PREVALENCE OF MATERNAL MORTALITY RATE IN (CHC) SAFANA

WARD, SAFANA LOCAL GOVERNMENT AREA KATSINA STATE

BY

ABUBAKAR BELLO
19/HPKK/014

A RESEARCH SUBMITTED TO THE DEPARTMENT OF

ENVIRONMENTAL HEALTH SCIENCES, COLLEGE OF HEALTH

TECHNOLOGY KANKIA IRO, SCHOOL OF HEALTH

TECHNOLOGY, KANKIA KATSINA STATE

IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE

AWARD OF DIPLOMA IN HEALTH EDUCATION AND

PROMOTION, BY WEST AFRICA HEALTH EXAMINATION

BOARD (WAHEB

DECEMBER, 2020
 DECLARATION

This project work was conducted by Abubakar Bello under the supervision

of Mal. Nura Surajo Kankia. Department of Environmental Health Sciences,

Kankia Iro School of Health Technology Kankia, Katsina State

__________________________ _______________
Abubakar Bello Date:
19/HPKK/014

ii
 APPROVAL PAGE

This is to certify that this project titled “Prevalence of Maternal Mortality

Rate in (CHC) Safana Ward, Safana Local Government” was written by

Abubakar Bello, a student of Health Education and Promotion, School of

Health Technology Kankia, Katsina State.

__________________________ ______________________
Project Supervisor Date
Mal. Nura Surajo

__________________________ ______________________
Head of Department Date
M. Sanusi Umar Radda

__________________________ ______________________
External Supervisor Date

iii
 DEDICATION

This project work is dedicated to my lovely parent Alhaji Alkali Bello

(Rimi) Safana, Hajiya Lariya Bello and my Brother, Dikko and Jamilu who

took my responsibility during my entirely study, May Almighty Allah

(S.W.T) reward them abundantly, Ameen.

It is also dedicated to my lovely girlfriends Fatima Yakubu Yusuf Kankia

and Khadija Muhammed Katsina State.

iv
 ACKNOWLEDGMENT

All praise to be Almighty Allah (S.W.T) whom sparing my life to start and

end of this program with much gratitude, I acknowledge the effort of my

able supervisor Mal. Nura Surajo Kankia for his time and attention during

my research work.

I am very grateful to my parents Alhaji Alkali Bello (Rimi) Safana, Hajiya

Lariya Bello for their prayers, love, care, encouragement, financially and

moral support given to my entire study.

I am very grateful to all members of my family, most especially my brothers

and sisters: Hajiya Habi Bello, Malam Sani Rimi, Aminu, Yahayya,

Ibrahim, Aliyu, Huwaila, Sahiba, Basiru, Shafi’u, Basiru, Aauwal Goje,

Aisha, Nafisa, Hafsat, Fiddausi, Basma, Rukayya, Murja, Hauwa’u, Hassan,

Lawal, Fatima, Huzaima, Amina, Hinde, Nana, Rais, Babawo, Abubakar and

Usman (Funtua) may Almighty Allah (S.W.T) blessings be upon them,

Ameen.

I wish to acknowledge my HEP friends and my friends at home for their

unconditional love, support and encouragement.

v
I want to give a big thanks to all my lecturers for their supports and

corrections in my life as a student, throughout my stay in the College of

Health Sciences and Technology Kankia Iro.

My appreciation will be uncompleted without give thanks to the Head

Department of Community Health for his fatherly advice. Thank you sir,

Thank you all!

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 TABLE OF CONTENTS

Cover Page i
Declaration ii
Approval Page iii
Dedication iv
Acknowledgment v
Table of Contents vii
Abstract ix
CHAPTER ONE

1. Introduction 1.1
3. Statement of the problem 1.2
7. Signification of the Study 1.3
7. Objective of the Study 1.4
7. Research Question 1.5
8. Scope/Delamination of the Study 1.6
9. Definition of Terms 1.7
CHAPTER TWO

11. Introduction 2.1

11. The Concept of the Maternal Mortality 2.2
15. Objective of Maternal Child Health Service 2.2
16. Factors Influencing the Health of Mother and the Child 2.3
17. Component of Maternal and Child Health 2.4
18. Pulmonary Embolism 2.5.1
18. Hypertension 2.5.2
19. Anesthesia 2.5.3

vii
19. Hemorrhage and Trauma 2.5.4
20. Ectopic Hesitation 2.5.5
20. Major Puerperal Infection 2.5.5
21. The Obstetrical Causes Maternal Morality 2.6.
21. Severe Anaemia 2.6.1
21. Obstructed Labour 2.6.2
21. Prevention Measures of Maternal Mortality 2.7
22. Control Measures Problems 2.8
CHAPTER THREE

