Epidemiological study of maternal death in Assam

Abstract Problem considered Deaths due to pregnancy and child birth are potential threats to women of reproductive age. Despite the presence of proven interventions, maternal deaths in Assam have been highest among all the states of India. Aims To assess the distribution and determinants of maternal death in Assam. Methods A mixed method community based cross sectional study; where quantitative study done by community based verbal autopsy and qualitative study by in-depth interview (IDI) was conducted amongst stakeholders. Results Of 150 deaths investigated, hemorrhage 32(21.3%), pregnancy induced hypertension (PIH) 26 (17.3%) and sepsis 15(10%) were major direct causes, while anaemia 43(28.7%) was major indirect cause. Live birth as outcome found in 71(72.4%). Mean age of women having maternal deaths was 25 years. Early marriage was more common in High MMR Districts and 21.3% death was of adolescent pregnancy. Majority deaths 61(40.7%) occurred in postnatal period. Deaths happened mostly 90(75%) during hospital emergency hours. Tea garden community (p = 0.000), occupation of deceased (p = 0.003), husbands occupation (p = 0.033), gravida (p = 0.046), parity (p = 0.006) and blood pressure (p = 0.031) were major determinants of Maternal Deaths. In majority of the deaths 99(66%) the nearest CHC/FRU did not provide emergency obstetric services. Conclusion Social determinants exist as important determinant of maternal mortality. Access to quality care also found to be influencing the epidemiology of maternal death.