Maternal mortality in rural areas of Dodoma region, Tanzania: a qualitative study

Abstract

Background: A major public health concern in Tanzania is the high rate of maternal deaths as the estimated Maternal Mortality Ratio (MMR) is 454 per 100,000 live births (TDHS, 2010). The main objective of the present study was to find out the contributing factors to maternal mortality in rural areas of Dodoma region of Tanzania. Methodology: The verbal autopsy technique was used to reconstruct " the road to maternal death. " A structured open-ended questionnaire was developed on the basis of the " three delays " model: delay in the decision to seek care, delay in arrival at a health facility and delay in the provision of adequate care. The sample comprised of 20 cases, 4 for each district of Dodoma. Data were collected by conducting in-depth interviews with close relatives of the deceased women and those who accompanied the women (neighbours) during the time the illness developed to death. Results: There was delay in receiving appropriate medical care and that eventually lead to the death of the pregnant woman, due to underestimation of the severity of the complication, bad experience with the health care system, delay in reaching an appropriate medical facility, lack of transportation, or delay in receiving appropriate care after reaching to the hospital. Conclusion: This study shows that women do try to reach adequate health services when an emergency occurs, but that there are many obstacles that delay this process. Improving accessibility and quality of Emergency obstetric care services in the area is necessary if maternal deaths are to be prevented.