23. Methodology 3.1

23. Sample and Sampling Technique 3.4
23. Instrument for Data Collection 3.5
23. Valid and Reliability of the Instrument 3.6
24. Administration of the Instrument 3.7
24. Method of Date Analysis 3.8
CHAPTER FOUR

25. Data Presentation and Analysis 4.1

CHAPTER FIVE

29. Summary 5.1

30. Conclusion 5.2
31. Recommendation 5.3
31. Suggestion of the studies 5.4
32. References
33. Questionnaire

viii
 ABSTRACT

This research Project is based on the Prevalence of maternal mortality rate

In Safana ward, Safana Local Government, It was written in order to find

out major Causes of Maternal mortality rate, as well as to find out the roles

of government and non-governmental organization to ward controlling

those diseases.

ix
 CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

According to the World Health Organization (WHO) a maternal death is

defined as the death of women as a result of pregnancy, irrespective of the

duration of the pregnancy from any cause related to aggravate by the

pregnancy or its management but not from accident or incidental cause.

Generally, there is distraction between a direct maternal complication, the

pregnancy, delivery, or management of the two and indirect maternal death that

is a pregnancy related death in a patient with preexisting or newly developed

health problem unrelated to pregnancy. However, a number of issue need to be

recognized first of all, the world health organization definition is only one of

many other definition may also include accidental or incidental causes, cases

with incidental causes include deaths second to violence against women by the

socio economic and cultural environment. Also it has been reported that about

10% of maternal deaths may occur after 42days after a cermanation or

delivery.

MAJOR CAUSES

As stated by the who in its 2005, world health organization report the major

causes of maternal death are; severe bleeding/hemorrhage (21%) infection (13),

1
unsafe abortion (13%) eclampsia (12%) obstructed labour (8%) other direct

cause (8%) and indirect causes (20%) are thing such as malaise, aneamia,

HIV/AIDs and are aggravated by it. five percent (5%) of post-partum

hemorrhage death, account within 24hours our 90% of maternal death occur in

developing homicide occurs for 2 to 40 deaths per 100, 000 live births possibly

Luther due to under reporting unintended pregnancy resulted in almost 700,

000 maternal deaths from 2015 – 2017 (approximately one fifth of the maternal

death during that period). The majority (62%) resulted from complication from

unsafe or unsanitary abortion another issue that is associated with maternal

mortality is the lack of skilled medical care during could birth and the distance

of travelling to the nearest clinics to receive proper care. In developing nations,

as well as rural areas this is especially true. Travelling to and back from the

clinics is very difficult and costly, especially poor families. When time could

have been used for working and providing incomes, even so the nearest clinic

may not provide decent care because of the lack of qualified staff and

equipment such as the lack of qualified staff and equipment such as ones in the

homicides and villages, the world health organization (WHO) estimates that

approximately 1, 000 women globally die every day due to complication from

pregnant or delivery, the number of maternal deaths was estimated to be 529,

000 in 2010 worldwide. However, it is well recognized the maternal mortality

number are often significantly under reported. In fact; According to the United
2
Nation, it is estimated that the number of maternal deaths globally could fall

ruling range 277, 000 to 817, 000 per year. The decline in maternal death has

been due to target to improve a sepsis flied management and blood transfusion

and better prenatal care. However, while hypertension; bleeding and infection

have been licensed as major causes of maternal mortality in Nigeria. Is it not

better to weak and poor primary health care system in Nigeria very few health

centres in Nigeria can boast to competent staff in a well-organized environment

with every drugs and equipment in place. As a result of this ineptitude and

lack, the Nigeria leader who were supposed to equip these health center but

have failed only resort for flying their pregnant wives to ever seas, with their

loots, where equipment expected to see in health centre are for safe delivery,

thereby a bending those pregnant wives who cannot afford the overseas trip to

their fate.

1.2 HISTORICAL BACKGROUND OF THE AREA OF STUDY

Safana is a Local Government area in Katsina state Nigeria. Its headquarters

are in the town of Safana in East of the area at 12 24'30''E/12.408339v

7.40694E.

The west border of the area is shared with Zamfara State and has town district

head which is Yariman Katsina and Gatarin Katsina. It has an area of 281km

and a population of 183,779 at the 2006 population census.

3
Safana Local Government was created by the former Head of state and

Commander in Chief of Armed forces of Nigeria General Ibrahim Badamasi

Babangida (IBB) sequel to the Dasuki out of the defunct Dutsim-ma Local

Government.

