Analysis of the Causes of High Maternal Mortality Rates in Hospitals: Contributing Factors and Solutions for Improvement
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Published:
Mar 30, 2025
Keywords:
Maternal Mortality, Healthcare Systems, Socio-economic Barriers, Medical Practices, Healthcare Provider Training
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Articles
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Abstract
This research investigates the causes of high maternal mortality rates in hospitals, aiming to identify key contributing factors and propose solutions for reducing preventable deaths. By analyzing hospital records, conducting interviews with healthcare providers, and reviewing patient surveys, the study explores a range of issues, including healthcare infrastructure, staffing levels, medical practices, socio-economic barriers, and cultural factors. The findings highlight the critical role of well-resourced healthcare systems, efficient management practices, and timely interventions in improving maternal outcomes. Additionally, socio-economic and cultural barriers were identified as significant contributors to high mortality rates, particularly among vulnerable populations. The study underscores the importance of improving access to quality maternal care, enhancing healthcare provider training, and addressing systemic inequalities. The research concludes with a call for sustained action, policy reforms, and further research, particularly focusing on long-term interventions and targeted support for at-risk groups, to effectively reduce maternal mortality rates and improve global maternal health.
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How to Cite
Ramadhani, M., & Rukaiyah, R. (2025). Analysis of the Causes of High Maternal Mortality Rates in Hospitals: Contributing Factors and Solutions for Improvement. International Journal on ObGyn and Health Sciences, 3(2), 49–59. https://doi.org/10.35335/obgyn.v3i2.210
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Barber, S. L., Gertler, P. J., & Harimurti, P. (2007). Differences In Access To High-Quality Outpatient Care In Indonesia: Lower quality in remote regions and among private nurses is a manifestation of the educational, policy, and regulatory frameworks upon which the Indonesian health system is based. Health Affairs, 26(Suppl2), w352–w366.
Black, R. E., Taylor, C. E., Arole, S., Bang, A., Bhutta, Z. A., Chowdhury, A. M. R., Kirkwood, B. R., Kureshy, N., Lanata, C. F., & Phillips, J. F. (2017). Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 8. summary and recommendations of the Expert Panel. Journal of Global Health, 7(1).
Combs Thorsen, V., Sundby, J., & Malata, A. (2012). Piecing together the maternal death puzzle through narratives: the three delays model revisited. PloS One, 7(12), e52090.
Eberhard-Gran, M., Garthus-Niegel, S., Garthus-Niegel, K., & Eskild, A. (2010). Postnatal care: a cross-cultural and historical perspective. Archives of Women’s Mental Health, 13, 459–466.
Filippi, V., Chou, D., Ronsmans, C., Graham, W., & Say, L. (2016). Levels and causes of maternal mortality and morbidity. Disease Control Priorities, 2, 51–70.
Forward, A. F. Y. (n.d.). BETTER BIRTHS.
Ghaferi, A. A., Birkmeyer, J. D., & Dimick, J. B. (2009). Variation in hospital mortality associated with inpatient surgery. New England Journal of Medicine, 361(14), 1368–1375.
Gibson, C. B. (2017). Elaboration, generalization, triangulation, and interpretation: On enhancing the value of mixed method research. Organizational Research Methods, 20(2), 193–223.
Graham, W. J., Bell, J. S., & Bullough, C. H. W. (2001). Can skilled attendance at delivery reduce maternal mortality in developing countries? Safe Motherhood Strategies: A Review of the Evidence.
Hamburger, P. (2004). The new censorship: Institutional review boards. The Supreme Court Review, 2004, 271–354.
Knight, H. E., Self, A., & Kennedy, S. H. (2013). Why are women dying when they reach hospital on time? A systematic review of the ‘third delay.’ PloS One, 8(5), e63846.
Mrisho, M., Obrist, B., Schellenberg, J. A., Haws, R. A., Mushi, A. K., Mshinda, H., Tanner, M., & Schellenberg, D. (2009). The use of antenatal and postnatal care: perspectives and experiences of women and health care providers in rural southern Tanzania. BMC Pregnancy and Childbirth, 9, 1–12.
Murthy, S., & Adhikari, N. K. (2013). Global health care of the critically ill in low-resource settings. Annals of the American Thoracic Society, 10(5), 509–513.
