Determinants of adverse pregnant outcomes in Mutare district clinics, Manicaland Province, Zimbabwe

Abstract

Globally, neonatal mortality, and still births are major public health problems. Though preventable, nearly three million babies die every year in their first month of life and a similar number are stillborn, accounting for 7% of global burden of disease, which is higher than the burden of Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS). Up to 50% of all deaths within the first month occur within the first 24 hours of life, and up to 75% occur in the first week. Zimbabwe’s Neonatal Mortality Rate (NMR) rose from 33/1000 deaths per 1000 live births in 1990 to 39/1000 in 2012. The country is far from reaching Millennium Development Goal 4 (MDG4) on child survival as the pattern on rising NMR is evident in districts like Mutare. Though interventions like result based financing (RBF), increase in midwifery training, provision of Basic Emergency Obstetric and Neonatal Care (BEMNOC) have been implemented in the district, the district has a high NMR of 55.2 deaths per 1000 live births. This study aims to explore the determinants of adverse pregnancy outcomes in Mutare facilities. The primary objective of the research is to determine if pregnancy outcomes differ by socio-economic, maternal, neonatal, delivery and health system factors. The study will employ a retrospective cross-section analytical approach. Records of pregnant women who delivered at 7 sampled facilities during the period January 2014 to June 2014 will be reviewed. The working definition for adverse pregnancy outcomes for this study will be women who had a fresh still birth or early neonatal deaths. The results from the study will be presented as a report in partial fulfilment of the requirements for the award of the degree on Master of Public Health by the University of Pretoria. A presentation of the results will be made to the Health Executive of Mutare districts as well as Manicaland Province. The results will also be published in a reputable journal and availed for public consumption.