The two district area comprises many Villages head respectively which are:

1. Zakka
2. Tsaskiya
3. Runka
4. Baure
5. Baude
6. Gorah
7. Alhazawa
8. Guzirawa
9. 'Yar lilo
10.'Yar santa
11.Dan dari
12.Tashar luna
13.Kunamawa
14.Jarkuka
15.Tulun busawa
16.Habul
17.Kunkunna
18.Tashar bukiti
19.Katsalle
20.Gobirawa
4
 21.Sabawa
22.Hayi
23.Gimi
24.Mangwarori
25.Ba Dole

GEOGRAPHICAL LOCATION OF THE STUDY

Safana Local Government is located in the tropical part of the country with two

(2) main season, these are dry and wet seasons through November to march

POPULATION: Based on 2006 census Safana Local Government area has a

projected population of 183,779 people.

AGRICULTURE: Safana Local Government area is one of the food

producing areas of the state, the Local Government area can reach with the

fertile land capable of producing both cash and crops in large quantities for the

improvement of standard living of the producer and there, neighboring

communities. To table among these crops produced in the area are maize,

cotton, guinea, corn, millet, beans, groundnut, cassava, potatoes, cheese E.T.C

EDUCATION: In terms of education Safana Local Government has primary

and post primary school that is Government Day Secondary School (GDSS)

Zakka Government Day Secondary School Safana (GDSS) Babban Duhu

5
Community Secondary Safana (GRBSS) Safana but now is day Secondary

School.

HEALTH CARE DELIVERY: Safana Local Government has twenty

two( 22) dispensaries, two health offices (attached to each dispensaries)and one

(1)cold chain store at the headquarter Safana.

The primary health Care (PHC) center department of consist (5)as listed viz

1. Essential drugs and equipment unit

2. Disease and child unit immunization disease control unit

3. Maternal and child health (MCH) and family planning unit

4. Health education and water sanitation unit

5. Monitoring and evaluation unit

COMMERCE AND INDUSTRY: The people of Safana Local Government

area, practice local craft such as carpentry, block cement, wearing, dying, dry,

dearner, and drivers and numerous traditional industry e.g poetry, black smith.

TOURISTS ATTRACTION: Safana Local Government area has the tours

attraction of natural forest reserve called Dajin rugu and one water spring

coming bounder the stone at Gimi Northern part of the Runka Village.

SOCIAL DEVELOPMENT: Safana Local Government area has electrical

power supply from the power Holding Company of Nigeria (PHCN) and also it
6
has police station post office and video center.in the terms of community effort

towards the development of the area there are many youth and sport clubs.

1.3 STATEMENT OF THE PROBLEMS

Maternal mortality is becoming rampant pausing to the women of our society

today, several lives were lost as a result of pregnancy or delivery (labour), and

these may be due to several problems. Therefore, the need to identify these

problems and deal with them accordingly so that the lives of women and their

children could be safe and the mothers are manufacturing of all the citizens that

make the nations more forwards.

1.4 SIGNIFICANCE OF THE STUDY

This research work is highly significant especially to the ministry of health that

is responsible of providing maternal and child health care services to the

community or society. Likewise organization could also find very useful.

1.5 OBJECTIVES OF THE STUDY

1. Identify the role of maternal and child health care services in the

prevention of maternal death

2. Determine how effective the maternal and child health care services are

rendered in the area of the study

3. Outline factors that contribute towards maternal death

7
 4. Discuss on how maternal & child health (MCH) could assist in checking

maternal death.

1.6 RESEARCH QUESTION

- What are the causes of material morality rate?

1.7 SCOPE/DELIMITATION OF THE STUDY

This research project is delimited to Safana Ward, Safana Local Government

clinic. The main purpose of the study is determined the rate of maternal

mortality among women’s of child bearing age in Safana Local Government

Area.

8
1.8 DEFINITION OF TERMS

1. ABORTION: Is the expulsion of the product of conception saving the

twenty (20) weeks of gestation.

2. ANEMIA: Is a condition in which the blood is deficient in red blood cells,

in hemoglobin or in total volume.

3. ANTI PARTUM HEMORRHAGE: is the abdominal bleeding from the

vaginal canal before birth.

4. ANTI – NATAL CARE: It simply refers to the care given to pregnant

women before delivery.

5. DYSTOCIA: Is define as the difficulty of labour

6. ECLAMPSIA: Is a conclusive state on attack of conclusion as to anemia of

pregnancy to or associated with child birth.

7. EMBOLISM: Is the birth of a death fetus

8. GYNECOLOGY: Is defined as the branch of medical sciences that deals

with treatment of female’s genital tract.

