Pregnancy Outcomes and Maternal and Perinatal Health Indicators by Facility Type and Program Support, Kigoma Region, 2013 and 2018
| Kigoma Region | Hospitals | Health Centers | Dispensaries | ||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PS | NPS | PS | NPS | PSa | NPS | PS EmONC | PS FP | NPS | |||||||||||||||||||
| 2013 | 2018 | % Change/ Sig. Levelb | 2013 | 2018 | % Change/ Sig. Levelb | 2013 | 2018 | % Change/ Sig. Levelb | 2013 | 2018 | % Change/ Sig. Levelb | 2013 | 2018 | % Change/ Sig. Levelb | 2013 | 2018 | % Change/ Sig. Levelb | 2013 | 2018 | % Change/ Sig. Levelb | 2013 | 2018 | % Change/ Sig. Levelb | 2013 | 2018 | % Change/ Sig. Levelb | |
| Number of health facilities | 81 | 83 | 2% | 93 | 114 | 23% | 3 | 3 | 0% | 3 | 3 | 0% | 12 | 13 | 8% | 13 | 14 | 8% | 17 | 18 | 6% | 49 | 49 | 0% | 77 | 97 | 26% |
| Maternal outcomes | |||||||||||||||||||||||||||
| Number of facility deliveries | 25,313 | 48,768 | 93% | 12,864 | 36,419 | 183% | 9,844 | 9,151 | -7% | 1,793 | 4,871 | 172% | 7,153 | 15,237 | 113% | 5,352 | 10,280 | 92% | 1,642 | 8,505 | 418% | 6,674 | 15,875 | 138% | 5,719 | 21,268 | 272% |
| Number of direct obstetric complicationsc | 3,997 | 6,200 | 55% | 1,772 | 3,017 | 70% | 3,096 | 3,390 | 9% | 773 | 1,447 | 87% | 868 | 2,176 | 151% | 925 | 1,306 | 41% | 20 | 301 | 1405% | 15 | 333 | 2120% | 72 | 264 | 267% |
| Number of cesarean deliveries | 1,637 | 3,061 | 87% | 653 | 1,410 | 116% | 1,382 | 2,026 | 47% | 411 | 863 | 110% | 255 | 1,035 | 306% | 242 | 547 | 126% | 0 | 0 | N/A | 0 | 0 | N/A | 0 | 0 | N/A |
| Total number of maternal deaths | 96 | 101 | 5% | 18 | 47 | 161% | 79 | 68 | -14% | 10 | 23 | 130% | 15 | 28 | 87% | 7 | 13 | 86% | 0 | 2 | N/A | 2 | 3 | 50% | 1 | 11 | 1000% |
| Total number of direct maternal deaths | 85 | 88 | 4% | 17 | 41 | 141% | 69 | 58 | -16% | 10 | 20 | 1% | 14 | 26 | 86% | 6 | 13 | 117% | 0 | 2 | N/A | 2 | 2 | 0% | 1 | 8 | 700% |
| Perinatal outcomes | |||||||||||||||||||||||||||
| Number of newborns delivered in facilities | 25,634 | 49,378 | 93% | 13,003 | 36,784 | 183% | 9,987 | 9,315 | -7% | 1,835 | 4,955 | 170% | 7,275 | 15,487 | 113% | 5,420 | 10,431 | 92% | 1,663 | 8,553 | 414% | 6,709 | 16,023 | 139% | 5,748 | 21,398 | 272% |
| Number of live births delivered in facilities | 24,870 | 48,585 | 95% | 12,736 | 36,469 | 186% | 9,487 | 8,921 | -6% | 1,750 | 4,859 | 178% | 7,039 | 15,148 | 115% | 5,289 | 10,279 | 94% | 1,652 | 8,518 | 416% | 6,692 | 15,998 | 139% | 5,697 | 21,331 | 274% |
| Number of stillbirths delivered in facilities | 764 | 791 | 4% | 267 | 310 | 16% | 500 | 393 | -21% | 85 | 96 | 13% | 236 | 338 | 43% | 131 | 148 | 13% | 11 | 35 | 218% | 17 | 25 | 47% | 51 | 66 | 29% |
| Number of intrapartum stillbirths delivered in facilities | 415 | 381 | -8% | 141 | 139 | -1% | 274 | 221 | -19% | 46 | 46 | 0% | 123 | 130 | 6% | 68 | 57 | -16% | 7 | 15 | 114% | 11 | 15 | 36% | 27 | 36 | 33% |
| Number of predischarge neonatal deaths | 299 | 471 | 58% | 105 | 178 | 70% | 225 | 255 | 13% | 35 | 61 | 74% | 71 | 199 | 180% | 58 | 97 | 67% | 1 | 8 | 700% | 2 | 9 | 350% | 12 | 20 | 67% |
| Number of perinatal deaths (stillbirths and predischarge neonatal deaths) | 1,063 | 1,262 | 19% | 372 | 488 | 31% | 725 | 648 | -11% | 120 | 157 | 31% | 307 | 537 | 75% | 189 | 245 | 30% | 12 | 43 | 258% | 19 | 34 | 79% | 63 | 86 | 37% |
