Pregnancy Outcomes and Maternal and Perinatal Health Indicators by Health Facility Type, Kigoma Region, 2013 and 2018
| Kigoma Region | Hospitals | Health Centers | Dispensaries | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2013 | 2018 | % Change | 2013 | 2018 | % Change | 2013 | 2018 | % Change | 2013 | 2018 | % Change | |
| Number of health facilities | 174 | 197 | 13% | 6 | 6 | 0% | 25 | 27 | 8% | 143 | 164 | 15% |
| Maternal outcomes | ||||||||||||
| Number of facility deliveries | 38,177 | 85,187 | 123% | 11,637 | 14,022 | 20% | 12,505 | 25,517 | 104% | 14,035 | 45,648 | 225% |
| Number of direct obstetric complicationsa | 5,769 | 9,217 | 60% | 3,869 | 4,837 | 25% | 1,793 | 3,482 | 94% | 107 | 898 | 739% |
| Number of cesarean deliveries | 2,290 | 4,471 | 95% | 1,793 | 2,889 | 61% | 497 | 1,582 | 218% | 0 | 0 | N/A |
| Number of maternal deaths (direct and indirect) | 114 | 148 | 30% | 89 | 91 | 2% | 22 | 41 | 86% | 3 | 16 | 433% |
| Number of direct maternal deaths | 102 | 129 | 26% | 79 | 78 | -1% | 20 | 39 | 95% | 3 | 12 | 300% |
| Perinatal outcomes | ||||||||||||
| Number of births delivered in facilities | 38,637 | 86,162 | 123% | 11,822 | 14,270 | 21% | 12,695 | 25,918 | 104% | 14,120 | 45,974 | 226% |
| Number of live births delivered in facilities | 37,606 | 85,054 | 126% | 11,237 | 13,780 | 23% | 12,328 | 25,427 | 106% | 14,041 | 45,847 | 227% |
| Number of stillbirths delivered in facilities | 1,031 | 1,101 | 7% | 585 | 489 | -16% | 367 | 486 | 32% | 79 | 126 | 59% |
| Number of intrapartum stillbirths delivered in facilities | 556 | 520 | -6% | 320 | 267 | -17% | 191 | 187 | -2% | 45 | 66 | 47% |
| Number of predischarge neonatal deaths | 404 | 649 | 61% | 260 | 316 | 22% | 129 | 296 | 129% | 15 | 37 | 147% |
| Number of perinatal deaths (stillbirths and predischarge neonatal deaths) | 1,435 | 1,750 | 22% | 845 | 805 | -5% | 496 | 782 | 58% | 94 | 163 | 73% |
| Kigoma Region | Hospitals | Health Centers | Dispensaries | |||||||||
| 2013 | 2018 | Sig. Levelb | 2013 | 2018 | Sig. Levelb | 2013 | 2018 | Sig. Levelb | 2013 | 2018 | Sig. Levelb | |
| Maternal indicators | ||||||||||||
| Institutional delivery rate,c,d % | 48.8 | 84.9 | *** | 13.5 | 14.0 | *** | 14.7 | 25.4 | *** | 20.6 | 45.5 | *** |
| Population cesarean delivery rate,d % | 2.6 | 4.5 | *** | 2.1 | 2.9 | *** | 0.6 | 1.6 | *** | 0.0 | 0.0 | N/A |
| Met need for EmONC, % | 44.0 | 61.3 | *** | 29.5 | 32.2 | *** | 13.7 | 23.1 | *** | 0.8 | 6.0 | *** |
| Direct obstetric case fatality rate, % | 1.8 | 1.4 | ** | 2.0 | 1.6 | NS | 1.1 | 1.1 | NS | 2.8 | 1.3 | NS |
| Facility MMR (maternal deaths in facilities per 100,000 live births in facilities) | 303.1 | 174.0 | *** | 792.0 | 660.4 | NS | 178.5 | 161.2 | NS | 21.4 | 34.9 | NS |
| Perinatal indicators | ||||||||||||
| Stillbirth rate (per 1,000 live births and stillbirths) | 26.7 | 12.8 | *** | 49.5 | 34.3 | *** | 28.9 | 18.8 | *** | 5.6 | 2.7 | *** |
| Intrapartum stillbirth rate (per 1,000 live births and stillbirths) | 14.4 | 6.0 | *** | 27.1 | 18.7 | *** | 15.0 | 7.2 | *** | 3.2 | 1.4 | *** |
| Predischarge neonatal mortality rate (per 1,000 live births) | 10.7 | 7.6 | *** | 23.1 | 22.9 | NS | 10.5 | 11.6 | NS | 1.1 | 0.8 | NS |
| Perinatal mortality rate (per 1,000 live births and stillbirths) | 37.1 | 20.3 | *** | 71.5 | 56.4 | *** | 39.1 | 30.2 | *** | 6.7 | 3.5 | *** |
Abbreviations: DHIS, district health information systems, EmONC, emergency obstetric and neonatal care; MMR, maternal mortality ratio; N/A, not applicable; Sig. Level, significance level.
↵a 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.
↵b Asterisks indicate significance levels calculated with a z-statistic as follows: ***=P <.01, **=P <.05, *=P<.1, NS=not significant.
↵c 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.
↵d 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.