9. LABOUR: Is a physical activities in parturition consisting essentially of a

prolong series of involuntary contraction of the uterus emasculative together

with both reflex and voluntary contraction of the abdominal wall.

10.MATERNAL MORTALITY: Is defined as the number of women dying to

pregnant, labour and pueperium in a year over total birth.

9
11.MATERNAL MORBIDITY: Is defined as the disease or relation to

abnormal or disordered condition in pregnancy period.

12.MENSTRUATION: Is defined as the flow of blood from the uterus once a

month in the female. From puberty to menopause

13.NEONATAL DEATH: It refers as the death of a newborn baby during

first month after birth

14.POST PARTUM HEMORRHAGE: Is the abdominal bleeding from the

birth canal after delivery.

15.POSTNATAL CARE: It is simply refers to the care given to women after

delivery.

16.SEPSIS: Toxic condition resulting from spread of bacteria or their product

forms of infection.

17.RISK: It refers possibility to loss, diseases or death or person considered in

terms of the possible bad of particular cause.

10
 CHAPTER TWO

LITERATURE REVIEW

2.1 INTRODUCTION

This chapter will be discussed under the following eight headings: The concept

of maternal mortality, The objective of maternal and child health services, the

factors influencing the health of the mother and child the component of

maternal and child health, the causes of maternal mortality and lastly the

control measures of maternal problems.

2.1 THE CONCEPT OF MATERNAL MORTALITY

This is defined as the death occurring during pregnancy attribution to

compilation of pregnancy, child birth or puerperium, there are about or death

from every 10, 000 pregnancies, about half the death are due to pregnancy (true

maternal death and others due to associated information is available from a

series confidential enquires into maternal death in England and Wales. The

latest report (the ninth in the year 1976 – 1978) gave the rates as 10- per

million of total birth (Turner, 1985).

According to the textbook for midwives with modern concept of obstetric and

neo-natal care by Margent F, state that the maternal mortality rate is the

number of death registered during the year of women dying from causes

attributed to pregnancy and child birth for 1, 000 registered total (live and still)
11
in the year. During 1981, the maternal mortality rate in English 0.09 per 1, 000

including abortion.

MATERNAL MORTALITY RATE: This is defined as the number of death

described to pregnancy and child bearing per thousand live and still births. The

means that any death that comes at pregnancy period or child bearing time

should be term as a maternal mortality.

Also continue saying that death from abortion should be included. Although,

they are often tabulated separately the present rate is about 0.12 per thousand

of which abortion account per 0.1 per thousand (UNICEF, 1996).

Although, most of these heading are clear if may whether unexplained death

from other causes have not been include under pulmonary embolism. A main

heading which does not appear clearly in the death from anesthetic difficulties

is which contributed in 10 percent of heading. The part placed by the section is

also hidden no less than 21 percent of deaths followed this operation,

performed for a variety indication (MYELES, 1985).

The world health organization revealed that each year women worldwide die

during childbirth, 95% in the developing countries shocked policy makes at

international levels. Over 90% of cases of mortality rate in developing

countries over hemorrhage, hypertensive disorder in pregnancy, puerperal

12
sepsis, unsafe abortion and obstetrics labour. The 30% - 40% of women who

encounter complication during pregnancy and delivery need to be attended by

doctors and midwives. In health centers or referral facilities located as close to

the most serious problems of all pregnant required hospital support, skilled

personnel to provide high quality obstetric care.

Acute pregnancy related to maternal problem neither suffered by over 30

million women as well as chronic long term disabilities (such as fistula or

prolapsed uterus) nor burdening million more. Women could be reduced or

prevented by one third to a half through improved management during labour

and delivery. And thus, estimated that the rate of maternal mortality could

reduce by at least half by the year 2001, through a world health organization

global effort named as safe motherhood (WHO, 1980).

Researchers have shown that Nigeria has one of the highest mortality rates in

the world, on estimate of 800 maternal deaths per 100, 000 women was

reported. This estimate however, tries to show that in adequate mobilization of

women during pregnancy especially in the rural areas, on the need of taken

care of detect complication that are likely to occur at it early occurrences so

that it can be managed effectively (UNICF, 1994).

MATERNAL MORTALITY: However, the term maternal mortality in the

hand lends itself to various interpretations which in the past have led to
13
confessions particularly when statistically companion of different criteria were

under taken. According to international classification of diseases, injuries and

causes of death which was revised in 1979 show maternal death is now defined

as the death of any women while pregnant or within forty two (42) days of

termination of pregnancy, irrespective of the cases related to or aggravated by

the pregnancy or its management but not from accident or incidental causes.

