Maternal Mortality Ratio and Associated Risk Factors in Mifi Health District, Cameroon: A Retrospective Facility-Based Study (2021–2023)

Introduction Maternal mortality remains a critical public health concern in Cameroon, reflecting persistent inequities in healthcare access and quality. Despite national strategies to reduce maternal deaths, the Mifi Health District continues to report disproportionately high rates, signaling underlying systemic and obstetric challenges. Methods This retrospective facility-based study assessed maternal mortality trends and associated risk factors in the Mifi Health District from 2021 to 2023. Specifically, it determined the maternal mortality ratio (MMR), identified major obstetric and socio-demographic risk factors, and examined health-system contributors such as emergency obstetric and neonatal care (EmONC) readiness and referral efficiency. Data were extracted from hospital records, registers, and maternal death audit reports and analyzed using SPSS 25. Descriptive statistics and chi-square tests assessed relationships between variables. Results The study found an MMR of 232 deaths per 100,000 live births significantly higher than the regional average of 123 accounting for 37% of total maternal deaths in the West Region. Hemorrhage (35%), infections (20%), and hypertensive disorders (20%) were the leading causes of death, while 86% of cases involved referrals primarily due to lack of equipment or specialist care. Delays in receiving adequate care (50%), reaching facilities (25.8%), and seeking care (13%) were the dominant contributory factors. The risk factors were mostly lacking in the registers (96%). Conclusion The study concludes that high maternal mortality in Mifi results from preventable obstetric causes and systemic weaknesses. It recommends strengthening EmONC services, improving referral coordination, training skilled personnel, enhancing adequate documentation, enhancing community awareness, and enforcing governance accountability to reduce preventable maternal deaths and achieve Sustainable Development Goal 3.1 in Cameroon.