Determination of maternal mortality and associated risk factors in the Jigawa North-East senatorial district, Jigawa State, Nigeria, 2018–2022

INTRODUCTION: This study examined maternal mortality rates and causes in three state hospitals—Hadejia General Hospital (HGH), Kafin Hausa General Hospital (KGH), and Birniwa General Hospital (BGH)—in the North-East Senatorial District of Jigawa State, Nigeria, between 2018 and 2022.
METHODS: This descriptive study retrospectively reviewed the hospital records of all maternal deaths, as defined by the World Health Organization International Classification of Diseases–Maternal Mortality (WHO ICD-MM). Maternal mortality ratios (MMRs) were calculated per 100,000 live births, and the causes were classified as direct or indirect. Trends over time and differences among the hospitals were analysed. Data are presented as numbers, percentages, and rates per 100,000 live births. SPSS version 22 was used for the analysis.
RESULTS: A sharp increase was observed in 2020, coinciding with the COVID-19 pandemic. The MMR increased from 1,454 to 5,045 in BGH, from 3,578 to 9,627 in HGH, and from 0 to 1,709 in KGH. Rates declined slightly in 2021–2022 but remained far above national and global targets. In BGH, anaemia was the leading cause of maternal mortality (45.35%), followed by eclampsia (27.91%) and postpartum haemorrhage (8%). In HGH, eclampsia was the leading cause (27.89%), followed by placental abruption, pulmonary embolism, hypovolaemic shock, and transfusion reactions, which collectively accounted for 24% of deaths. In KGH, postpartum haemorrhage was the most common cause (36.59%), followed by eclampsia (17.07%), difficult delivery (14.63%), and anaemia (9.76%).
DISCUSSION AND CONCLUSION: Maternal mortality in Jigawa State remains unacceptably high and is largely attributable to preventable direct obstetric causes and indirect factors. Reducing maternal mortality requires urgent improvements in obstetric care, stronger referral systems, greater consideration of indirect causes, continuity of services during crises, and sustained health education.

Keywords: Anaemia, COVID-19 pandemic, eclampsia, Jigawa state, maternal mortality rate, Nigeria.