(WHO, 1977)

And another way maternal mortality defined as any death occurring during

pregnancy six (6th) weeks of delivery and attributed to complication pregnancy

child birth or puerperal. (JAMES, 1980)

Once against the committee on maternal mortality of the international

federation of gynecology and obstetrics (FIGO) with approved of World Health

organization, defined maternal mortality as “the death of any women dying of

any causes while pregnancy or within forty two (42) days of delivery

irrespective of the duration and the site of pregnancy (WHO, 1984).

Every society whether developed or developing recognition of health needs and

problems of women and their children from birth to adolescence, and for this

reason both the pregnancy women and lactating mothers and their children are

often given special status in the society. In most African countries when a

women’s pregnant, she is often excused from annoying out heavy duties, such
14
as carrying heavy load. She is also given special food which is more nutrition’s

newly delivery and lactating mothers, children are also treated like ‘egg’ which

can break if handled carelessly.

They are fed with breast milk which is the most balanced food ever known to

man. Therefore one can safely say tradition is new. It is only approach that

appears different.

In maternal mortality child health, there are two areas of concern, these are;

- The biological demand of reproduction, growth and development

- The special vulnerability (Delicate position) of other and children as a

result of the above.

Having identified these two areas of concern, to meet the above mentioned

demands by providing primitive, preventing and curative services; For

instances, because infection or injury during the period of pregnancy child birth

growth and development may demand the individual child permanently,

preventive health measures such as immunization are often carried out as

integral part of maternal and child health services (AKINSOLA, 1992).

2.2 OBJECTIVE OF MATERNAL CHILD HEALTH SERVICES

The objectives of maternal and child health services generally begin with

solving the health problem of all individuals mothers and their children and
15
extended to solving the problems of all the individual members of a family

within that large community.

Therefore, it is generally cover the problem of mothering and parenthood. The

programme is means to ensure that every pregnancy women and nursing

mother’s maintain good health, learn the art of child care, have normal delivery

and be of healthy children who should grow up in a family numbers with

adequate medical attention and socialization (AKINSOLA 1993).

2.3 FACTORS INFLUENCING THE HELTH OF THE MOTHER AND

THE CHILD

- AGE OF MOTHER:

Women who get married at too young often stand the risk of having

complication during pregnancy labour, and delivery. Even after delivery they

lack the experience to take of themselves and their newly born babies.

- EDUCATIONAL LEVEL OF MOTHER

Illiterate mothers lack the knowledge of taking care of themselves during

pregnancy and after pregnant as well as the child.

- CHILD SPACING

The mother gap between two pregnancies/child births

16
- CLIMATE

The children can develop poor health due to poor environmental condition.

- FAMILY SIZE

The larger size of the family is more likely that the health of the mother and

child will be poor due to poverty.

2.4 COMPONENT OF MATERNAL AND CHILD HEALTH

 MATERNAL CARE

Maternal care as a component of maternal and child health is very broad infant,

it cover both the health of the mother and the newly born child.

 ANTI – NATAL CARE

As component of maternal and child health, the aim of good anti- natal care is

to ensure that every expectant mothers has a normal delivery bears a health

child or children in the early years, the major causes of maternal mortality were

hypertension diseases, hemorrhage, abortion and infection with cardiae disease,

pulmonary embolism with great reduce in incipiencies in 1970 – 1982 data

(WHO, 1984).

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2.5.1 PULMONARY EMBOLISM

The principles background cause in increasing the risk of thromboembolic

disorder have long been recognized as a matter of analogue and party obesity

inspired activity and operative delivery deaths from it account about 15% of all

deaths in over half of the causes were sudden and entirely unsuspected but

available factors mainly associated appropriate treatment was present. Much

diseases following vaginal delivery were associated with known risk factors,

such as operative produce, following immobilization and early year

suppression of lactation with estrogen. Most of the death occurs for delivery

and being discharge from hospital and many cases, warning sing are presented

(MYLES, 1985).

2.5.2 HYPERTENSION

Hypertension disease in pregnancy account for embolism has hypertensive

disorder as the starting point. In a train of events leading to death, about 20%

of the death occurred before delivery. Most of the causes are cerebral in origin.

Principles hemorrhage with a cardiac failure, hepatic renal failure and many

others. Lack of adequate antenatal care is a principles factor resulting in failure

a defect warning promptly (VICTORIA, 1985).

