• Lisa Vallely, Yusuf Ahmed, and Susan F Murray.
• King's College London, Florence Nightingale School of Nursing and Midwifery, London, UK. susan_fairley.murray@kcl.ac.uk.
• Bmc Pregnancy Childb. 2005 Feb 1; 5 (1): 1.

BackgroundInformation on the extent of postpartum maternal morbidity in developing countries is extremely limited. In many settings, data from hospital-based studies is hard to interpret because of the small proportion of women that have access to medical care. However, in those areas with good uptake of health care, the measurement of the type and incidence of complications severe enough to require hospitalisation may provide useful baseline information on the acute and severe morbidity that women experience in the early weeks following childbirth. An analysis of health services data from Lusaka, Zambia, is presented. MethodsSix-month retrospective review of hospital registers and 4-week cross-sectional study with prospective identification of postpartum admissions. ResultsBoth parts of the study identified puerperal sepsis and malaria as, respectively, the leading direct and indirect causes of postpartum morbidity requiring hospital admission. Puerperal sepsis accounted for 34.8% of 365 postpartum admissions in the 6-month period. Malaria and pneumonia together accounted for one-fifth of all postpartum admissions (14.5% & 6% respectively). At least 1.7% of the postpartum population in Lusaka will require hospital-level care for a maternal morbidity. ConclusionsIn developing country urban settings with high public health care usage, meticulous review of hospital registers can provide baseline information on the burden of moderate-to-severe postpartum morbidity.

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