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Maternal deaths and the Ghanaian society.. An alarming everyday issue yet to be conquered

By Helena Selby - Ghanaian Chronicle

It is always said in Ghanaian languages that one's world comes to an end when one loses the mother. Mothers are considered to be the most important members of a family, though men are said to be the head of the home. The presence of a mother in a home full of children is mostly the criteria for determining the well-being of the children in future. It is very pitiful that though mothers are very important, when it comes to the nurturing of children, some children tend to lose theirs immediately they are born. Maternal mortality, which simply means a woman dying as a result of childbirth, has of late been a silent killer and a menace in our societies. Though the programmes for its eradication are being implemented, the results are yet to be recognized.

Situation in Ghana With the issue of maternal deaths in the Africa, Ghana is no exception. The rate of maternal deaths is on increase, owing to certain incidences beyond the control of those in charge. According to UNICEF's research on the progress of the nation in 1996, maternal deaths recorded in Ghana were 910. The Ghana Health Service (GHS), in its monthly health programme on reducing maternal death, Partnership for Action, disclosed that for every 10,000 births in the country, over 214 Ghanaian women die in the process of delivery.

In addition, more than 50 million women suffer complications, which lead to long-term health problems, including infertility and permanent incontinence.

More than half of infant deaths occur in the first month of life, which translates into enormous social consequences and economic loses for the nation, and over 12,000 more mothers would suffer maternal deaths, if nothing is done about the current level of maternal and newborn deaths, between now and 2015. It is being estimated by the GHS, that at the end of 2008, 940,000 pregnant women will be on record. If one may ask, how many of these women are going to lose their lives to maternal deaths?

Global Situation According to the World Health Organization (WHO), there is no other country in the world where mothers are more likely to die, during or immediately after pregnancy, than the Central African Republic. According to the latest national statistics, 1,355 out of 100,000 mothers die, while or after giving birth. In comparison, only seven out of 100,000 mothers die in the UK, 540 in India and 1,100 in Malawi. Estimates of the annual number of deaths, due to abortion complications, range from 155,000 to 204,000 women worldwide. Furthermore 1,600 women die from complications in pregnancy and childbirth every day, making the annual toll, at least, 585,000 deaths.

Maternal deaths and poverty Nothing in this world happens for happening sake. The alarming rate of maternal deaths in Ghana, and in Africa, can be attributed partly to the level of poverty, and low standard of living in the continent. Sometimes, countries without the means to access food end up having a starvation crisis, leading to complications for pregnant women, and the death of many of its citizens, especially women and children.

According to inquiries made by the United Nations, 25,000 lives are lost everyday from hunger and poverty. Sometimes, a bad case of diarrhoea leads to death, because of weakness caused by hunger. More than 800 million people know what it feels like to go to bed hungry, with most of them being women and children. Malnutrition causes more than half of all child deaths.

Poverty causes poor families to spend over 70% of their income on food, whereas an average American family spends just over 10%. Additionally more than 100 million children are stunted physically and mentally, from malnutrition.

Imagine a pregnant woman living in an environment of extreme poverty; imagine the agony she goes through with her unborn child; imagine the her unborn child using up all the remaining strength, energy and vitality in her; imagine finally, how she and her baby will look like at the end of the nine months, and what if she is not able to make it?

The issue of maternal deaths, and poverty can be seen vividly, when it comes to comparing the situation in Africa, to that of the developed world. According to a UNICEF research on the Progress of Nations in 1996, it was discovered that in Sub-Saharan Africa, the lowest maternal death recorded was 120 in Mauritius, and the highest 1,800 in Sierra Leone. Compared to that of Europe, the lowest recorded was six in Norway, and 120 in Romania.

Malnutrition

A complication of child birth, which often leads to death, is that of malnutrition. A pregnant woman needs to eat a meal full, with all the necessary nutrients of a balanced diet. A well-balanced diet should contain something from all the food groups: dairy products, fruit, vegetables, fish, meat, eggs, fat and carbohydrates. A pregnant woman needs to eat something from all these food groups every day, in order to get the proper amounts of energy. During pregnancy, the woman must make sure to nutritiously to maintain herself and the baby, since the growing baby gets its nutrients from the mother.

How will the plight of a pregnant woman, without any means to survive be? How will she afford all these nutritious foods for herself and her unborn baby? Women in Africa, who find themselves in this situation, tend to feed more on carbohydrates, since the cheapest foods available are carbohydrate-based. As a result of this, she and her unborn child do not get the necessary nutrients for their well-being, and a safe delivery

It is very important for every woman to go through antenatal care, before childbirth, to prevent any sort of complications. Women's Health AU explains that antenatal care is to ensure the supervision of maternal and fetal well-being during pregnancy, making available all appropriate choices to fulfill optimal potential, and providing all necessary support and preparation for the high quality life after birth.

Going through antenatal care enables pregnant women to be educated about the normal discomforts of pregnancy, emotional aspects like post-natal depression, local antenatal classes, reducing risk of STDS, parenting issues, including child-proofing the house, and coping with crying infants.

Lack of funds for antenatal care, will naturally prevent any pregnant woman from attending antenatal to check the well-being of herself and her baby. Not attending antenatal care will prevent a doctor or a nurse from detecting any sort of defects in the mother and child, hence bringing about the possibility of maternal death.

Medical causes of maternal death Another contributor to maternal death is medical complications. According to a research conducted by the Ministry of Health (MOH), some maternal deaths in Ghana occur due to excessive bleeding after delivery, which is 17% of the death rate, unsafe abortion takes 11%, hypertension 19%, anemia 12%, infection 10%, obstructed labour 7%, miscarriage, domestic violence and other causes (24%).

Government interventions Mothers are very important, not only to their children and families, but to the nation as a whole, since mothers are the initial influence on children, as they spend the most time with the child. The government realizing this has brought about free maternal care, which is under the National Health Insurance Scheme (NHIS). It was launched on 1st July 2008 and will be implemented through the registration of all pregnant women, under the National Health Insurance System (NHIS).

The package of entitlement, under the NHIS has been established by law. While the initiative is specially-designed to increase uptake of antenatal, delivery and postnatal care, pregnant women will be entitled to access all services, under the NHIS benefit package, as long as these are provided by accredited health facilities. The objective of the initiative is to rescue maternal mortality in the country. It is also a means of addressing Ghana's challenge in the attainment of the Millennium Development Goal 5 (MDG5).

With children being de-linked from the registration of their parents, the newborn is automatically covered by the NHIS. A separate NHIS card will be only issued after three months, however the infant is included under the mother's cover for the first 900 days after delivery, after which the child will be provided with his or her own card.

Conclusion A nation with about 40% of its population being children, automatically, is a nation with people to take care of the future of the nation. However, the future of that nation will not be prosperous, if they are not well-trained, nurtured and cultured by parents, especially a mother. Bringing up of a child, mostly, includes the foundation of a mother's nurturing. If one may ask, how will this nurturing be possible, if the mother dies during childbirth?