Maternal death peaked in 2021 – Statistics Botswana

Pini Bothoko | Tuesday September 19, 2023 06:00

The report highlighted several key causes behind the increase in maternal deaths, including COVID-19-related fatalities, severe pre-eclampsia at seven percent, and diseases of the circulatory system complicating pregnancy, childbirth, and the puerperium at 5.5 percent.

In 2021, there were 128 reported maternal deaths out of 53,326 live births, resulting in a maternal mortality ratio of 240 maternal deaths per 100,000 live births. The report noted that over the years, there has been a fluctuating pattern in the maternal mortality ratio, ranging from 127 deaths per 100,000 live births in 2015 to 240 deaths per 100,000 live births in 2021.

“This shows that the country is yet to reach the 70 deaths per 100,000 live births set by the World Health Organisation (WHO). However, in 2021 there was a major setback in Botswana trying to attain the Sustainable Development Goal with the highest maternal deaths ever recorded and this could mainly be attributed to COVID-19.

The highest reported leading cause was other viral diseases complicating pregnancy, childbirth, and the puerperium at 28.9%,” reads the report. Geographically, nearly 60.9% of maternal deaths occurred in the Gaborone and Francistown District Health Management Teams (DHMT), with Gaborone having the highest share at 34.4%.

Half of the maternal deaths (50%) occurred in referral hospitals, followed by 32% in district hospitals, 13.2% in primary hospitals, and 4.6 percent in clinics. Furthermore, the report revealed that the highest maternal deaths in 2021 were amongst women aged 35–39, accounting for 27.6% of cases, followed by ages 30–34 at 30.4%.

There were only two cases of maternal deaths reported for women aged 45 and above, and none reported for those under 15 years of age. “The two years show that maternal deaths are lower in early reproductive and late reproductive ages.

They generally increase as reproductive age increases and reach a peak in middle ages 30–34 in 2020 and 35–39 in 2021 thereby decreasing again with age,” the report states. Regarding seasonal variations in maternal deaths, the report indicated that deaths were lowest in January and steadily increased until July–August when the first peak occurred.

Additionally, a second peak in maternal deaths was observed at the end of the year, in November 2020 and December 2021. “In 2020 the major mode was observed in November while the minor in July whereas in 2021 the major mode was observed in July and August and the minor mode in December,” reads the report.

In terms of gestation at the time of maternal deaths, the report revealed that more deaths occurred during pregnancy compared to those that occurred post-delivery for both 2020 and 2021. Notably, there was an increase in the proportion of deaths that occurred post-delivery in 2021, rising from 22.2% to 46%.