A Review of Underlying Causes of Maternal Deaths inBenue North Central Nigeria

Most maternal death reviews are on impact assessment rather than the underlying factors. Maternal death review that goes beyond the number has not been widely studied in Nigeria despite the high contribution of underlying factors to maternal deaths in the country. To determine the underlying causes of maternal death in thefacility. This was a comprehensive facility based maternal death review at Federal Medical Centre Makurdi from 1 st January to 31 st December 2012. Factors surrounding each maternal death were analyzed prospectively to learn a lesson from each death by exploring gaps at the levels of the hospital, patient and the community. The MMR was 1381/100000 live births. Hospital factors were implicated in 39.3% and they were predominantly lack of ICU 19.0%, poor management of the referral chain 19.0% inability toassess complications fully 15.5%, laboratories challenges 11.9% and lack of obstetric skills (inexperience) 8.3%. Patient’s factor occurred in 32.1% and they were nonbooking (34.6%), non use of family planning (26.9%) and decision delays (32.7%). The Community factors occurred in 28.6% and they included transportation problem (28.6%), socio-cultural factors (28.6%), gender inequality (16.7%), inhibitory abortion laws 11.9% and illiteracy 9.5%.Maternal mortality was high in the facility because of the complex interaction of underlying factors with obstetric complications