Maternal mortality in Dar es Salaam, Tanzania, 1974-1977.

: A 4-year study on maternal mortality in Muhumbili Medical Center in Dar es Salaam was conducted. One obstetrician assigned causes of deaths to all pregnant women who died in the centre since 1974, and the deaths were regularly discussed at special maternal mortality meetings. The results show that during the period of study, there has been a steady increase of hospital admissions due to abortions and deliveries, and a similar increase in death rates from deliveries. Overall mortality rate is 2./1000 deliveries, representing 224 maternal deaths out of a total of 105,311 deliveries and 11,534 abortions. The rate showed very little improvement year by year. The top 5 causes of death included toxemia of pregnancy; deaths associated with cesarian sections; anemia; sepsis (other than that associated with abortions); and postpartum hemorrhage. Direct obstetric causes accounted for 86% of all deaths. Avoidability of maternal deaths in this series rests perhaps with 3 main groups: the woman and her family; the maternity unit or institutions' personnel and facilities; and the national policy on maternal health and whether this is given any priority in the usually overstretched national budget.