Identifying Factors Associated with Maternal Deaths in Jharkhand, India: A Verbal Autopsy Study

Nizamuddin Khan, Futures Group International
Manas Ranjan Pradhan, South Asia Network for Chronic Disease, PHFI

Based on a verbal autopsy study of 402 maternal deaths conducted in 2008, the paper explores the missed opportunities to save maternal lives, besides probing the socioeconomic factors contributing to maternal deaths in Jharkhand, India. This cross-sectional study was carried out in two phases and a multistage sampling design was used to select deaths for verbal autopsy. Informed consent was taken into consideration before verbal autopsy. The analytical approach includes bivariate analysis using SPSS, besides triangulation of qualitative and quantitative findings. Most of the deceased were poor (89%); non-literates (85%); and housewives (74%). Moreover, antenatal care was received by merely 23%; physician conducted delivery was only 14%; 76% died in community/at home; and 53% died during pregnancy/delivery. The decision delay, travel delay and treatment delay compounded with ignorance of obstructive complications, inadequate utilization of maternal healthcare services, poor health infrastructure and rituals are the major contributing factors of maternal deaths.