Graduation Year


Document Type

Senior Thesis


Bachelor of Science

Primary Major


Thesis Advisor

Patricia Harris, PhD, RN


Background: Maternal mortality rates reflect health inequities in access to obstetric care in some parts of the world including many African countries. Geographical barriers and limited number of skilled human resources have put women in rural areas at a significantly higher risk of maternal mortality.

Research Question: What impact does the ability to access healthcare have on maternal outcomes in African rural areas compared to urban cities?

Methods: A literature review was performed of credible databases. Six articles were reviewed extensively highlighting the purpose, strengths, and limitations of each study. Refer to Appendix A for the literature review table.

Findings: Rural African women are at a significantly higher risk of maternal mortality when compared to urban women. The odds of these women receiving obstetric care or skilled delivery services is decreased as the distance to a facility increases. Studies have also found that adequate access to quality health services can reduce preventable maternal deaths.

Proposal for Further Research: A mixed method study including a cluster randomized control trial and patient surveys. Interventions will include a two-year study with referrals to the Juba Teaching Hospital for prenatal care, delivery, and antenatal care. Community health nurses will also be deployed at local health facilities and clinics to perform basic maternal skills, patient education, and emergency obstetric care. This study will be approved by the World Health Organization, Juba Teaching Hospital, hospital board members and the Real Medicine Foundation and Medical Mission International.