Determinants of perinatal mortality among women of child-bearing age in Baringo Central Sub County, Baringo County

Abstract

Background: Perinatal deaths comprise of all the stillborn children of more than the 28 weeks’ gestation period and the mortality experienced during the first week of life. Perinatal mortality is a major issue major issue of concern on public health in the emerging countries. According to the World Health Organization (WHO) recent perinatal statistics, worldwide in 2020, approximately 2.4 million children died in their first month of life. This translate to approximately 6700 new-born deaths every day, this accounts to about 50% of all child deaths under the age of 5 years, In Kenya perinatal mortality stands at 31/1,000 live births The perinatal mortality rate in Baringo County has been increasing from 21/1000 in 2015 to 25/1000 in 2018. Majority of these deaths 9/1000 were reported in Baringo Central Sub County Objectives: To identify the determinants of perinatal mortality among women of child-bearing age in Baringo Central Sub-County, Baringo County, Kenya Methodology: A community based Cross sectional study design was conducted on women of productive age using purposive (multi-stage) sampling to enrol 384 study participants from August–November 2020. Quantitative data were collected by administering a structured questionnaires administered, and for qualitative data, Focused Group Discussion and key informant interviews were conducted. Data was analyzed using Epi Info Version 7.2.2. Qualitative data were transcribed, translated, grouped and analysed thematically. Descriptive statistics were performed on demographic data. Categorical variables data were summarized using proportions and percentages. Continuous variables were summarized using mean and standard deviations. For determinants of perinatal mortality, inferential statistics (Chi Square); prevalence odds ratio (pOR), adjusted odds ratios (aOR), with their corresponding 95%CI and P-Values. Variables with P-value ≤ 0.2 by bivariate analysis were entered into a multivariate model, with logistic regression, variables with P-value ≤0.05 were considered statistically significant. Results: A total of 384 study participants were enrolled, their mean age was 24±5 years Of the 384 study participants 59 (15.1%) recorded perinatal mortalities. Among mothers aged 25-29 years reported 23 (39%) perinatal deaths. The socio-economic and cultural practices that determine perinatal mortality were seclusion 43(72.9%; P=0.06.), dietary restriction 48(81.4%; p=0.001); traditional remedies 40 (67.8%), female genital mutilation 37 (62.7%); and late attendance to ANC when pregnancy is visible. Conclusion: perinatal mortality in Baringo Central Sub County was high. Majority of the teenage mothers (25-30 years) recorded high number of perinatal mortality rates Perinatal mortalities were high among neonates who had birth weight of less 1500gms and among mothers who experienced prolonged labour. Determinants of perinatal mortality were; Seclusion of women, dietary restrictions, seeking traditional remedies, female genital mutilation and late ANC attendance. Recommendations: Health education program on perinatal mortality to ANC mothers and the need for targeted community based Health education talks and sensitization on the determinants of perinatal mortality in Baringo Central Sub-County.