Date of Award

11-2023

Degree Type

Thesis

Degree Name

Master of Science in Advanced Practice Midwifery (MSc-APM)

First Advisor

Dr. Abednego Ongeso

Second Advisor

Dr. Rose Maina

Third Advisor

Prof. Eunice Ndirangu

Department

School of Nursing and Midwifery, East Africa

Abstract

Background: Stillbirth, a component of perinatal mortality, remains a global burden, with approximately 2 million occurring annually worldwide and mostly in low- and middle-income countries (LMICs). There is a dearth of studies on stillbirth in some Low-middle income countries, such as Eswatini. The purpose of this study was to assess the prevalence and associated factors for stillbirths among women giving birth in four selected hospitals in Eswatini.

Methods: A quantitative unmatched case-control study was conducted using records of stillbirths (cases) and live births (controls) from July 1 to December 31, 2021. Consecutive sampling and systematic random sampling were used to select the cases and controls, respectively. Data extraction was performed using a piloted tool, and descriptive statistics summarized maternal and foetal factors. Statistical significance in association was determined using chi-square or Fisher's test. Univariable and multivariable binary logistic regression analyses were conducted to identify factors associated with stillbirths at p < .05 and 95% confidence interval. Ethical and administrative approval was obtained before the study was conducted.

Results: The sample data analysis revealed a prevalence of 18.9% (95% CI: .169 - .210). The average ages in years of women with stillbirths and live births were 28.3(±6.9) and 26.9 (±6.6), respectively. Factors significantly associated with stillbirths included residing in the Hhohho region, alcohol consumption, positive syphilis test, not taking iron and folic acid, use of traditional remedies, hypertensive disorders of pregnancy, abnormal amniotic fluid volume, meconium-stained liquor grade II/III, antepartum haemorrhage, birth before arrival, referral from another hospital, vaginal delivery, and foetal complications. Protective factors against stillbirths included abstaining from alcohol, birth intervals of more than 24 months, and timely rupture of membranes.

Conclusion: The prevalence of stillbirths is significantly high in Eswatini. Several modifiable and nonmodifiable factors associated with stillbirth and protective factors were identified. The findings highlight the need for planning and implementing a targeted intervention

First Page

1

Last Page

138

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