Bill and Melinda Gates, in their recent ‘Goalkeepers: The Stories behind the data’ report highlighted "the fact that the number of mothers who die has been cut in half in the past generation is one of the more important successes in global health. It’s all the more impressive because reducing maternal mortality is really hard".
Part of this success can be attributed to one of the key strategies associated with Millennium Development Goal (MDG) 5: increasing coverage of skilled birth attendance.
A high proportion of maternal deaths are prevented with timely medical intervention. By providing antenatal care during pregnancy and skilled care during childbirth, as well as care and support in the weeks after childbirth, lives can be saved.
The Facts and Figures
In 2016, throughout sub-Saharan Africa, only half of live births benefit from skilled care during delivery.
I recently met with Kate Waswa, a nurse at Mukuru Health Centre in the outskirts of Nairobi County, to discuss maternal mortality in Kenya.
I learned that the most recent data (2015) demonstrated that per 100,000 live births there were 510 deaths. Although the data reveal a decrease from 759 deaths in 2000, this rate of maternal mortality is still significantly higher than the 2030 SDG target: reduce the global maternal mortality ratio to less than 70 per 100,000 live births.
Solutions
To save lives women must have the right information and knowledge. Kate mentioned
A risk is lack of knowledge to these mothers. Now, at least 90% of women, maybe 95%, are aware that they are supposed to come here [to the health centre].
She explained, "We have done that through linkages with the community health volunteers whom we engage. We talk to mothers on the importance of seeking services in a health care facility where they’ll get quality care, and in case of any questions we are able to address".
This makes sense. In 2014 the Kenyan DHS reported that in urban areas, like Nairobi County, 92.7% of women gave birth assisted by a skilled provider, while in rural areas the figure is startlingly lower; only 31.1% of women who received skilled care during childbirth.
To deliver those solutions to all women, the most important priority is persuading them to give birth in health facilities, where they can get skilled obstetric care, instead of at home.
Bill & Melinda Gates, Goalkeepers: The Stories behind the Data, 2017
Knowledge is important, but distance and lack of transportation also need to be taken into consideration. There is a strong relationship between poor transport and high levels of maternal mortality. Imagine being an expectant mother who is forced to walk for 6 to 8 kilometres before reaching a facility – wouldn’t you be less likely to travel, or fear the risk of having to deliver on the way?
As Bill and Melinda Gates have stated:
Reducing maternal mortality is really hard.
Yet we know that the most frequent causes of maternal death are postpartum haemorrhage, hypertensive disorders, infection and complications from childbirth – all matters that can be prevented through the quality of care and access to health facilities.
Looking ahead
Ahead of this week’s UN General Assembly, and the 2 year anniversary of the gavel going down on the 2030 Agenda for Sustainable Development, the UN’s Department of Economic and Social Affairs stated in 'The Sustainable Development Goals Report 2017': "To reach the 2030 target, reduce the global maternal mortality ratio to less than 70 per 100,000 live births, with no country having a maternal mortality rate of more than twice the global average the pace of progress in reducing maternal mortality needs to double".
There is still a lot to be done. E4A-MamaYe is about saving the lives of mothers and babies. We want women and girls to be able to access the quality health services they need when they need them. Across sub-Saharan Africa, we celebrate the success of reductions in maternal mortality.
We ask that you join us in doing more to ensure every year, until 2030 and beyond, more women survive childbirth.