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2.5.3 ANESTHESIA

The majority of death due to inculcation of gastric content and difficulty in

endo-radial, but it is a significant members of accuse substandard, operative

care may be adjudge to a major factors at least 3 quarters of the death and here

were available factors in mainly all cases. (WALKER 1995).

2.5.4 HEMORRHAGE AND TRAUMA

Maternal death from hemorrhage excluding abortion now account for about

80% of all maternal death, death anti-partum hemorrhage birth amplito

placenta and placental privica have shown dramatic reduction in recent years,

but coagulate disorder which to some extent reflect and promptness and

adequacy of treatment remain common and often lead to the terminal

complication of hemorrhage which are ultimately fetal occur without prior

warning, it is dear that there is primary a need for improving prophylaxis and

management.

Notable features re-under estimation of blood loss and treatment which

inadequate, including adequate transfusion and later causes hysterectomy and

for recognizing coagulation failure. (VICTORIA, 1985)

19
2.5.5 ECTOPIC HESTATION

This now the commonest causes of maternal death, in early pregnancy with

rate of over 45% higher than total abortion case. In this case death is usually

due to massive hemorrhage and in many cause, it is not even know at the out-

set that the patient is pregnant. It is known at the outset that the patient is

pregnant. It is therefore, not suppressing that delaying diagnosis and treatment

is common and this delays not in enable gestation is not known, it is difficult to

assess whether diagnostic is better and treatment is more effective.

(MEDICINE, 1997)

2.5.6 MAJOR PURPERAL INFECTION

This has until recently ranked among the top (4) abortion acts, more than half

of the death from Pepsis associated with abortive act range about 25million

maternities. Much of the improvement in recent years is attributable to better

obstetric supervene in long labour with rapture membranes, better general

maternal health and improved anti-biotic therapy may be on going contribution

with the role of improvement. (SEGUN, 1996)

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2.6 THE OBSTETRICAL CAUSES OF MATERNAL MORTALITY

There are a lot of obstetrical causes of maternal problem due to obstetrical

reasons, some of them includes, severe anemia, obstructed labour, pre –

eclampsia and so on.

2.6.1 SEVERE ANAEMIA

Anemia may be due to malaria, malnutrition deficiency and abnormal

hemoglobin (HB). The anemia to infection and heart failure is a predisposing

factor to post-partum hemorrhage. (MICKAEL, 1985)

2.6.2 OBSTRUCTED LABOUR

Maternal exhaustion and improper uterus is a common cause of death; it is

usually as a result of mismanagement of labour before administration to

hospital excessive shock and puerperal sepsis are usually anticipated in view of

the fragrances before admission (MICKAEL 1985).

2.7 PREVENTION MEASURES OF MATERNAL MORTALITY

 Adult health and family planning services

 Health education and preventive services

 Nutritional education and food demonstration

 Through immunization services

21
  Pre-natal care, anti – natal care and post – natal care

 Skill man power (knowledge in various health care) especially female

student from different tribe with different countries, in order to reduce the

number of male, manpower in relation with maternal health as one of the

exclude maternal health services, particularly religion aspects and culture

(MAHMOOD, 1988).

2.8 CONTROL MEASURES OF MATERNAL PROBLEMS

 Through diagnosis, diagnosis and treatment aspects

 Improved the area the tie techniques and skills of anesthetics

 Adiloutes in knowledge of blood coagulation disorder

 Through introduction of anti-biotic, has progressively lowered the

number of maternal from sepsis

 Early recognition and improved treatment of eclampsia and efficient to

management

 Improved standards in the greater willingness of women to take

advantage of such area.

 Closer cooperation with specialists in diabetes, renal and cardiac

diseases, hematology and chest condition

 Highlighting and scanning women at risk and providing intensive care

when needed (NATURE, 2002).

22
 CHAPTER THREE

3. 1 METHODOLOGY

This chapter discussed the following;

Research design, population/universe of the study, sample and sampling

technique, instrument for data analysis, validity and reliability of the

instrument, administration of instrument and techniques for data analysis.

3.2 SAMPLE AND SAMPLING TECHNIQUE

The researcher used simple random sampling technique therefore, 100 people

was selected from different part of the area of study to represent the entire

population.

3.3 INSTRUMENT FOR DATA COLLECTION

An accurately and relevant designed questionnaire was used by the researcher

that contain question directly matched with all the necessary information

needed by the researcher.

3.4 VALIDITY AND RELIABILITY OF THE INSTRUMENT

The questionnaire was designed ad supervised fully by the supervision,

therefore its validity and reliability is very much ensured.

23
3.5 ADMINISTRATION OF THE INSTRUMENT

The questionnaire was distributed directly to people in the area of study in

order to get relevant data, and later retrieved the filled-up questionnaires for

onward processes.