| Maternal indicators | |||||||||||||||||||||||||||
| Institutional delivery rate,d,e % | 31.2 | 48.6 | *** | 17.6 | 36.3 | *** | 11.3 | 9.1 | *** | 2.2 | 4.9 | *** | 8.4 | 15.2 | *** | 6.3 | 10.3 | *** | 2.3 | 8.5 | *** | 9.2 | 15.8 | *** | 9.1 | 21.2 | *** |
| Population cesarean delivery rate,e % | 1.9 | 3.1 | *** | 0.7 | 1.4 | *** | 1.6 | 2.1 | *** | 0.5 | 0.9 | *** | 0.3 | 1.0 | *** | 0.3 | 0.5 | *** | 0.0 | 0.0 | N/A | 0.0 | 0.0 | N/A | 0.0 | 0.0 | N/A |
| Met need for EmONC, % | 30.5 | 41.2 | *** | 13.5 | 20.1 | *** | 23.6 | 25.8 | *** | 5.9 | 11.0 | *** | 6.6 | 14.5 | *** | 7.1 | 10.0 | *** | 0.2 | 2.3 | *** | 0.1 | 2.5 | *** | 0.5 | 2.0 | *** |
| Direct obstetric case fatality rate, % | 2.1 | 1.4 | *** | 1.0 | 1.4 | NS | 2.2 | 1.7 | NS | 1.3 | 1.4 | NS | 1.6 | 1.2 | NS | 0.6 | 1.0 | NS | 0.0 | 0.7 | N/A | 13.3 | 0.6 | NS | 1.4 | 3.0 | NS |
| Facility MMR (maternal deaths in facilities per 100,000 live births in facilities) | 386.0 | 207.9 | *** | 141.3 | 128.9 | NS | 832.7 | 762.2 | NS | 571.4 | 473.3 | NS | 213.1 | 184.8 | NS | 132.4 | 126.5 | NS | 0.0 | 23.5 | N/A | 29.9 | 18.8 | NS | 17.6 | 51.6 | NS |
| Perinatal indicators | |||||||||||||||||||||||||||
| Stillbirth rate (per 1,000 live births and stillbirths) | 29.8 | 16.0 | *** | 20.5 | 8.4 | *** | 50.1 | 42.2 | ** | 46.3 | 19.4 | *** | 32.4 | 21.8 | *** | 24.2 | 14.2 | *** | 6.6 | 4.1 | NS | 2.5 | 1.6 | NS | 8.9 | 3.1 | *** |
| Intrapartum stillbirth rate (per 1,000 live births and stillbirths) | 16.2 | 7.7 | *** | 10.8 | 3.8 | *** | 27.4 | 23.7 | NS | 25.1 | 9.3 | *** | 16.9 | 8.4 | *** | 12.5 | 5.5 | *** | 4.2 | 1.8 | NS | 1.6 | 0.9 | NS | 4.7 | 1.7 | *** |
| Predischarge neonatal mortality rate (per 1,000 live births) | 12.0 | 9.7 | ** | 8.2 | 4.9 | *** | 23.7 | 28.6 | ** | 20.0 | 12.6 | ** | 10.1 | 13.1 | ** | 11.0 | 9.4 | NS | 0.6 | 0.9 | NS | 0.3 | 0.6 | NS | 2.1 | 0.9 | * |
| Perinatal mortality rate (per 1,000 live births and stillbirths) | 41.5 | 25.6 | *** | 28.6 | 13.3 | *** | 72.6 | 69.6 | NS | 65.4 | 31.7 | *** | 42.2 | 34.7 | *** | 34.9 | 23.5 | *** | 7.2 | 5.0 | NS | 2.8 | 2.1 | NS | 11.0 | 4.0 | *** |
Abbreviations: DHIS, district health information systems; EmONC, emergency obstetric and neonatal care; FP, family planning; MMR, maternal mortality ratio; PS, program-supported; NPS, non-project-supported; Sig. Level, significance level.
↵a Includes group 1 and 2 health centers.
↵b Asterisks indicate significance levels calculated with a z-statistic as follows: ***=P<.01, **=P<.05, *=P<.1, NS=not significant.
↵c Includes antepartum, intrapartum and postpartum hemorrhage, eclampsia/preeclampsia, puerperal sepsis, obstructed labor/uterine rupture, other direct obstetric complications (e.g. embolism, anesthetic complications), and first trimester complications related to all pregnancy losses.
↵d The institutional delivery rate in 2013 includes imputations using DHIS-reported number of deliveries for missing months of outcomes, which were primarily in dispensaries. All other indicators were calculated without these imputations, as DHIS only contains aggregate data.
↵e The institutional delivery rate and the cesarean delivery rate use the expected annual number of live births in the regional population as denominators, as shown in Table 2.