A Study of Refugee Maternal Mortality in 10 Countries, 2008–2010
Open accessAbstract
CONTEXT: Little is known about the prevalence of maternal mortality in refugee camps for populations displaced by conflict, or about the factors contributing to such deaths. METHODS: Maternal Death Review Reports were used to analyze maternal deaths that occurred in 2008-2010 in 25 refugee camps in 10 countries. Assessed outcomes included causes of death; delays in women seeking, reaching or receiving care; and additional aspects of case management. We conducted detailed analyses of avoidable factors that contributed to deaths in Kenya, where the majority of reported cases occurred. RESULTS: Reports were available on 108 deaths, including 68 in Kenya. In every country but Bangladesh, maternal mortality ratios were lower among refugees than among the host population. The proportion of women who had had four or more antenatal care visits was lower among refugee women who had died (33%) than among the general refugee population (79%). Seventy-eight percent of the maternal deaths followed delivery or abortion, and 56% of those deaths occurred within 24 hours. Delays in seeking and receiving care were more prevalent than delays in reaching care. In Kenya, delays in seeking or accepting care and provider failure to recognize the severity of the woman's condition were the most common avoidable contributing factors. CONCLUSIONS: Additional interventions in community outreach, service delivery and supervision are needed to improve maternal outcomes in refugee populations.
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Delays in seeking timely maternity care from health care professionals are crucial to address among the Rohingya population where many preventable pregnancy-related deaths occur within the camps when care is not sought.
“Delays in seeking timely maternity care from health care professionals are crucial to address among the Rohingya population where many preventable pregnancy-related deaths occur within the camps when care is not sought.”
From Community-based referral transportation system for accessing emergency obstetric services in the Rohingya refugee camp during the COVID-19 pandemic in Bangladesh: facilitators and barriers through beneficiaries’ and providers’ lens using a mixed-method design (2022) · cites this paper as [4]
The Results and Discussion (page numbers unavailable) identify delays in seeking care as common, avoidable contributors to maternal deaths in the refugee camps studied. The paper does not identify its findings as specific to Rohingya women or establish that many deaths occurred because care was never sought; it reports that 83% of recorded deaths occurred at camp or referral health facilities. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA previous study of UNHCR maternal death review reports in 2008 to 2010 analyzed data from 10 countries, including six in the EHAGL region, finding timing and causes of death similar to reported global trends and identifying delays in care at health facilities that contributed to preventable deaths.
“A previous study of UNHCR maternal death review reports in 2008 to 2010 analyzed data from 10 countries, including six in the EHAGL region, finding timing and causes of death similar to reported global trends and identifying delays in care at health facilities that contributed to preventable deaths. 11”
From Review of maternal death audits in refugee camps in <scp>UNHCR</scp> East and Horn of Africa and Great Lakes Region, 2017–2019 (2023) · cites this paper as [11]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredIn refugee camps, reported maternal and neonatal mortality rates have often been shown to be lower than in host populations.
“In refugee camps, interviewees pointed out that reported maternal and neonatal mortality rates have often been shown to be lower than in host populations, and this has been demonstrated in the literature [27].”
From Implementation of maternal and perinatal death surveillance and response (MPDSR) in humanitarian settings: insights and experiences of humanitarian health practitioners and global technical expert meeting attendees (2022) · cites this paper as [27]
The Discussion (page not provided) reports lower maternal mortality ratios among refugees than host populations in every country except Bangladesh, while cautioning that maternal deaths were likely underreported. The paper does not report a corresponding comparison of neonatal mortality rates. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThis study, along with the Hynes et al. study, is the only recent study that examines this number of audits from refugee settings.
“However, this study, along with the Hynes et al. study, is the only recent study that examines this number of audits from refugee settings. 11”
From Review of maternal death audits in refugee camps in <scp>UNHCR</scp> East and Horn of Africa and Great Lakes Region, 2017–2019 (2023) · cites this paper as [11]
An increased proportion of deliveries are now occurring in facilities, but required care was not always available.
“Indeed, an increased proportion of deliveries are now occurring in facilities, but this study demonstrates that required care was not always available. 11”
From Review of maternal death audits in refugee camps in <scp>UNHCR</scp> East and Horn of Africa and Great Lakes Region, 2017–2019 (2023) · cites this paper as [11]
Compared with an analysis of refugee maternal death audits from 2008 to 2010, there was an increase in ANC attendance among the deceased, with 55% attending at least four visits versus 33% in the previous study.
“Compared with an analysis of refugee maternal death audits from 2008 to 2010, the authors saw an increase in ANC attendance among the deceased, with 55% attending at least four visits versus 33% in the previous study. 11”
From Review of maternal death audits in refugee camps in <scp>UNHCR</scp> East and Horn of Africa and Great Lakes Region, 2017–2019 (2023) · cites this paper as [11]
Refugees living in protracted camps generally have lower crude and under-five mortality rates than surrounding host communities, and possibly lower maternal mortality rates.
“Previous studies using UNHCR data have shown that refugees living in protracted camps generally have lower crude and under-five mortality rates than surrounding host communities, and possibly lower maternal mortality rates [16, 17].”
From Neonatal mortality burden and trends in UNHCR refugee camps, 2006–2017: a retrospective analysis (2021) · cites this paper as [16]
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- Authors
- Hynes, M., Sakani, O., Spiegel, P., & Cornier, N.
- Affiliations
- Office of the United Nations High Commissioner for Refugees (CH)
- Venue
- International Perspectives on Sexual and Reproductive Health
- Publisher
- Guttmacher Institute
- Published
- 2012-12
- Volume
- 38
- Issue
- 04
- Pages
- 205-213
- ISSN
- 1944-0391 (ISSN-L)
- OpenAlex
- W2082085333
- Cited by
- 57
- References
- 25
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 2 · 2023: 4 · 2022: 5 · 2021: 11 · 2020: 5 · 2019: 7 · 2018: 8 · 2016: 2 · 2015: 5 · 2014: 3 · 2013: 1
- FWCI
- 2.51
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Perspectives on Sexual and Reproductive Health (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Health Professions › General Health Professions › Health and Conflict Studies
- Keywords
- refugee camps, displaced persons, prenatal care, abortion-related deaths, postpartum mortality, avoidable causes of death, Kenya
- MeSH terms
- Abortion, Spontaneous, Adolescent, Adult, Africa, Cause of Death, Developing Countries, Female, Humans, Kenya, Maternal Mortality, Maternal Welfare, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Refugees, Risk Factors, Young Adult
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