Maternal Health Prior to Neonatal Mortality in Blantyre, Malawi

Tuesday, 19 November 2013: 9:10 AM

kaye I Bultemeier, PhD, MSN, APRN/BC
School of Nursing, Lincoln Memorial University, Harrogate, TN

Learning Objective 1: The learner will be able to articulate the warning signs and symptoms of women who experienced a neonatal death in Blantyre, Malawi

Learning Objective 2: The learner will be able to discuss the impact of the lack of response to warning signs on perinatal mortality

Maternal Health Prior to Neonatal Mortality in Blantyre, Malawi

Kaye Bultemeier PhD,FNP-C-Lincoln Memorial University, University of Malawi

Background/Significance: Since the introduction of the MMGs the incidence of neonatal death in Malawi has improved from 42/1000 (2006) to 22/1000 in 2010. The levels remain unacceptable. Approximately ½ of all deliveries in Malawi occur outside of a health care facility. In rural areas this has been attributed to factors related to transportation and cost of reaching a health facilityThere was a need to examine the health of antenatal mothers, before delivery, to determine whether antenatal factors existed which assist in identifying women at risk of delivering a stillbirth or experiencing a neonatal death in the urban area of Blantyre city.

Objectives/aims: To examine material factors, prior to the delivery, that subsequently resulted in a neonatal death.

Methods: A retrospective exploratory study of maternal health prior to delivery of an infant that ended in a neonatal death. A purposive sample of 127 families, who had experienced a neonatal death. The families were identified through village chiefs, community health centers, and community members. Inclusion criteria:  Families who experienced a neonatal death, or stillbirth, within three days of delivery between January and May of 2011 and lived in the city of Blantyre, Malawi. Trained Health surveillance assistants, using the WHO verbal autopsy form, administered oral questionnaires, in the home.

Results: Positive Maternal Health Indicators included: High blood pressure 16.2%, severe abdominal pain 20.2%, headache 20.4%, vaginal bleeding 7.3%, puffy face 4.6% and fever 3.8 %.

Conclusions: The findings indicate that the women and their families lack the ability to identify maternal warning signs. This lack of awareness delays access to a health care facility. Efforts to increase the awareness and responsiveness to these warning signs are needed to further reduce the neonatal mortality rates.