An Analysis of Maternal Deaths from a Referral Tertiary Healthcare Facility in Freetown, Sierra Leone

Main Article Content

Michael Ezeanochie
Rossetta O.G Cole
Jasonta F Coker
Adeniji Adetunji Adetunji
https://orcid.org/0000-0002-8489-1511

Abstract

Background


Although progress has been made recently in reducing maternal mortality in Sierra Leone, maternal mortality remains an important public health problem in the country that needs further reduction to meet the SDG targets by 2030.


Methods


This was a retrospective review of 86 consecutive maternal deaths at the Princess Christian Maternity Hospital (PCMH), Freetown from October 2022 to September 2023


Results


The mean age of the study population as 27.1 (SD 5.8) years and majority (88.7%) were between Para 1 to 4.  In addition, 16% of patients were booked at Princess Christian Maternity Hospital (PCMH), 53.5% booked at referral health facilities and 30.2% were unbooked. Hypertensive disorders of pregnancy (29.1%), postpartum haemorrhage (14%) and puerperal sepsis ( 10.5%) were the leading causes of maternal deaths.  Most of the maternal deaths occurred within 24hrs of admission into the hospital accounting for 53.5%, while 27.9% died after 24hrs to 72hrs of admission into the hospital. Overall, about 85% of the women experienced delay in accessing  or receiving care while Type 3 delay was the commonest form identified in 52.3% of cases respectively.


Conclusion


Maternal mortality remains a public health problem in PCMH Freetown. Hypertensive disorders of pregnancy and postpartum haemorrhage are the leading causes. Delay in accessing or receiving care are contributory to maternal mortality. Addressing these challenges can sustain recent progress that has been made in reducing maternal mortality in Sierra Leone


 

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How to Cite
1.
An Analysis of Maternal Deaths from a Referral Tertiary Healthcare Facility in Freetown, Sierra Leone. SLJM [Internet]. 2025 Nov. 7 [cited 2025 Dec. 4];2(2):41-5. Available from: https://sljm.org/journal/index.php/sljm/article/view/170
Section
Original Article

How to Cite

1.
An Analysis of Maternal Deaths from a Referral Tertiary Healthcare Facility in Freetown, Sierra Leone. SLJM [Internet]. 2025 Nov. 7 [cited 2025 Dec. 4];2(2):41-5. Available from: https://sljm.org/journal/index.php/sljm/article/view/170

References

World Health Organization. Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, world bank group and UNDESA/population division. World Health Organization; 2023;1–86 p

Shafiq Y, Caviglia M, Juheh Bah Z, Tognon F, Orsi M, K Kamara A, Claudia C, Moses F, Manenti F, Barone-Adesi F, Sessay T. Causes of maternal deaths in Sierra Leone from 2016 to 2019: analysis of districts' maternal death surveillance and response data. BMJ Open. 2024. 12;14(1):e076256.

Ministry of Health and Sanitation . Sierra Leone national reproductive, maternal, newborn, child and adolescent health strategy 2017–2021. Sierra Leone Minist Health Sanit; 2017

Musarandega R, Nyakura M, Machekano R, et al.. Causes of maternal mortality in sub-Saharan Africa: a systematic review of studies published from 2015 to 2020. J Glob Health 2021;11:04048.

Say L, Chou D, Gemmill A, et al.. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health 2014;2:e323–33.Statistics Sierra Leone Stats SL and ICF. 2020. Sierra Leone Demographic and Health Survey 2019. Freetown, Sierra Leone, and Rockville, Maryland, USA: Stats SL and ICF International.

Olagbuji BN, Ezeanochie MC, Igbaruma S, Okoigi SO, Ande AB. Stillbirth in cases of severe acute maternal morbidity. Int J Gynaecol Obstet. 2012 Oct;119(1):53-6

Okonofua FE, Ntoimo LFC, Ogu R, Galadanci H, Mohammed G, Adetoye D, Abe E, Okike O, Agholor K, Abdus-Salam R, Randawa A. Prevalence and determinants of stillbirth in Nigerian referral hospitals: a multicentre study. BMC Pregnancy Childbirth. 2019. 30;19(1):533

Tura AK, Scherjon S, van Roosmalen J, Zwart J, Stekelenburg J, van den Akker T. Surviving mothers and lost babies - burden of stillbirths and neonatal deaths among women with maternal near miss in eastern Ethiopia: a prospective cohort study. J Glob Health. 2020. 10(1):01041310

Kenneth Lynch, Etienne Nel, Tony Binns. ‘Transforming Freetown’: Dilemmas of planning and development in a West African City. Cities, 2020;Volume 101, 102694, ISSN 0264-2751

Thaddeus S, Maine D. Too far to walk: maternal mortality in context. Soc Sci Med. 1994;38(8):1091-110.

Ande A, Olagbuji B, Ezeanochie M. An audit of maternal deaths from a referral university teaching hospital in Nigeria: the emergence of HIV/AIDS as a leading cause. Niger Postgrad Med J. 2012;19(2):83-7.

Okonofua F, Imosemi D, Igboin B, Adeyemi A, Chibuko C, Idowu A, Imongan W. Maternal death review and outcomes: An assessment in Lagos State, Nigeria. PLoS One. 2017 Dec 14;12(12):e0188392

Latunji OO, Akinyemi OO. Factors influencing health-seeking behaviour among civil servants in ibadan, nigeria. Ann Ib Postgrad Med. 2018;16(1):52-60.

Thaddeus S, Maine D. To far to walk: maternal mortality in context. Soc Sci Med. 1994;38:1091–1110

Sharma V, Leight J, AbdulAziz F, Giroux N, Nyqvist MB. Illness recognition, decision-making, and care-seeking for maternal and newborn complications: a qualitative study in Jigawa State, Northern Nigeria. J Health Popul Nutr. 2017;36:46.

Wallace HJ, McDonald S, Belton S, Miranda AI, da Costa E, Matos LDC, Henderson H, Taft A. The decision to seek care antenatally and during labour and birth - Who and what influences this in Timor-Leste? A qualitative project exploring the perceptions of Timorese women and men. Midwifery. 2018;65:35-42

Statistics Sierra Leone - SSL and ICF International. 2014. Sierra Leone Demographic and Health Survey 2013. Freetown, Sierra Leone: SSL and ICF International.

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