Correlates of Pregnancy Related Complications in Mandera East, Mandera County, Kenya
Issakow, Abdi Maalim
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Complications during pregnancy and childbirth are a leading cause of death and disability among women of reproductive age worldwide. About eight hundred women die from pregnancy or childbirth-related complications around the world every day. In most low-income countries, high maternal mortality of women (462 per 100,000) of reproductive age is attributed to pregnancy-related causes. In Kenya, Mandera County contributes the highest burden of maternal mortality ratio 3795 per 100,000 live births; therefore, this study sought to determine factors influencing complications in pregnancy among women in Mandera County, Kenya. Specifically, the study examined health facility attributes, maternal characteristics, and socio-cultural drivers that reinforce complications in pregnancy. This study employed a descriptive cross-sectional study design utilizing quantitative and qualitative data collection methods among 350 respondents seeking maternal health service in health facilities in Mandera County. Stratified, simple random, and proportionate sampling techniques were used to sample health facilities and respondents. An interviewer-administered questionnaire during data collection. Quantitative data were analyzed using SPSS version 20. Frequencies and percentages were used to describe data. Chi-square and fisher‟s exact test were used to test the association between the dependent and independent variables. Data were considered significant at p<0.05. Findings illustrate that Anaemia (28%), vaginal discharge (13 %), miscarriage (9%), lower limb oedema (24%), and haemorrhage (17%) were the prevalent complications during pregnancy. Laceration (39.1%) anaemia (22.8%), and haemorrhage (19%) were the reported forms of complications during delivery. Spontaneous delivery was the preferred mode of delivery among respondents. Sepsis (56.5%), Haemorrhage (25.9%), and stillbirth (10.9%) were the prevalent complications after delivery. Data shows that the median number of Antenatal visits was three and one for a postnatal visit. Slightly more than half of the respondents (54.4%) were satisfied with staff attitude. At least 87.2% of respondents in the study had undergone female genital mutilation, and the majority of participants attested that their communities supported early child marriage. Inferential analysis shows that complications during pregnancy were associated with age (p=0.026), household income (p=0.05) time-taken to the health facility (p=0.02). Complications during delivery were associated with average waiting time (p=0.02) and perceived staff attitudes (p=0.021). Complications after delivery were associated with time taken to health facilities. In conclusion, anemia, vaginal discharge, and haemorrhage were the prevalent complication during pregnancy, delivery, and the postpartum period. Antenatal and post-natal care visits were optimally low. This study recommends concerted efforts to emphasize the need to sensitize women of reproductive age to identify common obstetric danger signs and symptoms and other stakeholders on the importance of maternal and child health. There is a need to document incidence and prevalence of maternal morbidity at the health facility level to inform decision-making regarding the quality of maternal health services. The County health department needs to increase the number of health facilities within the county to enable access to Maternal health services to reduce the time -taken to access health facilities.