The World Health Organisation (WHO) defines maternal mortality as deaths occurring in women while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.
Global situation
Although maternal mortality rates have been steadily declining in most of the developed world, it continues to be a great concern in sub-Saharan Africa as almost 99 per cent of all maternal deaths occur in developing countries and more than half of these deaths occur in sub-Saharan Africa.
Thus, the WHO estimates that 75 per cent of maternal deaths occur as a result of complications due to pregnancy and childbirth.
Evidently, the difference between the maternal mortality ratios (MMR) in the developed world and the developing world is unacceptably high.
Ghana’s situation
In Ghana, maternal mortality, which has been categorised as a public health issue, is being tackled from all angles including strengthening the midwifery workforce and primary health services, improving transport and emergency response systems and fortifying measures to increase skilled attendance at birth.
Also, there are efforts to resolve the three notorious delays that have been identified as contributory factors to maternal mortality that is delay at the household or community level in deciding to seek care for pregnancy complications, delay in reaching the facility that provides emergency obstetric care and the delay that occurs in receiving care after arrival at the health facility.
With the numerous interventions put in place, Ghana’s MMR declined from 760 per 100,000 live births in 1990 to 570 in 2000 then to 319 per 100,000 live births in 2015 and 310 per every 100,000 live births in 2017.
At the opening of the third National Maternal, Child Health and Nutrition Conference 2021, the Director-General of the Ghana Health Service (GHS) Dr Patrick Kuma Aboagye is quoted as stating that a total number of 875 maternal deaths were recorded in 2018 and 838 in 2019.
This figure, he said, further decreased to 776 in 2020 despite the increase in total deliveries while institutional maternal mortality reduced from 117 in 2019 to 106 in 2020, amidst the COVID-19 pandemic and all its associated impact.
Although the numbers keep reducing, it is still clear that Ghana has to double up its efforts to reduce maternal mortality and needs all hands-on deck as one death of a woman who is giving life to another human being is one too many.
The challenge
Ghana’s potential success at coming closer to the maternal mortality rates in the developed world is hampered by a health workforce crisis, infrastructural challenges, poor emergency response system, healthcare policy issues and socio-cultural factors.
The major health complications that account for nearly 75 per cent of all maternal deaths in the country are severe bleeding mostly after childbirth, infections usually after childbirth, high blood pressure during pregnancy, which is pre-eclampsia and eclampsia, complications from delivery and unsafe abortion.
The TRIO
The University of Ghana Medical Centre (UGMC) in collaboration with Training for Improved Outcomes (TRIO) Bridge Foundation, a UK-based change and transformation charity, is embarking on a women’s health initiative from September 30 to October 4, 2022 to train staff at UGMC on how to work as a team when handling obstetric emergencies with the aim of reducing maternal morbidities.
The UGMC, which is Ghana’s first-ever quaternary medical centre recently opened its doors to the general public for quality health care, training and research and the partnership with the TRIO Bridge Foundation is expected to train medical professionals at the centre using a multi-facetted approach that leans strongly on teamwork and effective communication among healthcare workers.
The TRIO Bridge Foundation is devoted to promoting maternal health care in developing countries by training health professionals in the areas of management of postpartum haemorrhage, pre-eclampsia and eclampsia, maternal sepsis, obstructed labour, foetal surveillance in labouring women and human factors, teamwork and communication with an aim to improve and enhance both maternal and foetal health through teaching and hands-on targeted training.
A Director and Trustee of the Foundation, George Noi-Lartey, indicated his excitement at the upcoming training and said it was the expectation of his team that the UGMC would become a hub for the training of healthcare personnel nationwide so far as the management of obstetric emergencies was concerned.
Announcing the collaboration in an interview with the Daily Graphic, the Chief Executive Officer (CEO) of the UGMC, Dr Darius Osei, expressed delight at the collaboration between the two organisations.
He said he was optimistic that the training would help reduce the country’s maternal mortality ratio through knowledge transfer and the learning of best practices in the management of obstetric emergencies from The TRIO Bridge team who are coming from the UK — a country that records some of the lowest maternal mortality rates in the world.