13 July 2009

Ghana: Civil Society to Campaign Against Maternal Deaths

Accra — The Alliance for Reproductive Health Rights (ARHR) has announced plans to organize a national civil society campaign on maternal health to highlight how Civil Society Organizations (CSOs) can collectively contribute to improved maternal health in the country.

Already, some CSOs supplement government's efforts in health service provision by providing maternal health services to poor and deprived communities in the country.

Others are engaged in advocacy to help bring to the fore peculiar Maternal Health (MH) needs of women in different parts of the country.

Their roles include but not limited to running community clinics that provide MH services, mobilizing for additional resources needed to provide MH services at grassroot level and training health workers and educating community members on issues related MH.

A concept paper by ARHR, states the proposed campaign is aimed at creating the avenue for CSOs to harmonize experiences and strategies they are adopting to address maternal mortality in Ghana.

The paper takes a critical look at the situation of maternal health in the country and provides recommendations on how CSOs can actively contribute to improve the situation.

Maternal Mortality Ratio (MMR) reflects women's risk of dying during the time of pregnancy. It covers death during pregnancy, childbirth and up to 42 days after delivery.

The 2007 Maternal Health Survey report estimates Maternal Mortality Ratio (MMR) to be 580 per 100,000 live births. Model estimates by WHO/UNICEF and UNFPA indicates 560 deaths per 100,000 live births at 2005, while Ghana Health Service institutional rates, 2007 states 230 deaths per 100,000 live births.

Globally, it is estimated that 1,500 women die every day from pregnancy-related complications. Sadly, most of these deaths occur in the developing world and most of them are avoidable, (WHO).

Improving MH is the focus of the Millennium Development Goal (MDG) 5, one of the eight goals adopted by the international community. It aims to reduce MMR by three-quarters by 2015.

The ARHR recalled several safe motherhood programmes adopted at the national and global level but have yet to yield the desired results to bring to the barest minimum the incidence of maternal illness and deaths.

"Although Ghana has no recent nationally representative data on maternal mortality, previous estimates range between 214 and 740 per 100,000 live births", stated the alliance,

Regionally and across urban / rural divides, there are marked differences in maternal mortality rates, with the northern parts of the country and rural communities generally recording higher ratios; they generally have poor access to health care in all description of access that is geographical, financial and socio-economic.

It cites severe bleeding (mostly postpartum hemorrhage), infections (mostly sepsis), hypertensive disorders in pregnancy (usually eclampsia) and obstructed labour.

"Complications after unsafe abortion cause 11% of maternal deaths in Ghana, anaemia causes 12% of maternal deaths. Other indirect causes include diseases that complicate pregnancy such as malaria, HIV/AIDS and cardiovascular diseases."

According to the alliance, poverty and inequities in access to MH services, socio-cultural practices and gender relations, lack of accurate data on maternal mortality and limited number of skilled attendants, are some of the factors driving the worsening condition of maternal deaths and illness.

WHO 2007 data spells out that a woman's lifetime risk of maternal death is one in 75 in developing regions compared to one in 73, 000 in developed regions.

The ARHR laments that the problem of MH in Ghana is heavily concentrated in poor rural areas which are often beyond the reach of the formal health system.

Consequently, women in these areas may not have access to any professional care when pregnant.

The lack of data on MMR is said to have led to confusion over the correct rate to be used for any intervention, thus, Ghana continues to rely on conflicting and sometimes outdated estimate. Several pregnancy related deaths, especially those that do not occur in a health facility are not recorded.

"Inaccurate data inhibit monitoring of progress and evaluation of specific interventions, and help keep maternal mortality low on the political agenda."

Early and regular visits to health facilities for antenatal services during pregnancy help to assess the physical status of the woman during pregnancy which leads to the provision of the appropriate assistance during and after delivery.

The ARHR emphasizes that the level of assistance a woman receives during the birth of her child has important health consequences for both the mother and the child.

It stated that considering that new mothers and their new born babies stand the greatest risk of dying within the two days after delivery, postnatal care should be received immediately after delivery.

Such check-ups provide an opportunity to assess and treat delivery complications and to counsel new mothers on how to take care of themselves as well as their newborn babies.

As a strategy for improvement, the alliance recommended that an extensive research be undertaken on a timely and routine basis to obtain good data for use by policy makers, CSOs, the media, service providers and others who are working to improve the situation.

"Improving maternal health in the country requires a renewed focus on family planning, skilled care at delivery and emergency obstetric care. A more sustained political commitment towards addressing maternal health is also critical to improving the health of pregnant women in the country," it added.

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