Five Year Trend (2017 – 2021), Causes and Contributory Factors of Maternal Mortality in Health Facilities in the HO Municipality, Volta Region, Ghana

Introduction Maternal mortality is a global issue with documented interventions aimed at its reduction. Ghana has experienced a decline in maternal mortality ratios from 2017 to 2021. However, the Ho municipality has consistently reported the highest maternal mortality ratios in the Volta region of Ghana between 2017 and 2021. This study aimed to determine the trend and distribution, causes and contributory factors of maternal mortality and examine the referral patterns of maternal deaths in referral facilities in the Ho municipality. Method This retrospective descriptive cross-sectional study reviewed all maternal deaths recorded in health facilities within the Ho municipality between 2017 and 2021. Maternal audit reports were reviewed using a structured data extraction tool. Data analysis was conducted using IBM SPSS version 22. Results The average age of maternal death cases was 30 years, with the majority occurring among women during their second and fifth deliveries. The lowest cases were recorded among women with no formal education (2%). The leading causes of maternal death were hypertensive disorders in pregnancy (36%) and hemorrhage (25%). Key institutional contributory factors included: inappropriate case management (42%), delayed referrals (34%), and unavailability of blood and blood products (10%). A significant proportion of maternal deaths resulted from referrals from district hospitals outside the municipality, accounting for 95% of all referral deaths. Conclusion Maternal mortality in the Ho municipality is increasing, predominantly from hypertensive disorders in pregnancy and hemorrhage, associated with poor case management, largely from referral cases from district hospitals outside the municipality.