8 May 2018

Sierra Leone: 'Sierra Leone Has Highest Maternal Mortality Ratio'

Representative of the United Nations Fund for Population Activities, Dr. Kim E. Dickson, has revealed that the country has the highest maternal mortality ratio (MMR) in the world, with 1,360 maternal deaths per 100,000 live births, while one in every 17 women bear the risk of dying during labour.

'Every year in Sierra Leone thousands of pregnant women lose their lives while trying to give birth,' she said.

Dr Kim E. Dickson was speaking on International Day of the Midwife, May 5, 2018 on the theme, 'Midwives leading the way with quality care.'

She noted that approximately 70 percent of those deaths could be averted if the country's health workforce status (availability, distribution and competency) was strengthened.

She observed that globally midwives were key to reducing maternal and new-born deaths.

'However, in Sierra Leone, similarly, to other low-income countries around the world, there is a shortage of specialists such as midwives. The overall ratio of health workers to the population is low with physicians, nursing and midwifery personnel who can manage complicated pregnancies and deliveries at a ratio of 0.2/10,000 for physicians and 1.7/10,000 for nurses/midwives,' she said.

The UN diplomat said midwives provide up to 87 percent of childbirth-related services, making them the ideal health professional to support women through the maternity continuum of care.

'They save lives, support and promote healthy families and empower women and couples to choose the timing and number of children they want. Additionally, midwives also help avert sexually transmitted infections and prevent disabilities like obstetric fistula, mother-to-child transmission of HIV and female genital mutilation,' she said.

She said that at the heart of their work, UNFPA aims to put an end to preventable maternal deaths and that the country office supports the Government of Sierra Leone by investing resources and technical expertise for the training of healthcare providers, particularly nurse anaesthetists, surgical assistants, community health officers and midwives.

'UNFPA recognises that addressing all the causes of maternal mortality is essential for delivering the Sustainable Development Goals and ending maternal deaths in the country. In Sierra Leone, through UNFPA interventions, women delivering their babies with skilled birth attendance has increased from 42 per cent to 62 per cent in 2013 (DHS, 2013), and institutional deliveries have increased to 87 per cent.'

She disclosed that in 2010, UNFPA started supporting the National School of Midwifery in Freetown - through the enrolment and training of 59 student midwives and that in 2012 they supported the training of 60 student midwives at the School of Midwifery in Makeni.

'With UNFPA's interventions since 2010, the number of midwives in the country has increased significantly from approximately 100 in 2010 to over 600 in 2017. With midwives yielding a sixteen-fold return on investment, the ripple effect of improved health outcomes is significant. UNFPA is expanding midwifery services to support a resilient health system and currently we are supporting the three midwifery schools in the country. Whist real progress has been made, more work needs to be done with concerted efforts to address the main causes of maternal deaths in Sierra Leone such as haemorrhage, eclampsia and infection.'

Dr.Dickson further observed that midwives are the backbone of a strong resilient health system as they work to ensure the survival of mothers and children.

She noted that this year's theme was significant in highlighting the vital role that midwives play, not only in ensuring women and their new-borns navigate pregnancy and childbirth safely, but also receive respectful and well-resourced maternity care that can create a lifetime of good health and well-being beyond the childbirth continuum.

'As midwives, leading with quality care means providing evidence-based and people-centred reproductive health services.'

She maintained that the dedication of midwives to women was renowned and that given the crucial role they play in reducing maternal and infant mortality, UNFPA would continue to call for greater investments to increase the number of midwives and enhance quality and reach of their services.

'Strong political commitment and investment in midwives is needed to save thousands of lives every year. UNFPA reaffirms our pledge to support midwives and midwifery in Sierra Leone as we work towards the goal of ensuring that no woman dies giving life. We thank all the midwives for their professional commitment and dedication to their life-saving work that addresses the basic health needs and rights of the women and children in Sierra Leone,' she concluded.

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