INDIRECT ESTIMATES AND PERCEIVED CAUSES OF MATERNAL AND CHILDHOOD MORTALITY IN IWO LOCAL GOVERNMENT AREA, OSUN STATE, NIGERIA

Abstract

The data from the Vital Registration System that can be used for estimating maternal and child mortality (MCM) using the direct method, is often either unavailable or incomplete and inaccurate where it exists in Nigeria. These indicators are important for monitoring and evaluation of various maternal and child health programmes on going in Nigeria. Alternative and complementary method for generating plausible estimates of MCM need to be explored. Therefore, an indirect technique was used in this study to estimate MCM and its perceived causes in lwo Local Government Area (ILGA), Osun State, Nigeria. A cross-sectional survey was conducted among 1250 women of reproductive age (15-49 years). A two-stage cluster sampling method was used to randomly select four wards out of the 15 existing wards in ILGA with each ward representing a cluster. All households were visited in each selected cluster and an eligible woman was randomly selected in each household. A pretested, semi-structured questionnaire was used to collect data on socio-demographic characteristics, children ever born and those surviving, maternal death experience and perceived causes of MCM. The Sisterhood method and the Trussell variant of the Brass indirect technique were used to estimate maternal and child mortality respectively. Perceived causes of MCM was assessed on a 13-point scale with score more than mean ±ISD classified as right perception. Data were summarized using descriptive statistics, Chi square test and logistic regression model to investigate statistical significance of associated factors at p=0.05. Age of the respondents was 29.7±8.3 years, 69.4% had at least secondary education and 9.8% had no formal education. Majority (62.5%) of the respondents were Muslims and 98.8% were of Yoruba ethnic group. The adjusted total fertility rate was 3.86. Number of reported maternal deaths was 56 and 1350 sisters were at risk. The lifetime risk of maternal mortality was 4.15%. The estimated maternal mortality ratio was 1,074 per 100,000 live births. The adjusted infant mortality rate was 99 deaths per 1,000 births and under-five mortality rate was 180 deaths per 1,000 births. A bout 60.0% of the respondents had right perception relating to the causes of MCM. Majority (71.0%) reported that pregnant and nursing mothers do not go for antenatal care because they lack the money to pay for transport and hospital bill. More than half (53.8%) of the respondents agreed that women died during pregnancy because they do not deliver in the health centers. Respondents who reported less than three children (OR=0.24, Cl=0.11-0.57) were less likely to experience child loss compared to those who reported three or more. Young women who were aged I 5-24 years (OR= 1.89, CI=0.64.2.46) were more likely to experience child loss compared to those aged 25-34 years. Maternal, Infant and Under-five mortality were high in lwo Local Government Area. Poverty, place of delivery, age at child bearing and parity are factors that influenced maternal and child mortality. Therefore. integration of reproductive health services into existing health programmes especially primary health care is recommended to reduce maternal and child mortality.