Maternal deaths on the rise despite technology

By Elizabeth Mwai

At least 21 women die daily from childbirth-related complications.

The women, who have carried their pregnancy almost to term, do not enjoy the pleasure of cajoling their crying bundles of joy to silence.

Annually, this adds up to about 7,700 families losing their mother, sometimes the sole breadwinner, while in the process of delivering a sibling or her first child.

This grim statistics have remained unchanged over the last seven years despite advancement of new technology.

World Health Organisation (WHO) and African Medical and Research Foundation (Amref) say in a report, this loss of lives is preventable.

WHO Country Representative David Okello describes the reasons for continued high maternal mortality as a ‘puzzle’.

"Pregnancy is not a disease. Why should we allow a natural phenomena to kill?" asked Dr Okello.

Children whose mothers die during delivery are 10 times more likely to die within two years of their mothers’ death.

The report shows that babies whose mothers died during the first six weeks of their life are more likely to die before their second birthday than infants whose mother survived.

Okello is calling on professionals to undertake maternal death audits to unlock the deadlock that has seen women continue to lose their lives.

Intervention

The WHO country representative explains that such an analysis would establish the cause of maternal death and inform future intervention strategies.

He seeks professional discourse to unravel the challenge faced by medics resulting to the high maternal mortality, saying such disclosure would save lives.

He says if the medics could pressure each other to release information on circumstances of each maternal death, a solution could be found.

"We need a better understanding of why many mothers die during child birth," said Okello.

The current ratio given by the Government is 414 deaths per 100,000 live births. This has not changed as recorded by the Kenya Demographic Health Survey of 2003.

Despite technological advancement and publicity on the dangers of delivering at home, 60 per cent of women continue to give birth under unskilled care.

The WHO boss said action to reverse the trend could only be possible if professionals outlined the problems.

The Amref Director of Reproductive and Child Health John Nguba says reasons for the high maternal mortality are ordinary but disturbing.

"Ordinary because they are preventable. For example over-bleeding because one has delivered at home and there is no competent person to assist her," says Dr Nguba.

According to the Kenya Demographic Health Survey of 2009, 55 per cent of women deliver at home.

Nguba says reasons include delay in transport, health facility being far and sometimes not getting the care required in the available health centres.

The poor state of health status in remote areas and the lack of constant medical supplies are a major reason why women do not deliver in health centres.

It is estimated that about a quarter of hospitals have constant supply of medicines.

Sometimes these remote facilities have constant shortage of oxygen, anaesthetic equipment. According to Nguba this is caused by low budgetary allocation.

The country has failed to implement the recommendation of the Abuja Declaration advising countries to increase their health budgetary allocation to 15 per cent.

He points out that traditional and cultural practices by some communities in North Eastern and Coast Provinces are also responsible for women preferring to deliver at home.

Mixed reasons

It is rampant among nomadic and pastoral groups while in Nyanza it is because of mixed reasons including high prevalence of HIV/Aids and Malaria.

But Nguba, cautions against home delivery due to poor hygiene, which is responsible for about 22 per cent death, bleeding estimated to be 30 per cent, while high blood pressure, Malaria and HIV/Aids carries the rest.

When a woman becomes pregnant their immunity is lower and therefore they susceptible to disease.

On the other hand if a woman has HIV/Aids something like a throat infection can be risky.

The high case of maternal mortality has been a topic of interest in the Western world.