Sierra Leone Telegraph: 3 June 2017
A new report on the unacceptably high number of women dying during pregnancy or childbirth in Sierra Leone was launched this week in Freetown. Sierra Leone continues to have one of the world’s highest maternal mortality rates in the world. According to government data, there are an estimated 1,165 deaths for every 100,000 live births in the country.
The report which was launched by the Government of Sierra Leone and its UN partners – WHO, UNICEF and UNFPA, found that the number of women that are unnecessarily dying from maternal issues every day in the country, is equivalent to eight. And says also that the true figure may be much higher.
This latest Maternal Death and Surveillance Report, published last Wednesday, 31st of May, in the capital Freetown, is calling for united action from government, health workers, communities and partners to tackle the high number of maternal deaths in the country.
“This latest report reveals an unacceptably high level of maternal deaths in Sierra Leone, which is a true tragedy for our nation,” said Ernest Bai Koroma, president of Sierra Leone, though failing to accept full responsibility for the deplorable state of the country’s health care system, after ten years in power.
Once again, abdicating responsibility for solving such a scandalous and serious national problem, the president calls on a helpless nation to address the problem of maternal deaths in the country. “The Government, partners and I personally have committed to saving women’s lives through substantive investments in health services and quality of care. However, there are also things each and every one of us can do to help keep our mothers safe. Together we kicked out Ebola—we can end maternal mortality together too,” he said.
According to the report, which was produced by the country’s Ministry of Health and Sanitation with support from partners, the main causes of maternal deaths, defined as any death that occurs in pregnancy or in the six weeks after delivery, were largely bleeding, pregnancy-induced hypertension, infection, and unsafe abortions. Indirect causes include anaemia and malaria during pregnancy.
Close to 20 percent of maternal deaths were among teenagers (15-19 years).
The UN Resident Coordinator in Sierra Leone – Sunil Saigal said: “The United Nations and its agencies are deeply alarmed by the level of maternal deaths in Sierra Leone…. We remain dedicated to helping the Government and people of Sierra Leone build up their health system to end maternal mortality once and for all, and give the nation’s mothers the hope and future they deserve.”
Women and families are being asked to ensure that all pregnant women give birth in health facilities and to support family planning as an important first step to safe motherhood. The government and its UN partners say it will also be critical to engage adolescents on the risks of early pregnancy and increase knowledge and access to adolescent-friendly health services.
The report estimates that up to that seven in ten maternal deaths currently go unreported, with gaps occurring especially when deaths occur outside of government maternity wards.
This undermines health workers’ ability to adequately address the causes of mothers dying. Communities are therefore urged to report any maternal death that happens to their nearest health worker, say the government and its partners at the launching of the report.
The partners expressed their commitment to supporting the country to tackle the underlying causes of maternal deaths, but stopped short of calling on the Koroma government to stop wasting the country’s meagre finances on capital projects that only seem to be benefiting those better off in society, rather than focus on tackling poverty and illiteracy – the number one killer of women, especially in rural areas.
Sally Taylor, Head of DFID Sierra Leone, said, “This report underlines the importance of taking urgent action to reduce maternal mortality. The UK is committed to supporting the Government of Sierra Leone to strengthen health systems, expand access to family planning, including for teenage girls, and provide free healthcare to children and pregnant and lactating women.”
Sierra Leone has one of the world’s highest maternal mortality rates, at an estimated 1,165 deaths per 100,000 live births according to government data. This is equivalent to eight unnecessary maternal deaths every day, the joint statement from the Government of Sierra Leone and UN partners (WHO, UNICEF and UNFPA) concludes.
Since coming to power in 2007, president Koroma and his ruling APC have failed to prioritise key human development needs in the country – such as healthcare, education, low-cost housing, sanitation, water and electricity.
Instead the government has poorly spent hundreds of millions of dollars on road construction projects – with senior ministers and officials benefitting from massive contract kickbacks, while hundreds of women and children die unnecessarily every month.
To reverse the trend in maternal mortality requires a shift in how we provide health care services for pregnant and expectant mothers. We need to enhance the provision of primary health care services for this vulnerable group by training more community midwives who should be provided with adequate means of transport to deliver health services at the point of need.
For example in Ghana, I was involved in a project were they provided motorbikes for community nurses so that they can access remote areas to provide antenatal and post natal care with constant monitoring of the services they receive from conception to the critical hour of delivery. Maternity Worldwide uses an integrated approach to address each of the issues women face when trying to access safe childbirth.
This is based on the ‘Three Delays Model’ which identifies three groups of factors which may stop women and girls accessing the maternal health care they need: 1. Delay in decision to seek care due to: the low status of women;
Poor understanding of complications and risk factors in pregnancy, and when to seek medical help; Previous poor experience of health care; Acceptance of maternal death; Financial implications.
Delay in reaching care due to: Distance to health centres and hospitals; Availability of and cost of transportation; Poor roads and infrastructure; Geography – e.g. mountainous terrain, rivers.
Delay in receiving adequate health care due to: Poor facilities and lack of medical supplies; Inadequately trained and poorly motivated medical staff; Inadequate referral systems.
By providing adequate transport for community midwives and ambulances (e.g. motorcycle ambulances in hard to reach areas) we will at least be able to improve access to maternal health care and get more women to deliver at facilities that are operated by trained health care professionals.