Situational Analysis of Maternal Deaths in Paraguay: scopes from 2008 to 2018

Abstract

Introduction:

Maternal mortality in Paraguay, as a public health problem, reflects the deficit in social determinants and human rights, being an indicator that measures the access to health and development of a country. The Ministerio de Salud Pública y Bienestar Social -MSPBS- has been carrying out cost-effective interventions through the National Mobilization to reduce maternal and neonatal mortality -NMRMNM-, and to improve records.

Objective:

Analyze the situation of Maternal Deaths in Paraguay and the scope of 2008 to 2018 period.

Methods:

Observational, descriptive, transverse and retrospective study, identifying 1056 cases of maternal death -MD- in the 2008-2018 period, by reviewing records (SSIEV of the MSPBS) identified by ICD-10 codes: O00-O95, O98-O99 and A34, B20-B24. The information was translated into Excel program from Microsoft Corporation ™ 2007 version and analyzed using Epi Info 7.

Results:

In Paraguay, there is a Maternal Death Ratio -MDR- of 117.4 in 2008; in 2014, 63.9 according to the beginning of the NMRMNM; in 2018, 70.8 is recorded (the goals of Sustainable Development Goal 3 aim to reduce global MDR to < 70 maternal deaths per 100,000 live births), with 74.7% (95% CI 63.6-83.8) cases of direct MD. For the total causes of MD in the 2008-2018 period: abortion (20.1%), hemorrhagic complications (19.8%) hypertensive disorders (18.7%), sepsis (4.6%), AIDS (1.1%), obstetric tetanus (0.3%), other perinatal complications (35.4%); and the main causes of direct MD in 2018 continue to be: abortion (20.3%), hypertensive disorders (20.3%) and obstetric hemorrhages (15.2%). In the 2008-2018 period, for age groups: 20-29 years (40.7%), 30-39 years (37.0%), 10-19 years (13.3%) with annual rise or fall trends.

Conclusion:

Qualified institutional perinatal care and family planning should be guaranteed, promoting vital strategies such as: work with empirical midwives, prevention of adolescent pregnancy and abortion.