Determinants of post-partum complications in women Attended to at Jaramogi Oginga Odinga teaching and Referral hospital, Kisumu-Kenya

Abstract

United Nations Population Fund report (UNFPA, 2014) indicates that Kisumu County is amongst the 15 of the total 47 counties in Kenya accounting for 98.7% of total maternal deaths in the country most of which are related to pregnancy and child birth. This study was therefore conducted at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) to establish the determinants of postpartum complications among women of reproductive age (15-49 years old). JOOTRH was chosen since it is a major referral hospital in western Kenya receiving clients from more than 100 health facilities in the region. The specific objectives of the study were to identify the socio-demographic characteristics of women who experience postpartum complications and attended to at JOOTRH, to determine the influence of birth attendance to the occurrence of postpartum complications in women attended to at JOOTRH and to determine the influence of mode of delivery to the occurrence of postpartum complications among women attended to at JOOTRH. This was a cross sectional study in a hospital set up. A systematic sampling method was used to recruit women for the study from various service delivery points in the hospital. A total of 371 women were sampled and a structured questionnaire administered to them. Key Informant Interviews (KII) were also administered to 5 purposively identified service providers. The data was analyzed using SPSS (version 20). Proportions were determined using Chi square analysis. Independent variables, socio-demographic characteristics, birth attendance and mode of delivery were regressed against post-partum complications. Qualitative data were organized into themes based on specific objectives. Results demonstrate that out of 371 women 149 (40.2%) had postpartum complications. For those who could read, only 31.7% had complications compared to 68.3% among those who could not read. The women who had hospital delivery were 35% less likely to present with complications (OR=0.35, 95% CI=0.08-0.24, P<0.0001). The findings showed that socio-demographic status of women are predictors for post-partum complications. The post-partum complications identified were post-partum heamorrhage 63(42.3%), sepsis 37(34.8%), high blood pressure 13(8.7%), anaemia 12(8.1%) while the rest had others 21(16.1%). Vaginal delivery has higher risk of one developing postpartum complications even though CS also has a number of complications. It is recommended that all women should seek skilled birth attendance, there is need for effective health education on danger signs during pregnancy and delivery including high level of hygiene after vaginal or CS delivery. Results from the study can be used to re-examine the obstetric services offered within Kisumu County and beyond.