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264063 Extending verbal autopsy to investigate causes of maternal deaths in Kenya
Sunday, October 28, 2012
The maternal mortality rate in Kenya has stagnated in recent years without a decline. Poor monitoring of vital events leading to death, especially deaths occurring at home, prevents us from fully understanding the social contributors to death. While verbal autopsy is used to determine the biological causes of death, simply knowing the cause of death is not sufficient to understand why maternal deaths occur and what policies can be implemented to improve maternal health outcomes. Social autopsy aims to fill in these gaps.
Data was collected as part of a quasi-experimental design evaluating the impact of the availability and usage of reproductive health vouchers on women's health. A WHO standard verbal questionnaire and a social autopsy in-depth discussion was administered to every household that had a death of a woman aged 15-49 years. Two physicians independently coded the deaths according to ICD10 codes and the WHO definition of maternal deaths. A total of 600 deaths were identified in the study population and 60 of these met the WHO criteria of maternal death.
Qualitative textual analysis revealed that delays to seeking or receiving health care occurred on the individual, community and system levels. Individuals lacked knowledge of symptoms and danger signs, and had competing interests preventing them from seeking care. On the community level, delays occurred due to lack of transportation and/or wealth, indicating scarcity of resource sharing and community partnership. On the system level, much of the delay in receiving care was attributed to medical mismanagement and poor provider-client relations.
Learning Areas:Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related research
Social and behavioral sciences
Keywords: Maternal and Child Health, Barriers to Care
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I was responsible for the data analysis as part of an internship with the Population Council. I have been involved with quantitative and qualitative research in reproductive health professionally.
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.
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