Document Type



Obstetrics and Gynaecology (East Africa)


Background: HIV/AIDS epidemic is one of the major factors affecting women’s health and impeding national efforts to improve it especially in sub-Saharan Africa. Current evidence indicates that HIV/ AIDS is increasingly becoming a major cause or contributing factor to pregnancy-related deaths, almost overtaking the “traditional” causes and factors.

Objectives: To survey the contribution of HIV infection and AIDS to pregnancy-related deaths in Blantyre, Malawi.

Design: A retrospective, descriptive, facility-based survey.

Setting: The Queen Elizabeth Central Teaching Hospital, Blantyre, Malawi.

Subjects: All women recorded to have had pregnancy-related deaths between January 1, 1999 and December 31, 2000.

Results: There were 204 maternal deaths, 154 (75.5%) direct, the top five causes being puerperal sepsis (39.0%), postabortion complications (31.2%), obstetric haemorrhage (14.3%), eclampsia (8.4%) and ectopic pregnancy (3.9%). At least 38 (18.6%) of the total were HIV positive or had AIDS. The main causes of deaths amongst these were meningitis (23.7%), pneumonia (18.4%), puerperal sepsis (13.2%), postabortal sepsis (10.5%), severe anaemia (10.5%) and pulmonary tuberculosis (10.5%) Of those who died of puerperal and postabortal sepsis in the whole study group 8.3% had HIV/AIDS. Of the indirect maternal deaths, 50 (58%) were HIV positive or had AIDS.

Conclusion and recommendations: HIV/AIDS contributes to both direct and indirect maternal deaths in Malawi. National strategies to realise MDG5 targets should include addressing the HIV/AIDS epidemic within the entire population as well as scaling up contraceptive uptake and utilisation, especially amongst the most vulnerable groups.

Publication (Name of Journal)

East African Medical Journal

Creative Commons License

Creative Commons Attribution-Noncommercial 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 3.0 License