AI Insight
This cross-sectional study examined factors contributing to maternal deaths in Cameroon's conflict-affected North West Region, surveying 109 postpartum women and healthcare workers. While facility delivery rates were high at 96%, significant gaps were identified in implementing evidence-based interventions: only 38% of women received adequate antenatal care per WHO standards, partographs were correctly completed in just 61% of cases, and 45% of participants faced conflict-related barriers to accessing healthcare. The study found that maternal mortality was linked to interconnected factors including armed conflict disruptions, weak referral systems, inadequate emergency obstetric readiness at lower-level facilities, and poor compliance with established obstetric protocols.
Why it matters
The findings highlight critical healthcare system vulnerabilities in conflict zones that directly impact maternal survival, revealing that high facility utilization alone is insufficient without proper implementation of life-saving interventions. This research provides actionable targets for reducing maternal mortality in similar humanitarian settings, particularly strengthening emergency referral systems and improving adherence to evidence-based practices at community health centers.
⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Background Maternal mortality is a significant global public health crisis, particularly in sub-Saharan Africa and conflict-affected regions. Cameroon’s maternal mortality ratio is high at 406 deaths per 100,000 live births, while the ongoing Anglophone conflict has further exacerbated maternal healthcare delivery in the North West Region (NWR){middle dot} Despite the evidence-based interventions like partographs, obstetric kits, birth preparedness plans, and active management of the third stage of labour, implementation gaps persist across health facilities. Objective The study aimed to assess factors related to preventable maternal deaths in the NWR of Cameroon by exploring maternal health service usage, implementation of obstetric measures, demand-side challenges, accessibility barriers, and health system weaknesses. Methodology The study employed a quantitative descriptive cross-sectional survey design{middle dot} Data was collected with structured questionnaires from postpartum women and healthcare workers in selected health facilities and catchment communities in the NWR{middle dot} Also, a multistage sampling technique was adopted, and Cochran’s formula generated a sample size of 109 respondents{middle dot} In addition, data were analysed using SPSS version 27 and Stata version 18, employing descriptive and inferential statistics. Results In this study, while 70{middle dot}64 percent of females attended at least 4 ANC visits, only 38{middle dot}53 percent met WHO ANC adequacy requirements. Facility delivery was 96{middle dot}33 percent, yet only 38{middle dot}46 percent received completed delivery plans. Conflict-related challenges affected access, with 44{middle dot}95 percent reporting insecurity-associated movement difficulties, while 44{middle dot}95 percent reported increased transportation expenses due to the conflict. Near-miss complications were reported among 27.52 percent of participants. Delivery record reviews indicated that obstetric kits were utilised in 81{middle dot}76 percent of deliveries, partographs were accessible in 86{middle dot}49 percent of records but correctly filled in just 60{middle dot}81 percent , while oxytocin administration was 95{middle dot}95 percent. Integrated Health Centres showed poorer adherence with intrapartum interventions compared with District and Regional Hospitals (p <0{middle dot}05). Conclusion In the NWR, maternal mortality was associated with accessibility, interconnected demand-side, conflict-related, and health-system determinants. While utilization of some maternal interventions was high, major implementation gaps, such as weak referral systems, insufficient BEmONC readiness, poor partograph compliance, and conflict disruptions, continually compromise neonatal and maternal outcomes. Strengthening lower-level facilities, enhancing emergency referral systems, and improving implementation of evidence-based obstetric interventions are crucial for minimising maternal mortality in the NWR.