3.6 METHOD OF DATA ANALYSIS

In this research project chi-square contingency method of statistic has been

used for data analysis for chi-square contingency table. However, by using

these records of maternal mortality rate of Safana Hospital as the relevant data.

Formula: X2 = (ad – bc)2

KLMN

Gender Positive Responses Negative Responses Total

MALE A B K
FEMALE C D L
Total M N M

CHAPTER FOUR

24
 DATA ANALYSIS AND PRESENTATION

4.1 INTRODUCTION

This chapter deals with analysis and presentation of requite been collected

through the test of hypothesis based on the maternal mortality rate among the

pregnant women, using Safana Local Government, Comprehensive Hospital

Safana, Therefore, the hypothesis is to be tested through, the hypothesis is to be

tested through the correlation coefficient statistics in order to test the

association between maternal mortality rate

TABLE 1

4.1 Record of maternal mortality rate using Safana General Hospital

Record of 2015

January to December, 2015 the record is total 8

Therefore, 8x100
500

=16

Therefore the total number of maternal mortality rate in General Hospital

Safana is sixteen women’s death out of total Five Hundred birth due to

hypertension (eclampsia), post-partum hemorrhage and anti-partum

hemorrhage

25
TABLE OF 2015

Causes Frequency Percentage

Hypertension (eclampsia) 4 50%
Post-partum hemorrhage 2 25%
Anti-partum hemorrhage 1 12.5%
Lack of antenatal care 1 12.5%
Total = 8 100%

The above table shows that the total maternal mortality rate in Safana General

Hospital shown 4 women’s death due to hypertension (eclampsia) representing

(50%), post-partum hemorrhage with 2 frequencies representing (25%), anti-

partum hemorrhage 1 frequency representing (12.5%), while lack of ante-natal

care 1 frequency representing (12.5%), this shows thus hypertension

(eclampsia) carry the majority of death.

Table 2;
4.2 Record of 2016 from January to December record total is 14

Therefore 14 x 1000
500

= 28/1000

Table 2016

Causes Frequency Percentage

Hypertension 3 21.4%
Retentum placenta 2 14.2%

26
Anemia 4 28.6%
Pre–eclampsia 5 33.7%
Total 14 100%

The above table shown that the total of maternal mortality rate in Jibia General

Hospital shown 3 death due to hypertension (representing 21.4%), retention

placenta 2 frequency (representing 14.2%), anemia with 4 frequency

(representing 28.6%), pre – eclampsia 5 frequency (representing 35.7%). This

shows thus pre – eclampsia carrying the majority of death.

Table 3

4.3 Record of 2017 from January to December record total is 20.

Therefore, 20 x 1000
500

=40/1000

Therefore the total number of maternal mortality rate in General Hospital

Safana is forty women’s death out of total five hundred birth due to prolong

labour, ectopic pregnancy or gestation, at risk pregnant women’s hypertension.

TABLE OF 2017

Causes Frequency Percentage

Prolong labour 8 20%
Ectopic gestation 9 22.5%
At risk pregnant women 12 30%
Hypertension 11 27.5%
Total 40 100%

27
 The above tables shown that the total maternal mortality rate in Safana

General Hospital shown 8 women’s death due to prolong labour, (representing

20%), ectopic gestation 9 frequency (representing 22.5%). At risk pregnant

women’s 12 frequency (representing 30%), while hypertension 11 frequency

(representing 27.5%). This show’s thus at risk pregnant women’s carrying the

majority death in a year 2017, from the result obtained in the table above, it

indicated that the relationship between 2015-2017

Therefore maternal mortality rate has indicated positively since the calculation

shows 124.

CHAPTER FIVE

DISCUSSION OF FINDING

Summary, conclusion, recommendation and suggestion for further studies

5.1 SUMMARY

This project contain five chapters, namely chapter one the introduction, chapter

two literature review, chapter three research methodology, chapter four

discussion and analysis of result and chapter five summary, conclusion,

recommendation and suggestion for further, studies.

Chapter one contain background of the study, statement of the problem,

significance of the study, objective, research question, definition of terms.

28
Chapter two which is the literature review concept of maternal mortality,

definition of maternal mortality rate, objective of maternal child health

services, factors influencing the health of mother and child health, prevention

measure of maternal mortality, control measure of maternal problems and

component of maternal and child health.

Chapter three which is the research methodology discussed on the research

design, population and universe of study, sample and sampling techniques,

instrument for data collection, validity and reliability of the instrument,

administration of the instrument and finally the techniques for data analysis.

