Abstract

This study investigated the factors influencing pregnancy and birth outcomes among pregnant women and postpartum mothers at Cite Verte District Hospital, Cameroon. A cross-sectional design was employed, with data collected from 60 participants using structured questionnaires.

The findings revealed that socioeconomic factors, such as financial constraints (63.3%), lack of health insurance (86.7%), and low antenatal care attendance (50% attended only 1–3 visits), significantly hindered access to maternal healthcare.

Environmental challenges, including unsanitary living conditions (46.7%) and limited proximity to healthcare facilities (33.3% lived >5 km away), further exacerbated risks. Healthcare-related barriers, such as staff shortages (35%) and dissatisfaction with care quality (51.7%), were also critical contributors to adverse outcomes.

The study underscores the need for targeted interventions, including expanded health insurance, improved infrastructure, and community-based education, to enhance maternal and neonatal health.

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

Pregnancy and birth outcomes are critical indicators of maternal and child health, reflecting the effectiveness of healthcare systems, social structures, and policy frameworks worldwide.

Global context

Globally, significant progress has been made in reducing maternal and neonatal mortality over the past decades. However, disparities persist between high-income, low-and middle-income countries. According to the World Health Organization (WHO), approximately 295,000 women died during pregnancy and childbirth in 2017, with 94% of these deaths occurring in low resource settings, predominantly in sub-Saharan Africa and South Asia (WHO, 2019). Adverse pregnancy and birth outcomes, including maternal mortality, stillbirth, and neonatal deaths remain a major public health challenges, particularly in developing regions.

American context

In the united-states, pregnancy-related mortality rates have been increasing over the past few decades, with a current rate of 22 deaths per 100,000 live birth. The centers for disease control and prevention (2020), has identified several factors that contribute to these disparities, including inadequate access to health care, poor health outcomes and social determinants of health.

 European context

In Europe, pregnancy and birth outcomes vary significantly across countries. According to WHO (2020), the European region has a maternal mortality ratio of 16 deaths per 100,000 live birth with significant variations between countries. For example the United Kingdom has a maternal mortality ratio of 9 deaths per 100,000 live birth, while Bulgaria has a ratio of 27 deaths per 100,000 live births WHO (2020).

African context

In Africa, the burden of adverse maternal and neonatal outcomes is alarming. The continent accounts for 66% of global maternal deaths and has the highest neonatal mortality rates, with 27 deaths per 1,000 live births (UNICEF, 2023). Factors such as limited access to quality health care, poverty, and sociocultural practices contribute to this crisis. Sub-Saharan African countries face systemic challenges, including underfunded health care systems, insufficient skilled birth attendance, and a high prevalence of preventable conditions like hemorrhage, infections and hypertensive disorders (WHO, 2021). Additionally teenage pregnancies and delays in seeking antenatal care exacerbate the risk, highlighting the needs for targeted interventions.

Cameroon context

Cameroon, situated in Central Africa, reflects the broader challenges faced by sub-Saharan Africa in maternal and neonatal health. The county has a maternal mortality ratio of 406 deaths per 100,000 live births and a neonatal mortality rate of 27 deaths per 1000 live births, significantly higher than the global averages (UNFPA, 2022). Urban like Yaounde, while better equipped with health care facilities, still face unique challenges including overcrowded hospitals, socioeconomic inequalities, and environmental risks. Rural areas are worse off, with limited health care infrastructure and skilled personnel. Cultural practices, such as preference for home births and reliance on traditional medicine, further complicates efforts to improve outcomes (Ngowe et al 2020).

 Problem statement

Pregnancy and childbirth are critical life events that can have significant impacts on the health and wellbeing of women and their families.  According to WHO, approximately 810 women die every day due to complications related to pregnancy and childbirth and million more experience serious health problem WHO (2020).

Also, a study published in the Pan-African medical journal found that adverse birth outcomes, including low birth weight, stillbirth and congenital anomalies, are significant contributions to neonatal and child mortality WHO (2022). Furthermore disparities in maternal and infant mortality and morbidity rate persist, with women and infants from low-income and marginalized communities being disproportionately affected UNICEF (2020).

In recent years, a number of efforts have been made to improve pregnancy and birth outcomes WHO (2019), progesterone supplement, influenza vaccination, nutritional interventions, calcium and low dose aspirin and dedicated preterm birth prevention clinic. The United Nations Sustainable Development Goals (SDGs) include targets to reduce maternal and infant mortality rates by 2030 United Nations (2015). Additionally, organizations such as WHO, UNICEF and the World Bank have launched initiative aimed at improving access to prenatal care, skilled birth attendance and emergency obstetrics care, (WHO 2018; UNICEF, 2019). Moreover the American College of Obstetricians and Gynecologists (ACOG) have developed guidelines and recommendations to support the provision of high-quality maternal and newborn care (ACOG, 2020).

Despite the efforts made by  international organizations pregnancy and birth outcomes still persist due to hemorrhage, infections and hypertensive disorders WHO (2021). During my internship at the Yaounde central hospital, I have witnessed the struggles that pregnant women go through, especially those from underprivileged backgrounds.

I remember seeing a young woman who arrived at the hospital in labor but was turned away because she could not afford the required medical fees. She was forced to seek alternative help, which put both her life and that of her baby at risk. In another instance, I saw a woman who had experienced complications during pregnancy but had not attended any prenatal check-ups due to lack of awareness and financial difficulties. By the time she was admitted, it was too late to prevent severe complications.

These experiences made me realize how financial barriers, lack of education, and delayed medical interventions can have devastating effects on pregnancy and birth outcomes. Seeing the pain and loss that some mothers go through has inspired me to investigate the key factors influencing these outcomes, with the hope of contributing to solutions that can improve maternal and infant health.

Research Questions

Main Research Question

What are the factors that influence pregnancy and birth outcomes among pregnant women and postpartum mother’s in the cite verte district hospital ?

Specific Research Questions

1. What socioeconomic factors influence pregnancy and birth outcomes for pregnant women and postpartum mothers at Cite Verte District Hospital?
2. What environmental factors contribute to adverse pregnancy and birth outcomes for pregnant women at Cite Verte District Hospital?
3. How do healthcare-related factors impact pregnancy and birth outcomes for postpartum mothers at Cite Verte District Hospital?

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