• Nigeria, the DRC, Ethiopia and Tanzania have the worst records in maternal healthcare in Africa. 
• One of the ways to reduce complications in child birth is to keep the girl child in school.
• New technology and ideas could help African countries improve its maternal health.

The majority of the annual almost 4.5 million maternal, newborn and stillbirth deaths are located in Sub-Saharan Africa, Central Asia and Southern Asia, a new World Health Organisation (WHO) report states.

Of those, around 290 0000 are maternal deaths, stillbirths total 1.9 million, and newborn deaths account for the most, at 2.3 million.

According to the report, the most-affected African countries are Nigeria, the Democratic Republic of the Congo (DRC), Ethiopia and Tanzania.

They are part of the top 10 most-affected countries in the world. The list is led by India. 

The stark reality presented by these countries is that they could fail to reach the 2030 target for Sustainable Development Goal (SDG) 3 to ensure healthy lives and promote well-being for all at all ages.

“If we do what we’ve always done, we will stay flat. We need new technologies and ideas,” said Dr Jeffrey Smith, the deputy director of Maternal, Newborn and Child Health at the Gates Foundation.

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Speaking to the press at the first biennial International Maternal Newborn Health Conference in Cape Town on Tuesday, Dr Queen Dube, a consultant paediatrician and clinical epidemiologist, said there should be better coordination to bring back the most-affected countries up to speed.

“The SDG target is in danger, unless something is done at local, regional and global levels,” said Dr Dube, who is also the chief of health services with the Ministry of Health in Malawi.

At the centre of maternal care was respect for women.

Dube said: “Dignity for women is very important. The other thing that is critical to the maternal newborn agenda, which has nothing to do with hospitals or health centres, is making sure our girls stay in school.”

According to the National Health Institute, in Africa, nearly one-third of teenagers become pregnant.

The United Nations Population Fund data states that girls aged 15–19 are twice as likely to die during childbirth as women aged 20 and above.

Negligence

Nsubuga Lwantale, of Uganda, speaking at different plenaries at the conference, told of her frustration when healthcare workers seemed uninterested in their work.

She was ignored by a receptionist at a hospital in Kampala when, along with her husband, they wanted to see a doctor due to a complication with her pregnancy.

The couple had to wait for four hours to see a doctor, who then referred her for an ultrasound scan. 

Unfortunately, by then, the unborn child had no heartbeat. 

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A few days later, she delivered a stillborn, a memory that she will forever live with and which makes her angry.

In some cases, it’s the mother who loses her life.

Painting an illustration of what transpires, Dr Koki Agarwal, who directs the five-year Momentum Country and Global Leadership award within USAID’s Momentum suite of projects, said it could take as little as 3–12 hours.

“Once convulsions set in, women can die within 12 hours. The rest die due to prolonged labour, lack of transfer, and the availability of C-sections, leading to fistula, uterine rupture and death. A pregnant mother could also die of sepsis within three days without immediate care,” she said.

Cases of negligence, a lack of basic healthcare and poor infrastructure should be addressed as serious challenges to achieving SDG 3 at a global level.

Hence, Dr Atul Gawande, the assistant administrator for Global Health at USAID, believes one’s background should not be a factor.

“Where you are born or how much income you have, should not affect your chances of survival,” he said.