Determinants of Maternal Death in a Pastoralist Area of Borena Zone, Oromia Region, Ethiopia: Unmatched Case-Control Study

BACKGROUND: Globally, more than 830 maternal deaths happen daily, and nearly, all of these occur in developing countries. Similarly, in Ethiopia, maternal mortality is still very high. Studies done in pastoralist women are almost few. Therefore, the objective of this study was to assess the determinant factors of maternal death in the pastoralist area of Borena zone, Oromia region, Ethiopia. METHODS: Community-based unmatched case-control study was conducted on 236 mothers (59 maternal deaths (cases) and 177 controls). The sample included pregnant women aged 15–49 years from September 2014 to March 2017. Data were collected using a structured questionnaire adapted from Maternal Death Surveillance and Response Technical Guideline, entered into the EpiData, exported into SPSS for analyses. Odds ratios (ORs) and 95% confidence interval (CI) were computed to determine contributing factors of maternal death and control potential confounding variables. RESULTS: About 51 (86%) of all maternal deaths were due to direct obstetric causes. Of this, hemorrhage (45%), hypertensive disorders of pregnancy (23%), and obstructed labor (18%) were the leading direct causes of maternal deaths. Husbands who had no formal education were 5 times higher compared with their counterparts (AOR = 5.1, 95% CI: 1.6–16). Mothers who were not attending ANC were 5 times more at risk for death than those who attend (AOR 5.3, 95% CI 2.3–12.1). Mothers who gave birth at home/on transit were twice to die compared to health facility delivery (AOR 2.6, 95% CI 2.4–6) that were contributing factors of maternal deaths. CONCLUSIONS: Husband's level of education, lack of antenatal care, and home delivery were the factors contributing to maternal deaths in the zone. Frequent and tailored antenatal care, skilled delivery, and access to education also need due attention.