PHA-Exchange> Maternal Deaths Disproportionately High... (3)

[Aviva]

From: Emmanuel Otolorin <eotolorin at jhpiego.net>
 
Maternal Deaths Disproportionately High... (3)
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The regrettable loss of numerous women during childbirth in sub-
Saharan African countries is a constant reminder of the region's 
"failure to thrive" in development. Yes, we all agree that the 
key to a reduction of maternal mortality and morbidity rates in 
the region is to have every woman deliver with a skilled birth 
attendant. This message has been around for a few years now. 
Yet, while many women attend antenatal clinics at least once (up 
to 98% in some countries), very few return to deliver at the 
health facility (less than 40% in most countries). So, the ques-
tion is why do the women stay away and what can we do to get 
them to return?
 
Studies have shown that the main factors for staying away are 
poor client-provider interaction and gross infrastructural decay 
of our health institutions. When women come to health facilities 
and are disrespected by staff, are abandoned or ignored for 90% 
of their hospital stay, are often given a shopping list to go 
and buy necessary materials for their own delivery (irrespective 
of the time of day or availability of financial resources) and 
with no affordable plan for looking after their other young 
children when away from home, it is not surprising that they 
will choose to remain at home with relatives and the infamous 
traditional birth attendant (TBA) who demonstrate empathy during 
their labour ordeal.
 
In addition to improving the health infrastructure in many of 
our countries (which everyone talks about ad nausea), we need to 
improve client-provider interaction. Our women must be re-
spected, their privacy, confidentiality and safety must be as-
sured, they should be attended to at all times while making pro-
visions to have at least one family member of their choice to be 
with them during the labour experience. It is only when our de-
livery rooms have become "women-friendly" and health facilities 
have been renovated to respond to their needs, can we begin to 
expect a significant decline in maternal mortality in the re-
gion. By that time, it will not be necessary to fly "first la-
dies and first daughters" to Europe and America for deliveries 
that can be conducted by student midwives.
 
Emmanuel Otolorin