Analysis of factors associated with maternal mortality in Kenyan hospitals

This paper examines the association of the sociodemographic characteristics of women and the unobserved hospital factors with maternal mortality in Ke nya using multilevel logistic regression. The data analysed comprise hospit al records for 58,151 obstetric admissions in sixteen public hospitals, con sisting of 182 maternal deaths. The results show that the probability of ma ternal mortality depends on both observed factors that are associated with a particular woman and unobserved factors peculiar to the admitting hospita l. The individual characteristics observed to have a significant associatio n with maternal mortality include maternal age, antenatal clinic attendance and educational attainment. The hospital variation is observed to be stron ger for women with least favourable sociodemographic characteristics. For e xample. the risk of maternal death at high-risk hospitals for women aged 35 years and above, who had low levels of education, and did not attend anten atal care is about 280 deaths per 1000 admissions. The risk for similar wom en at low-risk hospitals is about 4 deaths per 1000. To complement results from the analysis of individual patient records, the paper includes finding s from hospital staff reports regarding the maternal mortality situation at the hospitals.