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3 Reasons the Maternal Mortality Rate in Ghana has Decreased

Maternal Mortality Rate in GhanaIn September 2000, the United Nations launched the Millennium Development Goals (MDG): eight steps aimed at making the world a better place. These goals ranged from establishing universal primary education to slowing the spread of HIV/AIDS. The fifth goal in the MDG plan is to improve maternal health, with one of the specific targets being to reduce the maternal mortality rate by 75% between 1990 and 2015. The World Health Organization defines maternal death as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.” Unfortunately, the World Health Organization could only report a 44% decrease in global maternal mortality by the end of 2015. The African nation of Ghana was one of these countries that sat right at 44%. In comparison to the original goal, the overall statistics seem poor; however, a 44% decrease is still a notable feat. Here are three factors that have been especially influential in reducing the maternal mortality rate in Ghana.

3 Reasons Why the Maternal Mortality Rate in Ghana has Decreased

  1. Free maternal health services. Free services for those who could not afford to pay full price made a huge impact on pregnant women in Ghana. This assistance was especially helpful given that, at that time, the country used a “cash and carry” healthcare system that required upfront payments to receive attention from healthcare professionals. This requirement restricted low-income women from obtaining adequate maternal care. In 2003, affordable services were extended to all Ghanaian women—regardless of economic status—after the country adopted universal healthcare. The combination of universal healthcare and maternal health services provided by the United Nations enabled more women to schedule maternal care visits within their first trimester: in 2017, 98% of pregnant women received antenatal care by a professional, and 84% received postnatal care. With this improved accessibility, women could now monitor their babies’ health, prepare for any special cases and get the help they needed during pregnancy and following childbirth.

  2. Midwives. About 79% of women giving birth in Ghana were assisted by a nurse or midwife, a trained professional who helps during pregnancy and labor. Due to lower education requirements relative to medical professionals, midwives are often more accessible than doctors. Despite less schooling, these individuals are still able to provide physical and emotional support throughout pregnancy, write prescriptions and advise mothers on safely preparing for labor. Two training schools have recently opened in Ghana, accompanied by a 13% increase in national enrollment.

  3. High Impact Rapid Delivery Program (HIRD). The High Impact Rapid Delivery program was established by the Ministry of Health. This program addresses the need for quick and effective change in health policies to increase safety and maximize health within a given nation. Examples of high-priority items include promoting the use of iron tablets during pregnancy, guaranteeing skilled attendance during deliveries and regular de-worming. Of note, Project Fives Alive!, a group assisting HIRD from 2008-2015, advocated for stronger “coverage, quality, reliability and patient-centeredness” in the health industry. The initiative engaged future health professionals in a 12- to 18-month training program designed to quickly teach effective ways to improve their skills in caring for pregnant women and children under the age of 5. Project Fives Alive! made significant progress: the organization helped foster an 11% increase in skilled delivery, a neonatal care institution that boasted a coverage rate seven times higher than its baseline and representation in 33 of Northern Ghana’s 38 districts.

There has indeed been considerable progress in lowering the maternal mortality rate in Ghana over the past 25 years. However, there is still much progress left to make: the country still experiences an alarming rate of 308 deaths per 100,000 (2017), whereas the global rate stands at 211 deaths per 100,000. With continued help from the aforementioned initiatives, the development of new drugs and technology and a commitment to improving maternal health, there is hope that these numbers will further decline.

– Rebecca Blanke
Photo: Flickr

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Efforts to Improve the Maternal Mortality Rate in Malawi

Maternal Mortality Rate in MalawiThe maternal mortality rate in Malawi is one of the highest in the world. The country ranks at number 13 for the highest number of maternal deaths during pregnancy or after birth.

The maternal mortality rate in Malawi has decreased over the years, but it is still an alarming issue that the country is addressing. It is estimated that per every 100,000 live births, over 600 mothers die from mostly preventable causes.

In Malawi, the circumstances of maternal mortality are complex but preventable. Like most countries in sub-Saharan Africa, the health care system in Malawi is not as developed as the rest of the world. Having better access to health care and qualified personnel will save the lives of mothers and children in developing countries.

Causes of High Maternal Mortality

There are several causes related to the high maternal mortality rate in Malawi. Poverty is one of the main contributing factors. Given that half of the country’s population lives in poverty, most women cannot afford conventional health care.

