Determinants of perinatal mortality in Mutare district, Manicaland province 2018-2019.

Abstract

Perinatal mortality rate (PMR) is an indicator in the quality of care given to women during pregnancy, labour, delivery and the postnatal period. The PMR for Mutare district increased from30 to 35 per 1000 live births between 2017and 2018.The study sought to determine reasons for high perinatal rates in the district and assess available resources for optimum perinatal care in the district. Methods: A mixed method approach and unmatched 1:2 case control study design was conducted using a pretested interviewer administered questionnaire. A total of 73 cases and 146 controls were recruited into the study. A case was a woman who resided in Mutare district who had a perinatal death from 1stAugust 2018 to31st May 2019. A control was a woman who resided in Mutare district whose baby survived the same period. Two focused group discussions (FGD) were conducted in the district using the FGD guide. Key informant interviews were conducted. Results: The median age of cases and controls was23years (Q1=19:Q3=45) and 31 years (Q1=22:Q3=34). Gestational age of <36 weeks(OR 2.43, 95% CI 1.71-3.44), belonging to an apostolic sect (OR 1.93 95% CI 0.98-2.38)were independent risk factors for perinatal mortality. Delivering at a health facility was protective against perinatal death(OR 0.32 95% CI 0.05-1.95).Resource shortages were cited as contributing to perinatal mortality. Conclusion: Independent risk factors included gestational age <36 weeks and belonging to an apostolic sect. Health system related factors maybe associated with perinatal mortality in the district. Training of district managers on effective use of resources and contingency plans for an effective referral system was recommended