Ejn. Urassa et al., MATERNAL MORTALITY IN TANZANIA - MEDICAL CAUSES ARE INTERRELATED WITHSOCIOECONOMIC AND CULTURAL-FACTORS, South African medical journal, 86(4), 1996, pp. 436
Objective. To estimate the magnitude and the immediate and underlying
causes of maternal mortality, as well as the demographic, socio-econom
ic and reproductive factors related to different causes of maternal mo
rtality. Design. A community-based incident case-referent study. Setti
ng. Ilala district, Dar es Salaam, Tanzania. Participants. During the
2-year period, February 1991 - January 1993, 645 female deaths were id
entified, of which 117 (18%) were maternal deaths. Main results. Direc
t obstetric causes accounted for 62%, indirect causes 35% and in 3% cl
assification was not possible because of insufficient information, Abo
rtion-related complications were the most common cause of maternal dea
th, followed by haemorrhage, hypertensive diseases, anaemia and sepsis
, Twenty-four per cent of the teenage maternal deaths as well as one-t
hird of those in single women were due to abortion, and 61% occurred i
n cases where pregnancy was reported as unwanted, Most women (75%) saw
a doctor before they died, but 21% had used local medicine, The perin
atal outcome is poor, Only 40% of the deceased women left a live baby.
Conclusions. There is a need to make family planning more accessible,
particularly to single and divorced women who may lack social support
, Traditional patterns for decision-making in the family and the use o
f local medicines still play an important role in maternal mortality,
both because of the medical side-effects and by delaying hospital trea
tment.