Perinatal mortality in emergency obstetric health care facilities, Nakuru County, Kenya, 2014–2017: A descriptive cross sectional surveillance data analysis

Abstract

Introduction: Perinatal mortality is a major global public health problem. In 2016, 2.6 million perinatal deaths were reported globally, in Kenya, it accounted for 22.6 deaths/1000 live births. We sought to describe perinatal mortality in Nakuru County. Methods: We reviewed “perinatal mortality” on System data report between 2014–2017. Perinatal death was defined as any record of death in the first seven days of life and stillbirths that occurred in health facilities that provided emergency obstetric care. We assessed age, time and place of death occurrence, neonatal and maternal clinical characteristics. We calculated the perinatal mortality rate (PNMR), trends, frequencies and proportions for characteristics of interest. Results: A total of 59,152 births were reported in 9 facilities from 2014–2017, 929 of these births were subsequently classified as perinatal deaths. Overall PNMR was 15 deaths/1000 live births. Among those who died their mean age was 0.83±0.05 day. Early neonatal deaths: 533(57.6%), Stillbirths: 382(41.0%) and 14(1.4%) cause of deaths were not recorded. Nakuru Level-5 Hospital recorded 835(90%) perinatal 15 deaths. In 2014, PNMR was 25.1 deaths/1000 live births which reduced to 12.5 deaths/1000 live births in 2017. Of the infants who died 570(61.4%) were <1 day old. Partograph was not used in 464(49.9%) of the pregnant women. Reported contributors of perinatal deaths were birth asphyxia 275(29.6%), prematurity 267(28.7%) and low-birth-weight 252(27.1%). Conclusion: Nakuru County PNMR was higher compared to WHO recommendation of < 12 deaths/1000 live births, therefore, there is need to identify strategies to reduce incidences of asphyxia, prematurity and low birth weight. Comprehensive antenatal coverage, adequate care of infants at birth is likely to improve quality of life among the survivors and reduce PNMR.