Nair, M., Yoshida, S., Lambrechts, T., Boschi-Pinto, C., Bose, K., Mason, E. M., & Mathai, M. (2014). Facilitators and barriers to quality of care in maternal, newborn and child health: a global situational analysis through metareview. BMJ Open, 4(5), e004749.
Olonade, O., Olawande, T. I., Alabi, O. J., & Imhonopi, D. (2019). Maternal mortality and maternal health care in Nigeria: Implications for socio-economic development. Open Access Macedonian Journal of Medical Sciences, 7(5), 849.
Organization, W. H. (2004). World report on knowledge for better health: strengthening health systems. World Health Organization.
Organization, W. H. (2011). Evaluating the quality of care for severe pregnancy complications: the WHO near-miss approach for maternal health.
Ouma, P. O., Maina, J., Thuranira, P. N., Macharia, P. M., Alegana, V. A., English, M., Okiro, E. A., & Snow, R. W. (2018). Access to emergency hospital care provided by the public sector in sub-Saharan Africa in 2015: a geocoded inventory and spatial analysis. The Lancet Global Health, 6(3), e342–e350.
Prata, N., Passano, P., Sreenivas, A., & Gerdts, C. E. (2010). Maternal mortality in developing countries: challenges in scaling-up priority interventions. Women’s Health, 6(2), 311–327.
Rosa, W. (2017). Goal 3. Ensure health lives and promote well-being for all at all ages. A New Era in Global Health: Nursing and the United Nations, 2030, 265–282.
Sandelowski, M. (2000). Combining qualitative and quantitative sampling, data collection, and analysis techniques in mixed‐method studies. Research in Nursing & Health, 23(3), 246–255.
Schwab, F., Meyer, E., Geffers, C., & Gastmeier, P. (2012). Understaffing, overcrowding, inappropriate nurse: ventilated patient ratio and nosocomial infections: which parameter is the best reflection of deficits? Journal of Hospital Infection, 80(2), 133–139.
Snowden, J. M., Darney, B. G., Cheng, Y. W., McConnell, K. J., & Caughey, A. B. (2013). Systems factors in obstetric care: the role of daily obstetric volume. Obstetrics & Gynecology, 122(4), 851–857.
Sumankuuro, J., Crockett, J., & Wang, S. (2018). Perceived barriers to maternal and newborn health services delivery: a qualitative study of health workers and community members in low and middle-income settings. BMJ Open, 8(11), e021223.
Sundari, T. K. (2020). The untold story: how the health care systems in developing countries contribute to maternal mortality. Women’s Health, Politics, and Power, 173–190.
Uzochukwu, B. S. C., & Onwujekwe, O. E. (2004). Socio-economic differences and health seeking behaviour for the diagnosis and treatment of malaria: a case study of four local government areas operating the Bamako initiative programme in south-east Nigeria. International Journal for Equity in Health, 3, 1–10.
Ali, T. (2014). Identifying and responding to the challenge of staffing remote rural areas with health workers in middle and low income countries: the case of Sudan. The University of Manchester (United Kingdom).
Austin, A., Langer, A., Salam, R. A., Lassi, Z. S., Das, J. K., & Bhutta, Z. A. (2014). Approaches to improve the quality of maternal and newborn health care: an overview of the evidence. Reproductive Health, 11, 1–9.
Barber, S. L., Gertler, P. J., & Harimurti, P. (2007). Differences In Access To High-Quality Outpatient Care In Indonesia: Lower quality in remote regions and among private nurses is a manifestation of the educational, policy, and regulatory frameworks upon which the Indonesian health system is based. Health Affairs, 26(Suppl2), w352–w366.
Black, R. E., Taylor, C. E., Arole, S., Bang, A., Bhutta, Z. A., Chowdhury, A. M. R., Kirkwood, B. R., Kureshy, N., Lanata, C. F., & Phillips, J. F. (2017). Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 8. summary and recommendations of the Expert Panel. Journal of Global Health, 7(1).
Combs Thorsen, V., Sundby, J., & Malata, A. (2012). Piecing together the maternal death puzzle through narratives: the three delays model revisited. PloS One, 7(12), e52090.
Eberhard-Gran, M., Garthus-Niegel, S., Garthus-Niegel, K., & Eskild, A. (2010). Postnatal care: a cross-cultural and historical perspective. Archives of Women’s Mental Health, 13, 459–466.
Filippi, V., Chou, D., Ronsmans, C., Graham, W., & Say, L. (2016). Levels and causes of maternal mortality and morbidity. Disease Control Priorities, 2, 51–70.
