Abstract
Background: In 2017, the World Health Organization reported more than 295,000 maternal deaths on a global scale. The majority of these largely preventable misfortunes occurred within the intrapartum period. Interestingly, a significant relationship between environmental factors and hospital-based intrapartum care has been established in some studies. Objective: This study sought to assess the effect of environmental factors on maternal outcomes and the use of intrapartum healthcare services at the Ketté District Hospital. Methods: This was a cross-sectional . The study sampled 471 women presenting for peripartum care at the Ketté District hospital. A pilot study was initiated prior to data collection. The results were analysed at 95% confidence interval (CI) using EPI Info and the Statistical Package for the Social Sciences. Charts, tables and logistic regression were used to relate variables to observed outcomes. Results: Of the study participants, 24.2% (n=114) had a history of maternal complications. Socio-demographic characteristics associated with higher odds for maternal complications included age group 18-25 years (OR 1.89, 95% CI 1.16-3.11) where 26-33 years was the reference group, family size greater than 6 (AOR 2.17, 95% CI 1.18-3.98) where 3-4 persons was the reference group and being unemployed (AOR 2.46, 95% CI 1.12-5.41) where being self-employed was the reference group. One major factor associated with maternal complications was a travel distance of over 5 km from the health facility (OR 3.12, 95% CI 1.07-9.13) where a distance of 1-2 km was the reference. Obstetric and delivery determinants associated with maternal complications included delivery being assisted by a traditional birth attendant (AOR 3.70, 95% CI 1.71-8.04) where delivery at a health centre was the reference group. The perceived importance of environmental factors for ANC frequency showed greater odds for maternal complications when road quality was important (AOR 4.33, 95% CI 1.62-11.57); when travel time was important (OR 2.85, 95% CI 1.57-5.18); when travel distance was very important (OR 6.65, 95% CI 3.62-12.25); and when season was important (OR 3.59, 95% CI 1.91-6.78). Conclusion: Maternal outcomes were significantly influenced by distance, route network, and season of delivery. The implementation of sustainable measures via road maintenance and motorised transportation could greatly improve peripartum outcomes.
M.A. (Public Health)