A COMMUNITY-BASED INVESTIGATION OF AVOIDABLE FACTORS FOR MATERNAL MORTALITY IN ZIMBABWE

A community-based investigation of maternal deaths was undertaken in a rural province (Masvingo) and an urban area (Harare) of Zimbabwe in o rder to assess their preventability. Avoidable factors were identified in 90 percent of the 105 rural deaths and 85 percent of the 61 urban deaths. Delay in seeking treatment contributed to 32 percent and 28 pe rcent of rural and urban deaths, respectively Lack of transportation d elayed or prevented access to health facilities in the rural area, a m ajor problem in 28 percent of the cases studied. Suboptimal clinic and hospital management was identified in 67 percent and 70 percent of ru ral and urban deaths, respectively Lack of appropriately trained perso nnel contributed to suboptimal care. In both settings, the severity of patients' conditions was frequently unrecognized, leading to delays i n treatment and referral, and inadequate treatment. Appropriate commun ity and health-service interventions to reduce maternal mortality are discussed.