Forward, A. F. Y. (n.d.). BETTER BIRTHS.
Ghaferi, A. A., Birkmeyer, J. D., & Dimick, J. B. (2009). Variation in hospital mortality associated with inpatient surgery. New England Journal of Medicine, 361(14), 1368–1375.
Gibson, C. B. (2017). Elaboration, generalization, triangulation, and interpretation: On enhancing the value of mixed method research. Organizational Research Methods, 20(2), 193–223.
Graham, W. J., Bell, J. S., & Bullough, C. H. W. (2001). Can skilled attendance at delivery reduce maternal mortality in developing countries? Safe Motherhood Strategies: A Review of the Evidence.
Hamburger, P. (2004). The new censorship: Institutional review boards. The Supreme Court Review, 2004, 271–354.
Knight, H. E., Self, A., & Kennedy, S. H. (2013). Why are women dying when they reach hospital on time? A systematic review of the ‘third delay.’ PloS One, 8(5), e63846.
Mrisho, M., Obrist, B., Schellenberg, J. A., Haws, R. A., Mushi, A. K., Mshinda, H., Tanner, M., & Schellenberg, D. (2009). The use of antenatal and postnatal care: perspectives and experiences of women and health care providers in rural southern Tanzania. BMC Pregnancy and Childbirth, 9, 1–12.
Murthy, S., & Adhikari, N. K. (2013). Global health care of the critically ill in low-resource settings. Annals of the American Thoracic Society, 10(5), 509–513.
Nair, M., Yoshida, S., Lambrechts, T., Boschi-Pinto, C., Bose, K., Mason, E. M., & Mathai, M. (2014). Facilitators and barriers to quality of care in maternal, newborn and child health: a global situational analysis through metareview. BMJ Open, 4(5), e004749.
Olonade, O., Olawande, T. I., Alabi, O. J., & Imhonopi, D. (2019). Maternal mortality and maternal health care in Nigeria: Implications for socio-economic development. Open Access Macedonian Journal of Medical Sciences, 7(5), 849.
Organization, W. H. (2004). World report on knowledge for better health: strengthening health systems. World Health Organization.
Organization, W. H. (2011). Evaluating the quality of care for severe pregnancy complications: the WHO near-miss approach for maternal health.
Ouma, P. O., Maina, J., Thuranira, P. N., Macharia, P. M., Alegana, V. A., English, M., Okiro, E. A., & Snow, R. W. (2018). Access to emergency hospital care provided by the public sector in sub-Saharan Africa in 2015: a geocoded inventory and spatial analysis. The Lancet Global Health, 6(3), e342–e350.
Prata, N., Passano, P., Sreenivas, A., & Gerdts, C. E. (2010). Maternal mortality in developing countries: challenges in scaling-up priority interventions. Women’s Health, 6(2), 311–327.
Rosa, W. (2017). Goal 3. Ensure health lives and promote well-being for all at all ages. A New Era in Global Health: Nursing and the United Nations, 2030, 265–282.
Sandelowski, M. (2000). Combining qualitative and quantitative sampling, data collection, and analysis techniques in mixed‐method studies. Research in Nursing & Health, 23(3), 246–255.
Schwab, F., Meyer, E., Geffers, C., & Gastmeier, P. (2012). Understaffing, overcrowding, inappropriate nurse: ventilated patient ratio and nosocomial infections: which parameter is the best reflection of deficits? Journal of Hospital Infection, 80(2), 133–139.
Snowden, J. M., Darney, B. G., Cheng, Y. W., McConnell, K. J., & Caughey, A. B. (2013). Systems factors in obstetric care: the role of daily obstetric volume. Obstetrics & Gynecology, 122(4), 851–857.
Sumankuuro, J., Crockett, J., & Wang, S. (2018). Perceived barriers to maternal and newborn health services delivery: a qualitative study of health workers and community members in low and middle-income settings. BMJ Open, 8(11), e021223.
Sundari, T. K. (2020). The untold story: how the health care systems in developing countries contribute to maternal mortality. Women’s Health, Politics, and Power, 173–190.
Uzochukwu, B. S. C., & Onwujekwe, O. E. (2004). Socio-economic differences and health seeking behaviour for the diagnosis and treatment of malaria: a case study of four local government areas operating the Bamako initiative programme in south-east Nigeria. International Journal for Equity in Health, 3, 1–10.
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