In a developing country such as Ethiopia, where a woman gives birth to four children on average, 12,000 mothers reportedly die every year due to complications during pregnancy and delivery.
Ethiopia is one of the countries that adopted Millennium Development Goals (MDGs) and this included the goal of reducing maternal mortality by 75% from 1,250 in 2000 to 412 in 2018 out of 100,000 live births.
“The chances of dying during pregnancy, in childbirth, or in the days and weeks after delivery are declining in Ethiopia due to the growing economy, infrastructure development and most importantly an increase in access to healthcare,” said Zenebe Akalwolde, Mothers and Adolescent Health Team Leader in Ethiopia’s Health Ministry.
According to data obtained from the Ethiopia’s Ministry of Health, about 40,000 mothers died from pregnancy complications each year when the MDGs were introduced in 2000. This number has now gone down to 12,000 on average.
As many as 11,000-13000 mothers still die every year in Ethiopia due to birth-related complications, the main ones being hemorrhage, hypertension and infection, Zenebe told 7Dnews in an exclusive interview. Ethiopia is still among the countries with the highest mortality rate, he said.
According to the 2016 Ethiopian Demographic Health Survey (EDHS), more than 1400 mothers died per 100,000 live births in 1990. The mortality rate dropped to 801 in 2000, 673 in 2005 and 600 in 2011 per 100,000 live births.
The health official attributed the decline to the government’s interventions, which include expanding emergency obstetric care services during labour, with skilled birth attendants helping mothers in thousands of health facilities across the country.
“Enhanced knowledge in antenatal and postnatal care, provided by tens of thousands of health extension workers, and other community interventions mainly in rural parts of the country, have also contributed to the reduction of maternal mortality in the country,” Zenebe said.
According to the Ethiopian Demographic Health Survey (EDHS), 28% of mothers in Ethiopia give birth in health centres with the assistance of a birth attendant whilst the remainder opt for home birth, with about 62% of mothers visiting nearby health centres at least once for prenatal care.
In 2000, Ethiopia planned to build many health centres, each providing prenatal, delivery and postnatal service access to 25,000 people. However, due to the country’s growing population, which currently stands at over 100 million, this has not happened.
“The nation had less than 2000 midwives when the MDGs were introduced and their number has now hit over 12500 with at least one in each district. But the number of midwives is still small in a country where over 3.2 million mothers give birth annually,” the health team leader said.
According to the data obtained from the Ministry of Health, of the total 12,000 mothers who die due to complications during pregnancy and delivery, 50% perish due to hemorrhage and a total of 75% die after giving birth.
“There is a strong belief among Ethiopian mothers that pregnancy is normal and they refuse to undergo prenatal care, mainly in rural areas where road infrastructure is poor,” Zenebe said.
The Horn of African nation is currently offering health education across its 30 universities as part of its effort to deploy maternal and child health nurses mainly in rural areas where mothers give birth at home without a birth attendant. It is working to deploy one to three midwives at minimum in health centres that are short of ambulances to transport mothers to hospitals.
Ethiopia envisages reducing maternal mortality to 199 in 100,000 live births in 2020, down from the current 412, despite the World Health Organisation’s (WHO) report putting the number at 353. The east African nation further aspires to reduce maternal mortality to 70 or less by 2030, in line with the target set by the WHO.
The team leader believes causes of most maternal deaths are preventable and that the target set by WHO is attainable through the expansion of antenatal and postnatal care and services, and by equipping mothers and midwives with the necessary knowledge and skills.