The Nairobi Birth Survey 1. the study design, the population and outline results

Abstract

The Nairobi Birth Survey was planned with the following objectives: 1) establish the social, obstetric and epidemiological characteristics of the obstetric population of Nairobi, Kenya; 2) examine the pattern and distribution of antenatal and delivery care; and 3) assess the true incidence of stillbirths and 1st 24-hour neonatal deaths, congenital abnormalities and major obstetric complications. The Survey consisted of 1) a study of all stillbirths and 24-hour neonatal deaths over a period of 7 months (March-September 1981), and 2) recording of all births taking place in Nairobi over a 7 week period (June 15-August 4, 1981). During the 7 week period there were 5,293 single births, including 187 perinatal deaths, with a stillbirth rate of 23/1,000 births and a 24-hour neonatal death rate of 12/1,000. The obstetric population was found to be predominantly young, with 57.8% of all mothers being under 25 years of age. Nearly 20% were teenagers. 23% of the mothers were having their 5th or more children at the time of the Survey. In 79.3% of the mothers the antenatal period was uncomplicated. Hypertensive disease in pregnancy was found to be the leading cause of complications, existing in 10.4% of the pregnancies. The majority of the mothers delivered in public institutions. Together with the student midwives, midwives conducted 79.7% of the births. The 3 maternal deaths in this survey give a maternal mortality rate of .56/1,000 deliveries. 701 perinatal deaths occured in the 7 month study, which corresponds to 71.2%. These deaths were mostly associated with complications of labor, including prolonged and difficult labor. In 40.9% of the cases the deaths could have been avoided with appropriate action. In 436 babies that were autopsied, 33 had congenital abnormalities.