The majority of the population live in remote, rural areas, making it difficult for mothers to find access to quality maternal health care. In many cases, they cannot travel long distances on foot to the nearest available clinic. According to a 2014 study, 44 percent of women in rural areas attended at least 4 antenatal care visits whereas, in urban regions, the figure jumped to 51 percent.

In Malawi, women have historically given birth in their homes due to cultural beliefs and practices. In most cases, traditional birthing attendants were present. However, many of them were not trained to respond if something were to go wrong. This most commonly occurred in impoverished families. Today, the country recognizes the need for professionally trained personnel. In 2015-2016, 91 percent of women were recorded giving birth in a healthcare facility.

Most maternal deaths are related to diseases or complications during pregnancy or childbirth. The most common direct causes of maternal death are:

  • hemorrhages,
  • infection,
  • eclampsia,
  • obstructed labor and
  • abortion.

The indirect causes include malaria, anemia, HIV/AIDS and tuberculosis. In most cases, these diseases or complications would have been preventable if there was better access to health care.

Improving Malawi’s Maternal Mortality

Due to foreign aid, and the dedication of the Malawian government, the maternal mortality rate in Malawi is improving with every year. In 2001, out of 100,000 live births, 868 mothers died. Today, that number is significantly lowered to just over 600.

Former Malawian president, Joyce Banda made maternal health her top priority in 2014. Through her influence, the government of Malawi constructed new maternal health facilities in rural areas, created a new system to better train birthing attendants and changed cultural norms and attitudes regarding maternal health and pregnancy.

Banda also believed in the importance of educating young women about their reproductive health. A survey on Maternal and Perinatal Health has shown that women with lower levels of maternal education are at risk of high maternal mortality even if they have access to health care facilities.

Banda made lasting changes in Malawi for the women and children of today and the generations to come.

USAID Investments to Improve the Maternal Mortality Rate in Malawi

The United States financially supports Malawi by investing in maternal and child care. USAID is investing in maternal health facilities and quality care interventions in order to progress the country’s healthcare system. USAID is also supporting national family planning programs that promote maternal education and informed decision-making for the mothers of Malawi.

As the country continues to develop, the maternal mortality rate in Malawi is decreasing.

Due to more accessible facilities, better-educated mothers and the addition of trained professionals, the status of maternal health care in Malawi has made significant strides.

– Marissa Pekular
Photo: Flickr

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Top 5 Facts About Women’s Health Care in Cambodia

Women’s Health care in CambodiaThe Southeast Asian nation of Cambodia is currently experiencing its worst in maternal mortality rates. In Cambodia, maternal-related complications are the leading cause of death in women ages 15 to 46. The Minister of Health has created several partnerships with organizations such as USAID to help strengthen its healthcare system. Here are five facts about women’s health care in Cambodia.

Top 5 Facts About Women’s Health Care in Cambodia

  1. Health Care Professionals and Midwives
    USAID has provided a helping hand when it comes to educating healthcare professionals and midwives. Since USAID’s partnership with the Ministry of Health, USAID has helped raise the percentage of deliveries assisted by skilled professionals from 32 percent to 71 percent. The Ministry of Health was also able to implement the Health Sector Strategic Plan to improve reproductive and women’s maternal health in Cambodia.
  2. Health Care Facilities
    Between 2009 and 2015, the number of Comprehensive Emergency Obstetric and Newborn Care (CEmONC) facilities increased from 25 to 37. With more access and an increase in healthcare facilities, 80 percent of Cambodian women are giving birth in health care facilities.
  3. Postpartum Care
    The Royal Government of Cambodia renewed the Emergency Obstetric & Newborn Care (EmONC) Improvement Plan and extended the Fast Track Initiative Roadmap for Reducing Maternal and Newborn Mortality to 2020. This aims to improve women’s health care in Cambodia to improve the lives of women living with postpartum depression. It is also used to improve newborn care and deliveries.
  4. Obstetric Care
    Obstetric care has improved rapidly. According to a 2014 Cambodia Demographic and Health Survey, 90 percent of mothers receive obstetric care two days after giving birth, and three-quarters of women receive care three hours after. Intensive obstetric care has helped drop Cambodia’s maternal mortality rate significantly. In 2014, Cambodia’s maternal mortality rates decreased from 472 deaths per 100,000 live births in 2005 to 170 deaths per 100,000 live births.
  5. U.N. Women
    U.N. Women is working closely to help address the AIDS epidemic in Cambodia. The organization’s efforts to reduce the epidemic focus on protection and prevention. In 2003, 3 percent of Cambodian women reported being tested for AIDS. It has also been observed women in urban areas are more likely to get tested than those in rural areas. Ultimately, Cambodia has set a goal to eradicate AIDS from the country by 2020 through prevention and protection.

