A Maternal Death Review (MDR) committee meeting was recently held at the Kabala government hospital.
The meeting strengthened MamaYe’s evidence-based approach in identifying the causes of maternal deaths in the district and was used to inform district health officials about the major causes of maternal death in Koinadugu.
The meeting attracted representatives from the Ministry of Health and Sanitation, the District Medical Officer, as well as senior officers at the District Medical Office and government hospitals.
During the meeting, I learnt about some of the major indirect causes of maternal deaths in the district:
- Delays in referral of pregnant women from communities to health facilities
- High-risk pregnancies among adolescent girls
- Lack of staff with emergency obstetric training
- Limited quality of laboratory services for pregnant women
One of the factors contributing to maternal deaths was that women were arriving at health facilities late when their complication was already well advanced.
One of the recommendations that came out of the meeting was a need to improve community awareness of signs and symptoms of complications in pregnancy and labour. This could involve working closely with community organisations or having health workers conduct sensitisation messages during outreach activities.
Despite government efforts to address the high rate of maternal deaths in the country, Sierra Leone is estimated to have the highest maternal mortality ratio (MMR) globally.
The 2013 Demographic Health Survey, published by Statistics Sierra Leone, estimated the MMR at 1,165 maternal deaths per 100,000 live births.
The former Minister of Health and Sanitation, Mitta Kargbo, described these statistics as “unacceptably high”. This sad situation urged the government of Sierra Leone, through the Ministry of Health and Sanitation, to establish MDR committees across the country in 2009. A pilot of the MDR process was done in three districts (Pujehun, Kenema and Kambia).
In the same year, the government also set up a secretariat and national MDR committee. The committee is responsible for using a standardised approach to evaluate all aspects surrounding maternal deaths.
Dr. Michael Koroma, Regional MDR Investigator at the Ministry of Health and Sanitation, said during the MamaYe MDR meeting:
The purpose of reviewing maternal deaths is to gain insight into the medical (including health system failure and weakness issues) and social factors that lead to such events in order to decrease such deaths in the future.
Sister Sally Carew, from the Reproductive Health and Family Planning Directorate, also highlighted some key achievements since the establishment of the national MDR committee:
- Formation of MDR guidelines and protocols
- Training on and dissemination of MDR data collection tools
- Formation of MDR assessors
- Training of service providers, midwife investigators, and births and deaths officers on the MDR notification process
- Analysis and collation of maternal deaths
- The launch of the Free Health Care Initiative for pregnant women, lactating mothers and children under 5 years old in 2010
- An increase in facility deliveries and obstetric admissions
- A decline in maternal mortality
The District Medical Officer of Koinadugu, Dr. Francis Moses, praised MamaYe in facilitating the meeting.
Thank you MamaYe.
He added that the meeting has created the opportunity for health workers in the district to understand the processes that are involved during the investigation of maternal deaths.
We learned at the meeting that the district reported nine maternal deaths in 2014. For 2015, the district has recorded 14 maternal deaths between January and April.