Determinants of stillbirth in the five general hospitals of Lusaka, Zambia: a case-control study.
| dc.contributor.author | Makasa, Musonda | |
| dc.date.accessioned | 2024-03-04T14:32:42Z | |
| dc.date.available | 2024-03-04T14:32:42Z | |
| dc.date.issued | 2023 | |
| dc.description | Thesis of the degree of Master of Public Health | |
| dc.description.abstract | Background: About 98% of stillbirths that occur globally are recorded in low- and middle-income countries, where south Asia and sub-Saharan Africa account for 77% of the reported cases. An estimated 2.6 million stillbirths were reported every year since 2000. Recent data suggests a 25.5% decline from 24.7 to 18.4 per 1000 live births worldwide. Despite this reduction, sub-Saharan Africa (SSA) still recorded the slowest decline. Stillbirths are a consequence of multifactorial factors, and majority of them especially in low resource setting have no causal assignment. Objective: The main objective of this study was to evaluate the determinants of stillbirths among women who had childbirth at the five general hospitals of Lusaka, Zambia. Methods: This was a multi-facility based study conducted at Kanyama, Chipata, Chawama, Matero and Chilenje. An unmatched case-control study was designed at a ratio of 1:4. Cases (stillbirths) were consecutively enrolled, and controls randomly selected within 24 hours of occurrence of a case. A structured questionnaire was used to collect data. Summary proportions and frequencies for cases and controls were obtained from descriptive statistical analyses. Univariate analysis was conducted to obtain the crude association between stillbirth and independent variables. Multiple regression was used to assess determinants of stillbirths. A p-value of <0.05 was considered sufficient evidence of an association between stillbirth and independent variables. Results: total of 58 cases and 232 controls were included in the analysis with a ratio of 1:4 respectively. 77.6% cases belonged to the 20 – 34 years old age group while controls accounted for 74%. 52.6% cases had attained secondary education and 51.1% were in the control group. With employment 73.7% and 70.7% were cases and controls respectively. Babies with birthweight ≥2500g had higher odds of mortality (AOR=4.49; 95%CI: 2.84-8.99) than babies with birthweight <2500g. Antepartum hemorrhage was also noted to be a risk factor (AOR = 3.18; 95% CI: 1.21 – 8.09); another finding was previous experience of stillbirth had high odd of stillbirth (AOR=3.99; 95% CI: 1.73 – 6.73) compared with their counterparts without. Additionally, women with increase in parity > 2 (AOR = 3.02; 95% CI: 1.07 – 7.54) had higher odds of stillbirth compared to women with parity ≤ 2.Conclusion: this study revealed that babies with higher birth weight ≥2500g had higher risk of mortality probably attributed to haemorrhage. Antepartum haemorrhage, and previous stillbirth were noted as significant determinants of stillbirth. Program implementers should consider strategies that can mitigate these determinants to reduce stillbirth. | |
| dc.identifier.uri | https://dspace.unza.zm/handle/123456789/8486 | |
| dc.language.iso | en | |
| dc.publisher | The University of Zambia | |
| dc.title | Determinants of stillbirth in the five general hospitals of Lusaka, Zambia: a case-control study. | |
| dc.type | Thesis |