Determinants of Maternal Mortality in North Eastern Nigeria: A Population Based Study

Abstract

Aims: The aim of this study is to explore the determinants of maternal mortality across urban and rural areas of Borno State, North Eastern Nigeria. Method: A cross-sectional study design was used. Data were sourced from in-depth interview of women of reproductive age sampled across the state. 300 women of reproductive age were interviewed in urban areas, 100 each from the three senatorial districts of the state. Whereas 123 women were selected from three villages in each of the three senatorial districts. SPSS v16 was used for data analysis. Results: It was identified that early marriage is prevalent in both urban and rural areas of the state as more than 60% of the respondents in each area were married between 13 to 19 years of age. Similarly, about half of the respondents had their first pregnancy before 20 years of age, but no statistical significant difference was found between age at first pregnancy and pregnancy complications (ᵡ2= 19.4, df18, P>.05 in Urban Borno, ᵡ2= 11.2, df10, P>.05 in Rural Borno, α=0.05). Although, utilization of antenatal care (ANC) services were relatively high, but 17% (urban) and 29% (rural) of the women were found not to be attending ANC. Home delivery was also a common feature constituting 39% for urban Borno and 49% for rural Borno. A statistically significant relationship was found between level of education and maternal health/mortality in both urban and rural areas (P<.05). Accordingly, ethnicity is significantly associated with maternal health seeking behavior in Urban Borno (P<.05), as high parity was found to increase pregnancy complications in rural Borno state (P<.05). Conclusion: Major determinants of maternal deaths in urban/rural Borno state were poor access to basic obstetric care services, financial difficulty and illiteracy. The study thus recommends increase in awareness as well as a sustainable free maternal health services in the state.