Limits...
Maternal mortality in rural south Ethiopia: outcomes of community-based birth registration by health extension workers.

Yaya Y, Data T, Lindtjørn B - PLoS ONE (2015)

Bottom Line: The secondary outcome was the proportion of skilled birth attendance.It is possible to obtain a high-coverage birth registration and measure MMR in rural communities where a functional system of community health workers exists.The MMR was high in rural south Ethiopia and most births and maternal deaths occurred at home.

View Article: PubMed Central - PubMed

Affiliation: Centre for International Health, University of Bergen, Bergen, Norway; Arba Minch College of Health Sciences, Arba Minch, Ethiopia.

ABSTRACT

Introduction: Rural communities in low-income countries lack vital registrations to track birth outcomes. We aimed to examine the feasibility of community-based birth registration and measure maternal mortality ratio (MMR) in rural south Ethiopia.

Methods: In 2010, health extension workers (HEWs) registered births and maternal deaths among 421,639 people in three districts (Derashe, Bonke, and Arba Minch Zuria). One nurse-supervisor per district provided administrative and technical support to HEWs. The primary outcomes were the feasibility of registration of a high proportion of births and measuring MMR. The secondary outcome was the proportion of skilled birth attendance. We validated the completeness of the registry and the MMR by conducting a house-to-house survey in 15 randomly selected villages in Bonke.

Results: We registered 10,987 births (81·4% of expected 13,492 births) with annual crude birth rate of 32 per 1,000 population. The validation study showed that, of 2,401 births occurred in the surveyed households within eight months of the initiation of the registry, 71·6% (1,718) were registered with similar MMRs (474 vs. 439) between the registered and unregistered births. Overall, we recorded 53 maternal deaths; MMR was 489 per 100,000 live births and 83% (44 of 53 maternal deaths) occurred at home. Ninety percent (9,863 births) were at home, 4% (430) at health posts, 2·5% (282) at health centres, and 3·5% (412) in hospitals. MMR increased if: the male partners were illiterate (609 vs. 346; p= 0·051) and the villages had no road access (946 vs. 410; p= 0·039). The validation helped to increase the registration coverage by 10% through feedback discussions.

Conclusion: It is possible to obtain a high-coverage birth registration and measure MMR in rural communities where a functional system of community health workers exists. The MMR was high in rural south Ethiopia and most births and maternal deaths occurred at home.

No MeSH data available.


The map of the study area within southern Ethiopia.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4370399&req=5

pone.0119321.g001: The map of the study area within southern Ethiopia.

Mentions: The Ethiopian government has autonomous regional states within the Federal Republic. In turn, regional states are subdivided into zones (provinces), Woredas (districts), and Kebeles (villages). A zone is a cluster of 10–15 districts, and a district is a group of 20–50 villages. A Kebele is the lowest administrative structure and is comprised of 1,000–1,500 households. This study was conducted in three districts (Arba Minch Zuria, Bonke, and Derashe) in two zones (Gamo Gofa and Segen Area Peoples') in the Southern Nations, Nationalities, and Peoples’ Region (SNNPR, Fig. 1). The Gamo Gofa Zone (population = 1,740,828 people in 2010) [18], the centre of which is at Arba Minch, is 505 km from Addis Ababa to the southwest and the Segen Area Peoples’ Zone (636,794 residents in 2010) [18] is 575 km from Addis Ababa.


Maternal mortality in rural south Ethiopia: outcomes of community-based birth registration by health extension workers.

Yaya Y, Data T, Lindtjørn B - PLoS ONE (2015)

The map of the study area within southern Ethiopia.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4370399&req=5

pone.0119321.g001: The map of the study area within southern Ethiopia.
Mentions: The Ethiopian government has autonomous regional states within the Federal Republic. In turn, regional states are subdivided into zones (provinces), Woredas (districts), and Kebeles (villages). A zone is a cluster of 10–15 districts, and a district is a group of 20–50 villages. A Kebele is the lowest administrative structure and is comprised of 1,000–1,500 households. This study was conducted in three districts (Arba Minch Zuria, Bonke, and Derashe) in two zones (Gamo Gofa and Segen Area Peoples') in the Southern Nations, Nationalities, and Peoples’ Region (SNNPR, Fig. 1). The Gamo Gofa Zone (population = 1,740,828 people in 2010) [18], the centre of which is at Arba Minch, is 505 km from Addis Ababa to the southwest and the Segen Area Peoples’ Zone (636,794 residents in 2010) [18] is 575 km from Addis Ababa.

Bottom Line: The secondary outcome was the proportion of skilled birth attendance.It is possible to obtain a high-coverage birth registration and measure MMR in rural communities where a functional system of community health workers exists.The MMR was high in rural south Ethiopia and most births and maternal deaths occurred at home.

View Article: PubMed Central - PubMed

Affiliation: Centre for International Health, University of Bergen, Bergen, Norway; Arba Minch College of Health Sciences, Arba Minch, Ethiopia.

ABSTRACT

Introduction: Rural communities in low-income countries lack vital registrations to track birth outcomes. We aimed to examine the feasibility of community-based birth registration and measure maternal mortality ratio (MMR) in rural south Ethiopia.

Methods: In 2010, health extension workers (HEWs) registered births and maternal deaths among 421,639 people in three districts (Derashe, Bonke, and Arba Minch Zuria). One nurse-supervisor per district provided administrative and technical support to HEWs. The primary outcomes were the feasibility of registration of a high proportion of births and measuring MMR. The secondary outcome was the proportion of skilled birth attendance. We validated the completeness of the registry and the MMR by conducting a house-to-house survey in 15 randomly selected villages in Bonke.

Results: We registered 10,987 births (81·4% of expected 13,492 births) with annual crude birth rate of 32 per 1,000 population. The validation study showed that, of 2,401 births occurred in the surveyed households within eight months of the initiation of the registry, 71·6% (1,718) were registered with similar MMRs (474 vs. 439) between the registered and unregistered births. Overall, we recorded 53 maternal deaths; MMR was 489 per 100,000 live births and 83% (44 of 53 maternal deaths) occurred at home. Ninety percent (9,863 births) were at home, 4% (430) at health posts, 2·5% (282) at health centres, and 3·5% (412) in hospitals. MMR increased if: the male partners were illiterate (609 vs. 346; p= 0·051) and the villages had no road access (946 vs. 410; p= 0·039). The validation helped to increase the registration coverage by 10% through feedback discussions.

Conclusion: It is possible to obtain a high-coverage birth registration and measure MMR in rural communities where a functional system of community health workers exists. The MMR was high in rural south Ethiopia and most births and maternal deaths occurred at home.

No MeSH data available.