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Community Study of Maternal Mortality in South West Nigeria: How Applicable is the Sisterhood Method

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Abstract

A significant reduction in maternal mortality was witnessed globally in the year 2010, yet, no significant reduction in the maternal mortality ratio (MMR) in Nigeria was recorded. The absence of accurate data on the numbers, causes and local factors influencing adverse maternal outcomes has been identified as a major obstacle hindering appropriate distribution of resources targeted towards improving maternal healthcare. This paper reports the first community based study that measures the incidence of maternal mortality in Ibadan, Nigeria using the indirect sisterhood method and explores the applicability of this method in a community where maternal mortality is not a rare event. A community-based study was conducted in Ibadan using the principles of the sisterhood method developed by Graham et al. for developing countries. Using a multi-stage sampling design with stratification and clustering, 3,028 households were selected. All persons approached agreed to take part in the study (a participation rate of 100%), with 2,877 respondents eligible for analysis. There was a high incidence of maternal mortality in the study setting: 1,324/6,519 (20.3%) sisters of the respondents had died, with 1,139 deaths reportedly related to pregnancy, childbirth or the puerperium. The MMR was 7,778 per 100,000 live births (95% CI 7,326–8,229). Adjusted for a published Total Fertility Rate of 6.0, the MMR was 6,525 per 100,000 live births (95% CI 6,144–6,909). Women in Ibadan were dying more from pregnancy related complications than from other causes. Findings of this study have implications for midwifery education, training and practice and for the first time provide policy makers and planners with information on maternal mortality in the community of Ibadan city and shed light on the causes of maternal mortality in the area.

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Acknowledgment

This study was supported with funding from the University of Manchester.

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We declare that we have no conflicts of interest.

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Authors and Affiliations

  1. Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK

    Adetoro A. Adegoke

  2. The School of Nursing, Midwifery and Social Work, The University of Manchester, Room 5.327, Jean McFarlane Building, University Place, Oxford Road, Manchester, M13 9PL, UK

    Malcolm Campbell

  3. Primary Health Care and Health Management Centre, Yemetu, Ibadan, Oyo State, Nigeria

    Martins O. Ogundeji

  4. Department of Community Medicine, University College Hospital (UCH), Ibadan, Oyo State, Nigeria

    Taiwo O. Lawoyin

  5. The School of Nursing, Midwifery and Social Work, The University of Manchester, Room 6.333, Jean McFarlane Building, University Place, Oxford Road, Manchester, M13 9PL, UK

    Ann M. Thomson

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  1. Adetoro A. Adegoke
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  2. Malcolm Campbell
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  3. Martins O. Ogundeji
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  4. Taiwo O. Lawoyin
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Correspondence to Adetoro A. Adegoke.

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Adegoke, A.A., Campbell, M., Ogundeji, M.O. et al. Community Study of Maternal Mortality in South West Nigeria: How Applicable is the Sisterhood Method. Matern Child Health J 17, 319–329 (2013). https://doi.org/10.1007/s10995-012-0977-z

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