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Maternal mortality in Jordan: role of substandard care and delays
Understanding the factors that operate during pregnancy, delivery and postpartum is the key to success in the prevention of maternal mortality. This cross-sectional survey in Jordan for the years 2007-2008 aimed to identify the role of substandard care and delays in maternal deaths. All maternal deaths among women aged 15-49 years over this period (n = 76) were investigated retrospectively through file review and household interviews in all hospitals (n = 102) and forensic medicine departments in Jordan; elements of substandard care and delays at hospital, home and transport levels were evaluated. Substandard care accounted for 52.6% of deaths, delay in seeking care 55.3%, delay in transport 15.8% and delay in hospital care 17.1%. Women who did not recognize the danger signs of pregnancy (OR 6.32), refused medical advice to terminate the pregnancy (OR 1.78) or at a gestational age > 37 weeks (OR 1.85) were significantly more likely to delay seeking care, as were those with larger mean family size.
Understanding the factors that operate during pregnancy, delivery and postpartum is the key to success in the prevention of maternal mortality. This cross-sectional survey in Jordan for the years 2007-2008 aimed to identify the role of substandard care and delays in maternal deaths. All maternal deaths among women aged 15-49 years over this period (n = 76) were investigated retrospectively through file review and household interviews in all hospitals (n = 102) and forensic medicine departments in Jordan; elements of substandard care and delays at hospital, home and transport levels were evaluated. Substandard care accounted for 52.6% of deaths, delay in seeking care 55.3%, delay in transport 15.8% and delay in hospital care 17.1%. Women who did not recognize the danger signs of pregnancy (OR 6.32), refused medical advice to terminate the pregnancy (OR 1.78) or at a gestational age > 37 weeks (OR 1.85) were significantly more likely to delay seeking care, as were those with larger mean family size.
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