The East African (Nairobi)
Halima Abdallah
26 October 2009
Nairobi — All countries in Africa should reduce their maternal mortality rates in line with the millennium development goals, says the African Union.
"Some states are making progress on these goals. We will build on such progress to encourage other states to pull up their socks. The data for some countries is very discouraging," said Kabede Kasa, the AU Commission's expert on reproductive health.
African countries committed themselves to achieve the eight MDGs by 2015.
However, the high maternal mortality rate in some countries will make it hard to realise these goals.
According to the 2003 Maputo agreement, countries are to reduce their maternal mortality rate by three quarters by 2015.
But African countries are still registering 495,000 out of the 500,000 global annual deaths from pregnancy related complications.
In Uganda, for instance, the mortality rate is at 435 per every 1,000 live births annually.
The 2008 MDG monitor shows that most countries in northern Africa are making steady progress on all the goals.
But those in eastern, central and southern Africa are trailing far behind, or are off track.
The countries most affected are those still at war or just emerging from armed conflict.
Maternal mortality is any death of a woman while pregnant or within 42 days of termination of pregnancy.
Most of the deaths result from bleeding during pregnancy, delivery or after delivery.
"Sixty per cent of the deaths occur due to excess bleeding. Bleeding kills very quickly. It can kill a woman within two hours," said Alice Mutungi, a senior lecturer in the gynaecology department, University of Nairobi.
There are many remedies to bleeding but most health centres in Africa lack blood for transfusion and essential drugs.
Misoprostol is one effective drug, but most countries are reluctant to license it because it can also be used to induce abortion when taken in a particular dose.
Other causes of maternal mortality include infections, obstructed labour, ruptured uterus and eclampsia (fits resulting from high blood pressure).
In August, the African Union adopted the Accelerated Campaign on Reduction of Maternal Mortality in Africa.
The campaign is expected to increase the continent's advocacy on maternal mortality.
African countries are expected to adhere to the 2003 Maputo agreement to increase their health budgets by up to 10 per cent of their national budgets.
The health budgets of most African countries are very little.
In addition, weak health systems, inadequate human resource, poverty, lack of access to family planning services, post abortion care and insecurity in some countries have overshadowed the efforts made on maternal health.
The MDG challenges require translation of political commitments to practical solutions.
This will entail peace building and enhanced healthcare even in crisis situations.
Health experts must improve on service delivery despite the meagre resources at most clinics and hospitals.
A study done in Kenya titled Skilled Birth Attendants Assessment, 2006, revealed that out of the skilled personnel handling women in labour, only 26 per cent were humane and professional.
"We are not delivering quality service to the people. There is a complete mismatch between what is happening in the communities and what is happening in the health facilities,' said Stephen Kinoti, a USAID Health Care Improvement Project officer.
On many occasions, midwives in health centres were rude to desperate women.
This could explain why most women prefer traditional birth attendants as they are firm but gentle.
Traditional birth attendants are also useful in situations where medical centres are far away.
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