Cambodia has seen much economic growth over the years, but the money provided for health care is minimal. Consequently, it is difficult for the government to provide all services. However, there have been great strides in improving women’s healthcare in Cambodia. By fighting to better the lives of women, the Cambodian government has set a goal to establish universal health care by 2030.

– Andrew Valdovinos
Photo: Flickr

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Tetanus Eradicated in India

Tetanus Eradicated in India
India has eliminated maternal and neonatal tetanus (MNT) as a threat to public health, Prime Minister Narendra Modi announced at the Call to Action 2015 Summit on Aug. 27. The announcement comes ahead of the nation’s goal of December.

Tetanus regularly targets newborns and mothers, usually resulting from births taking place in unsanitary conditions or dirty blades being used to cut umbilical cords.

The eradication of MNT comes 15 years after the creation of a campaign by UNICEF, WHO and UNFPA. The organizations launched the Maternal and Neonatal Tetanus Elimination Initiative in 1999 with the goal of abolishing MNT as a global health problem.

The initiative defines the elimination of MNT as a global health problem as every district having less than one case of neonatal tetanus per 1,000 live births. When that is accomplished, maternal tetanus is deemed eliminated as well.

At the time the initiative was created, there were an estimated 800,000 newborn deaths a year globally as a result of tetanus, according to WHO. That number is now less than 50,000.

Along with the initiative, the Indian government took its own steps to help eradicate the disease, which is estimated to have killed 160,000 children in the country in 1988.

In Dec. 2014, the Ministry of Health and Family Welfare in India launched Mission Indradhanush, a project aiming to increase the percentage of children completely vaccinated from 65 to at least 90 percent.

In addition to tetanus, immunizations provided by Mission Indradhanush help protect children against tuberculosis, polio, measles, hepatitis B, diphtheria and pertussis, and are free due to India’s Universal Immunization Programme.

In an effort to have more births occur in medical facilities, the Indian government developed a program in which women are paid up to $21 if they go to a clinic or hospital to give birth.

Health workers are also paid to make sure women in labor go to a medical facility. Dubbed “lady health workers,” they are paid up to $9 per mother and receive full payment only if they visit each baby at home and administer TB shots.

Even with these incentives, some women still insist on giving birth at home, as doing so is a local tradition in India. To ensure sanitary conditions, the government will send these women kits containing antibacterial soap, a clean plastic sheet, and a sterile scalpel and plastic clamp to be used on the umbilical cord.

While India has eliminated MNT, the infection is still considered a public health problem in 22 out of the 59 countries originally identified by the U.N. initiative.

– Matt Wotus

Sources: National Health Portal of India, Quartz, The New York Times, UNICEF, WHO
Photo: Google Images

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USAID Sets New Goals for Maternal Health

maternal health
The United States Agency for International Development, or USAID, is a government organization in charge of allocating funds and aid to global issues.

Millions around the globe have felt such power and emotion in the form of kisses, hugs, listening ears, and countless late nights.

However, maternal and child survival continues to be among the key issues that feed into the poverty crisis in developing countries around the world.

According to the UN, “a woman dies from complications in childbirth every minute – about 529,000 each year – the vast majority of them in developing countries.”

As part of the Millennium Development Goals, which concluded earlier this year in 2015, several countries banded together in order to increase maternal and child survival by three-quarters. While the target was not met, significant progress was made and millions of lives were saved in countries that normally do not receive the care and resources required for a healthy delivery.

Now that 2015 is coming to an end, many countries and organizations are now setting new goals to improve maternal and child survival. USAID recently came out with its new goal to reach an additional 38 million women with increased access to care during childbirth.

With this goal in mind, an action plan was put together in order to achieve this milestone. On their site the organization stated, “the USAID report details how to reach 38 million of the most vulnerable women around the world with increased access to health care during delivery by 2020.”

