Obstetric complications affect the long term survival of women in Burkina Faso

Katerini T. Storeng, University of Oslo
Seydou Drabo, University of Oslo
Rasmané Ganaba, Agence de Formation, de Recherche et d'Expertise en Santé pour l'Afrique (AFRICSanté)
Johanne Sundby, University of Oslo
Clara Calvert, London School of Hygiene and Tropical Medicine (LSHTM)
Veronique Filippi, London School of Hygiene and Tropical Medicine (LSHTM)

Little is known about the long-term survival of women who experience maternal ‘near-misses’ (life-threatening obstetric complications) in low-income countries. Based on a prospective cohort study in Burkina Faso, this paper examines the extent to which the experience of a near-miss complication compromises longer-term (3-4 year) survival and explores the causes of deaths that occur subsequent to such complications. Women were significantly more likely to die after near-miss complications than after uncomplicated delivery, often from unresolved problems related to the initial near-miss complication. A range of health systems weaknesses contributed to these deaths, principally related to financial barriers, poor quality of care, lack of follow-up care and unmet need for contraception. Immediate survival does thus not necessarily mean that a pregnancy-related death has been averted. Comprehensive primary healthcare strategies that address chronic illness and the indirect, as well as direct, causes of mortality are needed to ensure women’s long-term survival.