Journal of Health, Medicine and Nursing www.iiste.org ISSN 2422-8419 An International Peer-reviewed Journal Vol.26, 2016 82 Obstetric Complications in Two Major Urban Maternal and Child Clinics in Mogadishu Somalia: A Cross Sectional Study on Prevalence and Associated Factors Zainab Elmi Duhulo 1* Yeri Kombe 2 Simon Karanja 1 1.College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, off Thika Road, P.O. Box 103122 - 00101, Nairobi, Kenya 2.Centre for Public Health Research, Kenya Medical Research Institute (CPHR-KEMRI) Kenyatta National Hospital Complex off Ngong Road, P.O. Box 20752 - 00202, Nairobi, Kenya Abstract Somalia has the highest adult lifetime risk of maternal mortality of 1 in 18. Few pregnant women visit the antenatal care and have access emergency obstetric care services to detect and handle complications at childbirth. We assessed the cases of obstetric complications and associated factors in two major maternal and child clinic in urban areas of Mogadishu Somalia. This cross sectional study was conducted between 2015 and 2016 among women who had given birth at Banadir Maternity and Children Hospital and SOS Maternal and Child Clinic in Mogadishu Somalia. Participants’ information was collected through interviews and health records. Data were analyzed using bivariate and multivariable logistic regression to determine factors associated with being prepared, with statistically significant level at p < 0.05. A total of 203 out of 385 (52.7%) women had obstetric complications. This included 30% severe bleeding, 29.6% obstructed labor, 23.6% hypertensive disorder and 14.3% cases of sepsis. Employment status (OR 0.6, 95% CI 0.4 to 0.9) monthly income (OR 1.7, 95% CI 1.1 to 3.2), antenatal care attendance (OR 0.7, 95% CI 0.5 to 0.9), ANC initiation in the first trimester (OR 0.7, 95% CI 0.5 to 0.9), home delivery assisted by Traditional Birth Attendance (OR 1.7, 95% CI 1.7 to 2.4), worsening of past medical condition preceding the current birth (OR 1.6, 95% CI 1.2 to 2.3), current pregnancy termination (OR 1.9, 95% CI 1.1 to 3.4), vaginal delivery (OR 0.5, 95% CI 0.3 to 0.6), delivery assisted by a nurse (OR 0.4, 95% CI 0.3 to 0.6) were associated with obstetric complication. The high proportion of obstetric complication especially hemorrhage among women in Mogadishu Somalia, requires that women be monitored closely during pregnancy to reduce complications and death, in the absence of medical interventions. Economic empowerment, improved awareness of ANC, training of TBA would be key in reducing the obstetric complication in this region Keywords: Obstetric complications, prevalence and associated factors, two major urban maternal and child health clinic, Mogadishu Somalia. Introduction Although the 3 rd Universal Sustainable Development Goals (USDG) advocates for the healthy lives and promotion of well-being for all at all ages by 2030 (ICSU, ISSC, 2015), global maternal mortality still remains a challenge with 62% of the global annual maternal deaths reported in Sub Saharan Africa (WHO, 2014). Women in Africa because of more number of child birth and the greater risk with each pregnancy, the lifetime risk of dying from pregnancy-related complications or during childbirth are higher than other continent estimated at one in 38 versus one in 3,700 in the developed world (WHO, 2014; United Nation, 2014). Chad and Somalia are among the countries with the highest adult lifetime risk of maternal mortality of 1 in 15 and 1 in 18, respectively (WHO, 2014. About 80 percent of maternal deaths are due to pregnancy and childbirth related causes such as: unsafe abortion and obstetric complications such as severe bleeding, infection, hypertensive disorders, and obstructed labor (Measure communication, 2000). Other than studies done among Somali immigrants in developed countries which have reported varied outcomes in the rates of anaemia, gestational diabetes, hypertension, (Johnson et al., 2005; Robertson et al., 2005; Small et al., 2008), no data are available on the cases of obstetric complication and associated factors in Somalia. Many countries, particularly in sub-Saharan Africa, still have unsatisfactory levels of reproductive health visits (Wang et al., 2011). The Somali women both in Somalia and in other countries have low levels of access to quality reproductive health services (Malin & Gissler, 2009; Råssjö et al., 2013; Sorbye & Leigh, 2016). This is particularly worse in Somalia where investment in reproductive health is disproportionately low (Sorbye & Leigh, 2016). Poverty, underdevelopment, conflict, and internal displacements (Menkhaus, 2006; World Bank, 2015), insufficient health hospitals and professionals (Capobianco, 2008; Dagne, 2009; Sorbye & Leigh, 2016), illiteracy and the low value placed on women’s health, and social and cultural norms such as female genital mutilation (Thierfelder et al., 2005) has been associated with obstetric complication in Somalia. Following a fragile, but positive, transition mid-2012, Somalia has a full federal government in Mogadishu committed to inclusiveness, reconciliation and peace, based on a provisional constitution (World Bank, 2015). This study documents cases of obstetric complications and associated factors among the two largest reproductive health