Case study: Contributory Factors to In-hospital Maternal Mortality in a Governmental Hospital in Khartoum State in 2006

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Christelle Evans
Mutasim El-Feel
Abdelmageed Osman
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Napata College
Background: In-hospital maternal mortality rates in Sudan are currently high, at 0.09%(1). According to World Health Organisation standards, in-hospital maternal mortality should not exceed 0.025%(2). Common contributory factors are numerous, both in-hospital and in the community. This study aims to identify specific contributors to maternal mortality and morbidity in a governmental hospital to make recommendations to minimize them. Materials and Methods: The study basis was an initial case study of maternal morbidity in a governmental hospital with subsequent exploration of contributory factors. A participatory rapid appraisal approach was used, employing observational checklists and semi-structured interviews in order to identify problems at every level of the hospital system, cross-checking information with different stakeholders. Results: Results identified primary delays in seeking care and suboptimal care delivery as the main contributors to in-hospital maternal mortality and morbidity. Interviews with patients and staff also highlighted a need for more patient education and more supervision and training opportunities for junior staff.