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Winning battle against maternal mortality

The development of a country is directly linked to how it provides essential services to its populace, chief among them being the provision and accessibility of quality health services.

In health sector, the maternal and newborn health situation is a major indicator and it gives a general picture of a country’s basic care provided to pregnant women before, during and after child birth.

Globally, over 210 million women become pregnant every year, reports say. However 15 percent of these pregnancies end in complications causing deaths of around 358,000 women per 100 000 live births, according to the Emergency Obstetric and Neonatal Care (EmONC) Services Assessment Report carried out in 2011.

The report also observed that 99 percent of untimely deaths occur in developing countries which Malawi forms part of.

According to the report, the majority of the deaths are caused by were hemorrhage at 21 percent, unsafe abortions caused 13 per cent of the death while eclampsia caused 12 per cent, sepsis 8 per cent and obstructed labour at 8 per cent.

In 2004 the maternal mortality rate in Malawi stood at 984 deaths per every 100 000 live births, according to a Multiple Indicator Cluster Survey (MICS) done by Unicef.

Ten years on, the country has recorded a significant decline in numbers of women who are dying while giving birth and also children dying during birth.

Currently, the figures stand at 574 deaths on every 100 000 live births according to MICS carried out in 2014.

The drop in the figures has been attributed to, among others, improved coverage for antenatal care by skilled health personnel and a significant improvement on postnatal care with latest figures showing that 94 per cent of women stay at a health facility more than 12 hours after delivery.

Parent and Child Health Initiative (Pachi) is one such organisations which is working in this area of maternal and newborn health (MNH) to consolidate the efforts of eradicating maternal and neonatal deaths in the country through its Evidence4Action MamaYe Campaign.

This project seeks to ensure that decisions by policy makers and stakeholders are based on well-packaged evidence, and advocacy carried out based on this evidence and make everyone responsible and participate in ensuring that all levels are engaged to contribute towards saving the lives of mothers and newborns.

“The initiative is there to advance better lives for pregnant mothers and newborns [by helping them to receive] assistance from both the communities they live in and health facilities to make sure that the pregnancy experience is fulfilling [and] ends up in happy life for everyone involved,” said Mathias Chatuluka of Country Lead-MamaYe Malawi.

Chatuluka said strides made in improving the service delivery points, provider attitudes, infrastructure linking with the road networks and provision of ambulances and a lot of community mobilisation as well as putting enabling policies in place have gone a long way in reducing the maternal deaths and neonatal mortality.

Considering that most if not all of the deaths which occur in child birth are preventable, hope is retained that the battle to overcome maternal and neonatal morbidity is achievable.

“We are getting closer to winning the battle. It is something which cannot be done in a day and it is something which cannot be done by just an individual or a single ministry or a single organisation. It involves a multi-sectoral approach, drawing together all those concerned at every level be it community, district, national, all stakeholders, the government and the civil society.

“We need to pull our efforts together to make sure that we make the issues of maternal and newborn health a priority in the delivery of services,” he said.

Chatuluka said his organisation put in place a number of interventions and policies which have helped in repositioning and capacitating some of the cadres in the sector by giving them additional skills.

Today certain aspects of the service delivery are being done at community level, some at the health centre level, and cases which used to be regarded as referral to district hospitals are done at the health facilities and this has been achieved by training of the available personnel and making sure that they are given adequate and proper equipment to manage such conditions.

“It is something which requires continuous assessment and continuous development of skills to make sure that people who are going out there are well equipped and are providing the right services,” said Chatuluka.

At 21 per cent, hemorrhage looks to be the biggest obstacle the country is facing in its quest to make maternal and neonatal deaths a thing of the past. The amount of blood required in the country’s hospitals each day outweighs that which is collected.

Spokesperson in the Ministry of Health, Adrian Chikumbe said medical conditions like anemia, hemorrhage and road accidents have contributed to the high demand for blood in the hospitals as a result mothers who require blood after child birth have felt the pinch of the situation.

“One major step is by establishing Malawi Blood Transfusion Service as a dedicated entity to intensify blood collection. We also need to increase public awareness on the importance of donating blood,” Chikumbe told Mana.

Though some odds still appear stuck against the drive of eradicating maternal and neonatal deaths, it is worth noting that vital stakeholders like the ministry of health are hopeful that the battle will be won sooner than later.

“It is an uphill task considering our economic situation but it is achievable. One good thing is the number of partners which are showing interest to cooperate with us in this cause. We managed to reduce the child mortality rates and we should be able to do the same for maternal and neonatal deaths given the resources,” said Chikumbe.—Mana

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