19 May 2009
Dakar — The UN Children's Fund in Chad is studying the level of obstetric services available throughout the country as a starting point to help the government scale up emergency obstetric care.
Chad is one of the most dangerous places in the world to give birth, with 1,100 maternal deaths for every 100,000 live births, ranking 170th among 177 countries in the UN Human Development Index. As throughout sub-Saharan Africa, most of the deaths occur when a woman suffers complications such as haemorrhage or infection at childbirth and no medical facilities or personnel are accessible.
In a mapping exercise to begin in the coming weeks, UNICEF will study health facilities throughout Chad, assess local response capacity and identify the most effective referral measures to ensure mothers' survival, according to Marzio Babille, head of UNICEF in Chad.
"To save women from unnecessary death during or after delivery, more equitable coverage of essential services like emergency obstetric care is indispensable," Babille told IRIN. "This includes blood transfusions and caesarean sections."
While in the case of infant mortality, individual and community actions such as exclusive breastfeeding and the use of oral rehydration solutions can bring significant gains, making childbirth safer requires investment in infrastructure, facilities and skilled health workers, he said. "When you have a woman who is haemorrhaging in childbirth, it is not a question of dealing with that at the community level. She must have access to treatment, and the manpower just is not there."
As of 2004 Chad had four doctors and one midwife for every 100,000 people, according to World Health Organization (WHO) statistics.
UNICEF will do qualitative and quantitative assessments of maternal care in various regions of Chad, taking into account the ethnic, socio-economic and security context.
Maternal mortality is difficult to measure, and few developing countries know exactly how many women die in childbirth each year, according to a 2008 UNICEF report. Given this, UNICEF says indicators such as presence of skilled health personnel at a birth, or ante- and post-natal care are essential for tracking progress on maternal health.
"Unfortunately [the] maternal mortality ratio is a fairly non-specific figure that refers to retrospective mortality in pregnancy, delivery and post-partum," Babille said. "The data we have are not the data we need." The Chad assessment is meant in part to complement existing information in order to better plan investments in improving maternal care.
Bleeding, obstructed labour, hypertension and infections are the most common causes of mothers' deaths. In Africa between 1997 and 2002, the latest statistics available, 34 percent of maternal deaths were caused by haemorrhaging, with infections causing 10 percent and hypertension 9 percent, according to WHO.
[ This report does not necessarily reflect the views of the United Nations ]
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