Health Worker Familiarity with Maternal Mortality Cause Definitions in Kaduna State, Nigeria: A Cross-Sectional Study
Abstract:
Maternal mortality remains a critical
public health challenge in Nigeria, with a ratio exceeding 1,000 per 100,000
live births. Beyond timely access to care, health worker knowledge of maternal
mortality causes and their clinical definitions is vital for accurate
diagnosis, management, and surveillance. This study assessed health worker
familiarity with clinical definitions of maternal death causes in Kaduna State
and explored system-level influences. A cross-sectional survey was conducted
among 596 maternal healthcare providers across primary, secondary, and tertiary
facilities, both public and private. Respondents included doctors,
nurses/midwives, community health officers (CHOs), community health extension
workers (CHEWs), and ancillary staff. Data were collected using a structured
questionnaire capturing demographics, professional background, and
self-reported familiarity with clinical definitions of maternal death causes.
Analysis employed descriptive statistics, chi-square tests, and multivariable logistic
regression to examine associations with gender, cadre, education, facility
type, and experience. Overall, 96.1% of participants reported familiarity with
maternal death definitions. Postpartum hemorrhage (32%) and eclampsia (11%)
were most frequently cited, followed by medical mismanagement (12%). Bivariate
analysis showed no significant associations between familiarity and age,
education, experience, cadre, or facility type. However, multivariable analysis
identified male gender (aOR = 4.49; 95% CI: 1.07–18.9; p = 0.041) and CHO cadre
(aOR ≈ 31.5; p = 0.017) as significant predictors. All doctors reported
familiarity. In conclusion, maternal death cause familiarity is high across
cadres and facilities in Kaduna. However, gender and cadre disparities highlight
the need for equitable training opportunities, continuous capacity building,
adequate resources, and strengthened surveillance systems to effectively reduce
maternal mortality.
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