Factors associated with the occurrence of maternal deaths in the West Region between 2020 – 2022: case control study

Igiene e Sanità Pubblica 2024; 89 (2)41-58

Armand Tiotsia Tsapi1,2, Eric Defo Tamgno5, Jacques Delors Toumansie Mfonkou8, Edmond Fofou2, Tankeu Gilles Happi3, Emiline Zogning Makemdjio4, Djommo Metchehe Loic3, Guehoua Konga Ghislain6, Gianluca Russo7, Vittorio Colizzi1,4


1Evangelical University of Cameroon, Faculty of Science and Technology, Mbouo Bandjoun,
2 West Regional Delegation of Public Health, Reproductive Health Program, Bafoussam, Cameroun
3 Global Research Agency, Department of Research and Science, Dschang, Cameroon
4 University of Rome Tor Vergata, Department of Immunology and Biotechnology, Rome, Italy
5 University of Liège, Department of Health Sciences, Liège, Belgium
6 GIZ/Pro PASSaR Project, Technical Assistance West Regional Public Health Delegation
7 University of Rome la Sapienza, Department of Public Health, Infectious Diseases and Microbiology, Rome, Italy
8 University of Ebolowa, Department of Public Health, Faculty of Medecine and Pharmaceutical Sciences

WHO defines maternal mortality as any death of a woman occurring during pregnancy or within 42 days of its termination or after delivery. Our aim was to study the factors associated with the occurrence of maternal deaths in the West Region of Cameroon between 2020 and 2022.
This was a case-control study. Cases consisted of maternal deaths that occurred during the study period. The controls for their part were made up of women who normally gave birth in the same health facilities from which the cases came and during the same period as the cases. The only exposure criterion being the status of death. The data useful for our investigation were collected respectively with the investigation sheets, audit reports and via interviews with the heads of the health facilities where the maternal deaths occurred with a view to considerably reducing information bias. Analysis were done with IBM-SPSS 25 and RStudio 2023.03.0.
The West Region of Cameroon recorded 161 maternal deaths between 2020 and 2022.
67% of them were housewives. The most frequently identified causes were haemorrhage (ante-, per- and post-partum), followed far behind by complications and sepsis, with respective 42.2%, 12.4% and 10.6%. Slightly more than one child out of 10 had an abnormal presentation. Nearly 50% had a short labor (less than 10 hours), the partograph was used in 38% of the women, and the GATP practiced in 50.1% of them. Abnormal presentation of the fetus (aOR = 2.7 (95% CI: 1.4 – 5.1), p=0.002), failure to use the partograph (aOR = 4.4 (95% CI: 2 .6 – 7.4), p<0.001), the fact of not having an economic activity (aOR = 1.7 (95% CI: 1.0 – 2.7), p = 0.033), the fact of having taken less than 2 doses of VAT ( aOR = 2.8 (95% CI: 1.8 – 4.4), p<0.001) and the absence of practice of GATP (aOR = 1.6 (CI 95%: 1.0 – 2.6), p=0.040) were identified as factors that significantly favored the occurrence of maternal deaths.
Several factors negatively influence the occurrence of maternal deaths in the West Region.
Operational strategies such as continuous training of maternity ward staff, and the
establishment of systematic maternal death audits and review meetings should be
implemented to reduce and control these risk factors.