Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2021 Reproductive Health Factors and Maternal Mortality of Internally Displaced Women in Nigeria Fatima Mahmood Jibirilla Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Public Health Education and Promotion Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Health Professions This is to certify that the doctoral study by Fatima Mahmood has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. John Oswald, Committee Chairperson, Public Health Faculty Dr. Nancy Rea, Committee Member, Public Health Faculty Dr. Kai Stewart, University Reviewer, Public Health Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2021 Abstract Reproductive Health Factors and Maternal Mortality of Internally Displaced Women in Nigeria by Fatima Mahmood Jibirilla MPH, Walden University, 2015 Bachelors of Medicine, Bachelors of Surgery (MBBS), University of Maiduguri Nigeria, 2010 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Public Health Walden University June 02, 2021 Abstract Approximately 529,000 women die from pregnancy-related causes every year, with 99% of these maternal deaths occurring in developing countries. In Nigeria, each year, about 59,000 maternal deaths occurs with a mortality rate of 576 deaths per 100,000 births. Women constitute about half of the 33.2 million internally displaced persons (IDPs) worldwide. The purpose of this retrospective cross-sectional study was to explore the association between the reproductive health factors and maternal mortality of internally displaced women in Borno state Nigeria. The McCarthy and Maine’s model for determinants of maternal mortality informed this study. A secondary dataset of 400 women (age 14-49 years) who died from pregnancy or its complication and those who were alive in IDP camp clinic and specialist hospital between 2016 and 2020 were used. Data were analyzed using descriptive and inferential statistics, chi square and binominal logistic regression. The findings showed that not attending at least 4 antenatal care (ANC) and postnatal care (PNC) visits increase the odds of maternal deaths by 1.75 and 0.28 times, respectively, and the use of family planning method reduces the odds of maternal death by a factor of 0.73. Also the findings showed that women living in IDP camp have a higher risk of maternal death compared to women living in their personal homes. Also the risk of maternal death was high among adolescent mothers between the ages of 14-19 years in Nigeria. Findings from this study will draw the attention of the legislature to develop policies towards improving access to reproductive health services in the IDP camps and it would also address the issue of health inequality leading to positive social change. Reproductive Health Factors and Maternal Mortality of Internally Displaced Women in Nigeria by Fatima Mahmood Jibirilla MPH Walden university Sheffield UK, 2015 Bachelors of Medicine, Bachelors of Surgery (MBBS) University of Maiduguri Nigeria, 2010. Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Public Health Walden University June 02, 2021 Table of Contents List of Tables ......................................................................................................... vi List of Figures ...................................................................................................... viii Section 1: Foundation of the Study and Literature Review .....................................1 Introduction to the Study ...................................................................................1 Problem Statement .............................................................................................3 Purpose of the Study ..........................................................................................5 Research Questions and Hypotheses .................................................................6 Theoretical Foundation ......................................................................................7 Previous Literature and Research Applying the Theory ............................11 The Rationale for the Choice of the Theory ....................................................12 Synthesis of Previous Writings by Key Theorists Related to Neonatal Mortality ........................................................................................14 Key Statements and Definitions Related to the Theory ...................................17 Nature of the Study ....................................................................................19 Literature Search Strategy ................................................................................19 Key Search Terms ......................................................................................21 Inclusion and Exclusion Criteria and Scope of Literature Review ............21 Literature Review .............................................................................................22 Early Studies on Maternal Death ...............................................................22 Studies Conducted Globally Regarding Reproductive Health factors and Maternal Deaths .............................................................................25 i Literature on Selected Variables and Concepts ...............................................27 Antenatal Care Attendance and Maternal mortality ..................................27 Post-natal care and Maternal mortality ......................................................30 Family Planning and Maternal Mortality ...................................................31 Place of residence and maternal mortality .................................................35 Mothers' age in pregnancy and Maternal Mortality ...................................37 Research Methodologies of Reproductive Health factors and Maternal Mortality ..............................................................................................38 Definitions ..................................................................................................41 Assumption ................................................................................................43 Scope and Delimitations ............................................................................43 Limitations .................................................................................................43 Significance ......................................................................................................44 Significance to Theory ...............................................................................45 Significance to Practice ..............................................................................45 Significance to Social change ....................................................................46 Summary and Conclusions ..............................................................................47 Section 2: Research Design and Data Collection ..................................................50 Introduction ......................................................................................................50 Research Design and Rationale .......................................................................51 Study Variables ..........................................................................................51 Research Design .........................................................................................51 ii The Rationale for the Design .....................................................................52 Methodology ....................................................................................................54 Target Population and Size ........................................................................54 Sample and Sampling Procedure ...............................................................54 Sampling Frame (inclusion and exclusion criteria) ...................................55 Inclusions ...................................................................................................55 Exclusions ..................................................................................................55 Procedure for Gaining Access for Secondary Data ...................................56 Reputability and Justification of the data source .......................................56 Power analysis to determine the sample size .............................................57 Instrumentation ..........................................................................................60 Data Management ......................................................................................61 Variables and Measures .............................................................................61 Descriptive Variables .................................................................................61 Data Analysis Plan .....................................................................................63