Chapter four, which is contained on the discussion and analysis of result of the

three hypotheses from studies, are made with regards to the topic of writing.

Chapter five is where summary, conclusion, recommendation and suggestions

for further studies are made with regards to the topic of writing.

5.2 CONCLUSION

Visiting of pregnant mother to the maternal child health services at right time is

of great importance towards reducing the maternal death women as well as its

consequences from the data so for discussed in chapter two it clearly indicates

that there are many causes of maternal death more especially in rural area

where ignorance and poverty of the inhabited were in a great percentage.

29
Therefore the health education of the public both in rural and urban areas are

importance of visiting antenatal care by a pregnant women will contribute a

lots much more towards reducing of the maternal death which as a result of

many causes problems to the society which include population reduction, child

abused and other.

5.3 RECOMMENDATION

For us to have a lasting solution to the problems that arises of the maternal and

child health (mortality rate); Health care services should be embrace in the

prevention and control of maternal death. The researcher made the following

recommendations that;

1. Will assist towards the control of maternal death among women

2. Government should provide adequate and qualified health workers in the

hospitals and other facilities

3. Health Educators and Promoters should conduct the health education to

the community member towards the importance of visiting antenatal care

4. Non-governmental organization should organized seminar and workshop

to enlighten the public on how to reduce the occurring of maternal

mortality and its consequences

30
 5. Government should provide the Maternal Child Health (MCH) with

modern and effect

5.4 SUGGESTIONS FOR FURTHER STUDIES

Anybody wishes to undertake similar or relevant research make it in a scope

that is broader than this one so as to covered more areas that were not touched

by this work due to time factor and financial problems.

REFERENCE

1. AKINSOLA A.O (1993) A textbook on community health practitioner

2. UNITED NATIONAL INTERNATIONAL CHILDREN EMERGENCY

FUND (1996) guidance for potential user (free full textbooks).

3. SEGON ORSAJO (1998) Maternal mortality the travail of Nigeria

health correspondent vanguard newspaper

4. WALL L.L (1998) study farm planning, the social context maternal

mortality, morbidity and mortality among the Hausa of northern Nigeria

(published)

5. WORLD HEALTH ORGANIZATION, maternal and child estimates

development (free full text books)

31
 SAMPLE QUESTIONNAIRE

Katsina State College of Health

Science & Technology Katsina,
Kankia Iro School of Health
Technology Kankia, Department
of Public and Environmental
Health Science

Dear respondent,

I am a final year student of the above named institution studying Diploma in

Health Education and Promotion (HEP) caring out a research projects on

MATERNAL MORTALITY RATE IN SAFANA GENERAL HOSPITAL IN

SAFANA LOCAL GOVERNMENT, KATSINA STATE. I will highly

appreciate your cooperation on responding to the question below as your

contribution to this research work. I assure you of the greatest confidentiality

and that the information collected will be used for the research purpose only.
32
 Yours Faithfully,
Abubakar Bello
SECTION ‘A’ PERSONAL DATA

Educational Qualification: __________________________________________

Sex: ___________________________________________________________

Marital Status: ___________________________________________________

Occupation: _____________________________________________________

Tribe: _________________________________________________________

SECTION ‘B’

The respondents are to indicate their responses by ticking the item of which

they agree or disagree on the column provided against each item.

1. Are you aware about maternal and child health care services?

a. Yes ( ) b. No ( )

2. Do you attend any health facility for MCH services i.e. anti-natal and

post-natal care?

33
 a. Yes( ), b. No ( )

3. Are you satisfied with the attitude of health worker working in the health

facility you usually attend?

a. Yes ( ), b. No ( )

4. Do they test your urine during the anti-natal care?

a. Yes ( ), b. No ( )

5. Do they weight you in the clinic?

a. Yes ( ), b. No ( )

6. Do they test your blood pressure?

a. Yes ( ), b. No ( )

7. Do you receive immunization in the clinic during ante- natal care?

a. Yes ( ), b. No ( )

8. Are health workers in the health facility adequate enough to attend the

client?

a. Yes ( ), b. No ( )

9. Does the maternal death significantly be control?

a. Yes ( ), b. No ( )

10. Obstructed labour is some of the cause of maternal death?

a. Yes ( ), b. No ( )

11. Do they test your hemoglobin?

a. Yes ( ), b. No ( )
34
12. Does maternal and child health care services being carried out?

a. Yes ( ), b. No ( )

13. Does ante- natal care contribute towards maternal death?

a. Yes ( ), b. No ( )

14. Do the maternal death is significantly decrease?

a. Yes ( ), b. No ( )

35