title: A community-based investigation of avoidable factors for maternal mortality in Zimbabwe.
abstract: A community-based investigation of maternal deaths was undertaken in a rural province (Masvingo) and an urban area (Harare) of Zimbabwe in order to assess their preventability. Avoidable factors were identified in 90 percent of the 105 rural deaths and 85 percent of 61 urban deaths. Delay in seeking treatment contributed to 32 percent and 28 percent of rural and urban deaths, respectively. Lack of transportation delayed or prevented access to healthy facilities in the rural area, a major problem in 28 percent of the cases studied. Suboptimal clinic and hospital management was identified in 67 percent and 70 percent of rural and urban deaths, respectively. Lack of appropriately trained personnel contributed to suboptimal care. In both settings, the severity of patients' conditions was frequently unrecognized, leading to delays in treatment and referral, and inadequate treatment. Appropriate community and health-service interventions to reduce maternal mortality are discussed.
authors.affiliation: Department of Obstetrics and Gynaecology, Grooteschuur Hospital, Cape Town, South Africa.
authors.forename: S
authors.initials: S
authors.lastname: Fawcus
authors.forename: M
authors.initials: M
authors.lastname: Mbizvo
authors.forename: G
authors.initials: G
authors.lastname: Lindmark
authors.forename: L
authors.initials: L
authors.lastname: Nyström
mesh_terms: D000028:Abortion, Induced / Q000401:mortality; D000293:Adolescent; D000328:Adult; D002648:Child; D005193:Family Planning Services; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration*; D008428:Maternal Mortality; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011181:Postnatal Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality / Q000517:prevention & control; D011295:Prenatal Care / Q000706:statistics & numerical data; D013997:Time Factors; D014187:Transportation of Patients; D015030:Zimbabwe / Q000453:epidemiology