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Introduction: Worldwide approximately 2.7 million are stillborn, more than 98% of these occur in developing countries. To address the problem, incidence and determinants of stillbirth must be understood. Therefore the aim of this study was to assess incidence and determinants of stillbirth among women who gave birth in Jimma University specialized hospital. Methods: A cross-sectional study design among 413 mothers who gave birth in Jimma specialized hospital was employed. Study subjects were selected by systematic sampling technique from the list of women who gave birth in hospital in one month study period. Data were collected by using pretested and structured questionnaire. Data were edited, cleaned, coded, entered and analyzed using SPSS-20 statistical software. Univarate and bivariate (logistic regressions) analysis was employed. Results: The incidence rate of stillbirth in the Hospital during a month period was 8% or 80 per 1000 total births. The predictors that showed an independent close association with stillbirth were absence of complication (OR = 0.1, 95% CI (0.04-0.2)), referral from other health facility (OR = 0.3, 95% CI (0.1-0.7)), having antenatal care (OR = 0.3, 95% CI (0.1-0.7)) and normal vaginal delivery (OR = 0.2, 95% CI (0.1-0.8)). Conclusion: The incidence rate of stillbirths in our setting is high and the identified determinants were related to both ante-partum and intra-partum-period. Therefore, effort should be made to improve antenatal, obstetric services and delivery services in terms awareness, access, timing and referral system to emergency care and specialized service to reduce the number of stillbirths.
Facility based cross sectional study was conducted at Jimma University specialized Hospital maternity unit in the department of obstetrics and gynecology in south-west Ethiopia. The hospital is the only teaching and referral hospital for south western part of Ethiopia and gives different specialized clinical services including maternal and child service for about 15 million population including referral cases from different region including the South Sudanese refuges. The maternity unit in the Department of Obstetrics and Gynecology at the hospital has between 4 and 8 specialist physicians. There are between four and eight nurse and midwives nurse for each shift. The department also has specialty training in obstetrics and gynecology residents which took four year to finish the specialty training that means in the departments there are resident specialty from 1st year to 4th year. Jimma University specialized Hospital is a 500 bedded hospital with 45 maternity beds, 5 delivery tables. During admission, detail history regarding age, parity, obstetric history and other reproductive health status are taken. Regular checks up are done by obstetrician, resident obstetricians and medical interns. Most deliveries are conducted by resident doctors (obstetricians) with the help of midwife/nurses on duty. The sample size was determined using single population proportion formula assuming; 95% level of confidence, 50% proportion of antenatal care (ANC) and non-response of 10%. This made the final sample size 422 women. A systematic sampling technique was used to identify study participants. Participant mothers were identified using delivery registration record book. Every one mother who gave birth or delivered was interviewed, until the required sample size was attained. The data were collected using structured questionnaires and check lists which were adapted from similar survey used by similar studies [9, 11]. The questioners contain the following parts: Socio demographic factors (respondents’ age, marital status, religion, ethnicity, education status, income, the number of children a woman has, occupation and other information). Obstetric and reproductive factors (ANC follow up, number of pregnancy, parity, means of transport to hospital, cause of complication mother experienced). Infant and delivery related issues (history of still birth, type of delivery, delivery outcome of the mother, delivery outcome of the fetus, type of skilled personnel). The data were collected using pre-tested structured questionnaires which were adapted from similar survey used by similar studies [9, 11]. The questionnaires were prepared in English and translated in to Amharic and retranslated back to English to check its consistency. The interview was conducted after delivery and before the mother left delivery unit. All mothers were informed about the purpose of the study, importance of their participation and consent was ensured. Based on their willingness to participate in the study, they were interviewed by the interviewer. After they have completed the interview, the questionnaires were returned to the supervisors. Data collectors were recruited from other nearby institutions who were working in delivery unit. Training for data collectors and supervisors were given for two days, to make them familiar with the study instrument, consent form, how to interview, where to interview, when to interview, and on data collection procedure in general, by the principal investigator. All filled questioners were checked daily for completeness, accuracy, clarity and consistency by the supervisors and investigator. Necessary correction and changes were made on time. The data was cleaned, checked for inconsistencies and missing values, coded and entered in to statistical package for social sciences (SPSS) for versions 20.0. The data was organized and presented by using tables and frequencies to see the overall distribution of the study subject with the variables under study. For bivaret analysis, crude odds ratio was computed to assess the presence and degree of association between different variables with 95% confidence interval. Alpha value of 0.05 was considered for statistical significance. Logistic regression analysis was used to identify the independent risk factors or predictors variables on still birth. Research ethical clearance and approval was obtained from ethical clearance committee of Public Health and medical science college, Jimma University after submission of the proposal. A written consent was obtained from Jimma specialized hospital. All the study participants were informed about the purpose of the study and their consent were obtained before interview. Written informed consent was obtained from every study subject before the interview by explaining the objective of the research. All the information collected from the study subjects was handled confidentially through omitting their personal identification, conducting the interview in private place and the data were used for the research purpose only.
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