Intra-facility_maternal_deaths_Lagos_2018-2019.csv

Maternal and perinatal deaths that occurred amongst pregnant women who presented in the emergency room of the 24 public hospitals providing emergency obstetric care (EmOC) in Lagos, Nigeria between 1st November 2018 and 30th October 2019 were identified. Specifically, maternal death was defined as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes”. Perinatal death was defined as a foetal death occurring on or after 28-week gestation but before birth or neonatal death within seven days of life. Amongst these women, data on demographic characteristics, obstetric history, travel to the hospital, obstetric complication (as defined in the WHO’s Monitoring EmOC guidelines), and mode of birth were extracted. Based on the travel data extracted from the patient records, additional data were collected to estimate the driving distance (in kilometres (km)) and travel time (in minutes (mins)) of the pregnant women to the hospital using Google Maps (Alphabet Inc., Mountain View, California, US), which offers closer-to-reality estimates. To map the journeys in Google Maps, the street name of women’s self-reported addresses and referral points were geo-referenced for each woman who had traceable journeys in the application. The ‘typical time of travel’ feature in Google Maps was used for the period of the day of travel for specific time slots (9.00 a.m., 3.00 p.m., 6.00 p.m., and 9.00 p.m. for morning, afternoon, evening, or night journeys, respectively), based on awareness of peak and non-peak travel periods in Lagos. A check was subsequently conducted in Google Maps to ascertain whether there was an alternative public hospital closer to the pregnant woman’s self-reported address for the period of the day of travel to care. Data were processed in Microsoft Excel.