This plan includes a focus on 24 target countries including, but not limited to Ethiopia, Nepal, Afghanistan, Haiti, and India.

With this aid, more mothers have had access to care during and after the birth of their children. A recent article from the USAID Impact blog reported successes within some of these target countries.

The organization reports that in Ethiopia, 38,000 workers have been trained and dispatched around the country to help mothers and children. In Nepal, female workers travel to provide women with antiseptic gel, free of charge, to reduce infant infection. Malawi has increased efforts to save infants born without fully developed lungs.

Similar stories are beginning to flourish in developing countries around the world. With countries receiving the necessary resources and aid during this vulnerable time for both mother and child, lives are being saved and general health standards improved.

The survival of these mothers and children around the globe is imperative if we are to alleviate the poverty crisis our world now faces.

To quote the USAID Impact post, “When a child dies, and when a mother dies giving birth, it is a tragedy for all of us…because it continues the cycle of extreme poverty that holds the entire world back. Together, we can break that cycle.”

When a mother is lost, children and fathers feel the strain and the community as a whole is affected. When a child is lost, the community misses out on that child’s potential accomplishments and impact. With USAID reaching out to the formerly unreachable, maternal and child survival increases and the community as a whole improves.

– Katherine Martin

Sources: UNICEF, USAID 1, USAID 2
Photo: pixabay

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Maternal Mortality in the Philippines

maternal mortalityIn 2000, the U.N. agreed on eight Millennium Development Goals that it hoped to reach by 2015. Included among these goals: promoting gender equality and empowering women, reducing child mortality and improving maternal health. For the Philippines, improving maternal health is an extremely important goal since the maternal mortality rate of the Philippines was high—209 deaths per 100,000 live births as of 1993. The target for the Philippines is the reduction of the MMR to 52 deaths per 100,000 live births by 2015. However, while maternal mortality has been decreasing in the Philippines, it has not been falling at a fast enough rate.

Maternal deaths are still a huge concern for the Philippines. By 2006, the maternal mortality rate decreased to a rate of 162 per 100,000 live births and currently, the MMR is 120 deaths per 100,000 live births—still nowhere near the target that the MDGs established.

Various factors are responsible for the high rate of maternal mortality that the Philippines face. According to the IRIN, some of the main causes of maternal deaths are hemorrhages, sepsis, obstructed labor, hypertensive disorders during pregnancy and complications associated with unsafe abortions. Having a physician, nurse or midwife who has had formal training present during the birth can decrease the maternal mortality rate, but currently, these skilled birthing attendants supervise only 60 percent of births in the Philippines. Others rely on traditional birthing attendants who do not have formal training and therefore are often unable to deal with complications.

Poor women and women in rural areas are at a disadvantage. Around 75 percent of the poorest quintile do not have a skilled birth attendant to help them through their pregnancy. Rural areas also have higher maternal mortality rates because many women in rural areas begin having children at a young age. Since adolescent women are normally not developed enough for childbirth, these young mothers face many complications during and after pregnancy and contribute to the high maternal mortality rate.

Another problem that adds to the high maternal mortality rate in the Philippines is the low level of contraceptive use. The Philippines is 80 percent Catholic, so birth control pills, condoms and other forms are contraceptive use are considered to be similar to abortion. This has led to limited access to contraceptives, since contraceptives were previously not widely available at health care clinics.

This limited access to contraceptives has negative effects. In 2006, there were three million pregnancies in the Philippines. Half of those pregnancies were unplanned, and one third of the unplanned pregnancies resulted in abortions. A higher rate of contraceptive use will prevent this from happening and will consequently decrease the maternal mortality rate.

While rates of contraceptive use have not risen much from 2006 to 2014, there is hope that contraceptive use will now increase dramatically due to a birth control law that the Philippine Supreme court approved in April 2014. The law requires the government’s health centers to have free condoms and contraceptive pills. It may be too soon to tell whether that law has a significant effect on maternal mortality. However, the law will hopefully help the Philippines to reach its MDG by the end of 2015. Other ways to help reduce maternal mortality are providing more antenatal care and more widespread access to health facilities.

– Ashrita Rau

Sources: UNDP, IRIN News, Philstar, WHO, Huffington Post, United Nations, BBC
Photo: Flickr