sierra Leone Ministry of Health and Sanitation, Freetown, Western Area, Sierra LeoneMangiagalli Center, Fondazione IRCCS Ca` Granda Ospedale Maggiore Policlinico, Milan, ItalyGovernment of Sierra Leone Ministry of Health and Sanitation, Freetown, Western Area, Sierra LeoneDoctors with Africa CUAMM, Padova, Veneto, ItalyReproductive Health and Family Planning Programme, Government of Sierra Leone Ministry of Health and Sanitation, Freetown, Western Area, Sierra LeoneBombali District Ebola Response - Surveillance Team, Sierra Leone Ministry of Health and Sanitation, Bombali District, Makeni, Bombali, Sierra LeoneIntroduction Sierra Leone is among the top countries with the highest maternal mortality rates. Although progress has been made in reducing maternal mortality, challenges remain, including limited access to skilled care and regional disparities in accessing quality care. This paper presents the first comprehensive analysis of the burden of different causes of maternal deaths reported in the Maternal Death Surveillance and Response (MDSR) system at the district level from 2016 to 2019.Methods The MDSR data are accessed from the Ministry of Health and Sanitation, and the secondary data analysis was done to determine the causes of maternal death in Sierra Leone. The proportions of each leading cause of maternal deaths were estimated by districts. A subgroup analysis of the selected causes of death was also performed.Results Overall, obstetric haemorrhage was the leading cause of maternal death (39.4%), followed by hypertensive disorders (15.8%) and pregnancy-related infections (10.1%). Within obstetric haemorrhage, postpartum haemorrhage was the leading cause in each district. The burden of death due to obstetric haemorrhage slightly increased over the study period, while hypertensive disorders showed a slightly decreasing trend. Disparities were found among districts for all causes of maternal death, but no clear geographical pattern emerged. Non-obstetric complications were reported in 11.5% of cases.Conclusion The MDSR database provides an opportunity for shared learning and can be used to improve the quality of maternal health services. To improve the accuracy and availability of data, under-reporting must be addressed, and frontline community staff must be trained to accurately capture and report death events.https://bmjopen.bmj.com/content/14/1/e076256.full |
| spellingShingle | Francesco Barone-Adesi Francesca Tognon Fabio Manenti Marta Caviglia Yasir Shafiq Zainab Juheh Bah Michele Orsi Abibatu K. Kamara Caracciolo Claudia Francis Moses Tom Sessay Causes of maternal deaths in Sierra Leone from 2016 to 2019: analysis of districts’ maternal death surveillance and response data BMJ Open |
| title | Causes of maternal deaths in Sierra Leone from 2016 to 2019: analysis of districts’ maternal death surveillance and response data |
| title_full | Causes of maternal deaths in Sierra Leone from 2016 to 2019: analysis of districts’ maternal death surveillance and response data |
| title_fullStr | Causes of maternal deaths in Sierra Leone from 2016 to 2019: analysis of districts’ maternal death surveillance and response data |
| title_full_unstemmed | Causes of maternal deaths in Sierra Leone from 2016 to 2019: analysis of districts’ maternal death surveillance and response data |
| title_short | Causes of maternal deaths in Sierra Leone from 2016 to 2019: analysis of districts’ maternal death surveillance and response data |
| title_sort | causes of maternal deaths in sierra leone from 2016 to 2019 analysis of districts maternal death surveillance and response data |
| url | https://bmjopen.bmj.com/content/14/1/e076256.full |
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