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Maternal Mortality in East Africa

Professor Shane Doyle 

School of History, Faculty of Arts, Humanities and Cultures 

Relevant ESRC Discipline: Development Studies, Economic and Social History, Linguistics, Social Anthropology 

Globally, maternal health is characterized by greater inequity than almost any other aspect of medical provision. In 2015 women were 43 times more likely to die during pregnancy or childbirth in Kenya than in high-income societies. Despite substantial investment in maternity services since 2010, Maternal Mortality Ratios have remained stubbornly high, and the patient experience has worsened. Social science researchers used multiple approaches addressing different aspects of this complex problem: analysis of medical records identified recurring causes of death, ethnographic observation and sociolinguistic analysis highlighted the scale of miscommunication and antagonism within staff: patient interactions, and theatre-based research drew out how negative maternity encounters shaped future health-related decision-making. Overall, research found that patients sought to minimise exposure to maternity services because of anticipated disrespectful treatment, or because of confusion caused by competing maternal health schemes. The limited ante-natal attendance and delayed arrival at delivery suites which resulted were the most common factors resulting in maternal death. Antagonistic patient: provider relations also lowered staff morale and retention. This dissemination project will use workshops and briefings to share these findings with maternal health practitioners and policymakers in Kenya, advocating a greater focus on Respectful Maternity Care within training, and simplification of maternal health provision.