Determinants of Maternal Death in Nakuru County, Kenya: A Cross-Sectional Study

Abstract

Purpose: Maternal mortality remains a significant public health concern in Kenya, with Nakuru County among the regions experiencing high rates. Understanding the determinants of maternal deaths is crucial for targeted interventions and improved maternal health outcomes. This study aimed to identify the factors contributing to maternal deaths in Nakuru County using the Three Delays Model as an analytical framework.

Methods: A cross-sectional design was employed, analyzing 200 maternal death cases reported between 2018 and 2022 from five major health facilities in Nakuru County. Data were obtained through maternal death review forms, facility records, and verbal autopsies. Quantitative data were analyzed using SPSS version 27, with descriptive statistics, chi-square tests, and logistic regression applied to determine significant associations.

Results: Hemorrhage (30%), hypertensive disorders (25%), and sepsis (15%) emerged as the leading direct causes of maternal death. Indirect causes included anemia and HIV-related complications. The study found that 65% of maternal deaths were associated with the third delay (receiving adequate care at a health facility), while 20% and 15% were linked to the second (reaching the facility) and first delays (seeking care), respectively. Multivariate logistic regression analysis indicated that lack of skilled birth attendance (OR = 2.8; 95% CI: 1.6–4.7; p < 0.01) and absence of emergency obstetric care at facilities (OR = 3.2; 95% CI: 1.9–5.3; p < 0.001) were significant predictors of maternal mortality.

Conclusion: Maternal deaths in Nakuru County are primarily driven by preventable factors, especially delays in receiving adequate care and lack of skilled birth attendance. Strengthening emergency obstetric services, ensuring the availability of skilled personnel, and enhancing community awareness are critical to reducing maternal mortality.