Quality of care

In many sub-Saharan African countries, the services provided in many maternal health facilities do not meet the recommended quality standards needed to provide life-saving care. This puts the lives of mothers and babies at risk.

Our take on the issue

Improving the quality of health care throughout pregnancy, childbirth and the postnatal period is critical to saving lives.

Women and girls experience quality care when facilities are accessible, safe and well maintained, with access to clean water to prevent the spread of infection. Facilities should have a functioning toilet for women giving birth. They should have working electricity to provide light so that women can deliver safely at night. And they should be staffed by skilled birth-providers. Yet all too often, many of these necessities are simply unavailable.

Poor-quality care is one of the reasons why many women choose not to give birth in a health facility, or arrive too late to receive the emergency treatment that could save their lives.

Haemorrhage, hypertension, sepsis, abortion and embolism account for more than 60% of maternal deaths in sub-Saharan Africa, making the time around childbirth absolutely critical for maternal and newborn survival.

Only 50%
of women
give birth in a health facility
73% of women
only attend antenatal care
once during pregnancy
Over 1 million
extra health workers
needed in Africa by 2030

Global commitments

It is widely acknowledged that quality of care for women and girls across sub-Saharan Africa is essential if countries are to achieve their commitments under the 2030 Agenda for Sustainable Development.

Access to sexual and reproductive healthcare service – including family planning, information and education – is a priority outlined in Sustainable Development Goal 3.7 (SDG3.7). The goal also calls for the integration of reproductive health into national strategies and programmes.

SDG3.8 emphasises the importance of access to quality essential healthcare services and access to safe, effective and affordable essential medicines and vaccines for all.

To enable these things to happen, countries need to achieve universal health coverage, including adequate budgetary investments and financial risk protection for everyone. Without this investment, the poorest people are not able to access the life-saving care and treatment they want and need.

What mamaye is doing

MamaYe makes sure that evidence about quality of care is recorded and available, so it can help to improve the quality of services – and ultimately save lives.

In Sierra Leone, Malawi and Tanzania, we've developed the Quality of Institutional Care (QuIC) rapid assessment approach. This uses ‘traffic light’ scorecards to present information about the quality of maternal and newborn care. QuIC data is used by communities and activists to hold decision-makers to account, and ultimately ensure that those in power take action.

In Nigeria, Tanzania, Sierra Leone, Ghana, Ethiopia and Malawi, we’ve supported planners, health workers and communities in implementing the Maternal and Perinatal Death Surveillance and Response (MPDSR) tool.

MPDSR allows maternal and newborn deaths to be reviewed and analysed, so improvements to care can be made and deaths prevented.

In Malawi, our ‘clean clinics’ campaign called on decision-makers to save maternal and newborn lives. We asked them to ensure health workers have everything they need to provide a clean birth environment, so they can reduce the risk of infection.

Using the data generated by the MDSR system, we have the power to make evidence-based decisions that improve quality of care and target responses to where they will be most effective in saving lives. We are taking action in response to every death – from community to national level. This nationwide system has the power to save maternal lives now and for generations to come.
Prof Yifru Berhan Mitke,
Ethiopian Minister of Health
See what's happening