Still too many maternal deaths

In one of their latest reports on maternal mortality, two leading international bodies – the World Bank Group and the United Nations agencies – reported that maternal deaths have fallen by 44 per cent since 1990. This is quite encouraging news for Governments and international development partners who have been intimately involved in working towards reducing maternal deaths. However, the road ahead for many countries, including Guyana, is still a long one, as much more remains to be done in order to meet this specific Millennium Development Goal (MDG) target.

For example, despite global improvements, only nine countries achieved the MDG 5 target of reducing the maternal mortality ratio by at least 75 per cent between 1990 and 2015. These countries are Bhutan, Cabo Verde, Cambodia, Iran, Lao People’s Democratic Republic, Maldives, Mongolia, Rwanda and Timor-Leste. Despite this important progress, the Maternal Mortality Ratio (MMR) in some countries remains higher than the global average.

According to the report, maternal deaths around the world dropped from about 532,000 in 1990 to an estimated 303,000 this year. This equates to an estimated global MMR of 216 maternal deaths per 100, 000 live births, down from 385 in 1990. While this could be viewed as an important achievement, the figure is still high and more strenuous efforts need to be taken by all development partners in further reducing the death rate.

A new Global Strategy for Women’s, Children’s and Adolescents’ Health, launched by the United Nations Secretary General in September 2015, aims to help achieve the ambitious target of reducing maternal deaths to fewer than 70 per 100,000 live births globally, as included in the Sustainable Development Goals (SDGs). The authors of the report warn that reaching that goal will require more than tripling the pace of progress – from the 2.3 per cent annual improvement in MMR that was recorded between 1990 and 2015 to 7.5 per cent per year beginning next year.

The Global Strategy highlights the need to reinforce country leadership by mobilising domestic and international resources for women’s, children’s and adolescents’ health. It will be important to strengthen health systems so they can provide good quality care in all settings, promote collaboration across sectors, and support individuals and communities to make informed decisions about their health and demand the quality care they need.

The 2015 maternal mortality estimates present the tremendous progress achieved towards the MDG 5 on maternal mortality reduction. They show a strong trend of reduction over the years. At the same time, stakeholders have reported more and better data coming from various countries, enhancing the accuracy of the absolute numbers reported.

According to the report, efforts to strengthen data and accountability especially over the past years have helped fuel this improvement. However, much more needs to be done to develop complete and accurate civil and vital registration systems that include births, deaths and causes of death. Maternal death audits and reviews also need to be implemented to understand why, where and when women die and what can be done to prevent similar deaths.

In Guyana, while there is no need for alarm, the statistics are very worrisome and should cause the authorities to rethink their approach in dealing with the issue. It is clear that this country needs to do much more to reduce the number of maternal deaths taking place. For example, in 2014, a UN report ranked Guyana as second on the list for highest maternal deaths in the Caribbean after Haiti, which recorded 380 deaths between 1990 and 2013, followed by Guyana with 250. Also, it was recently reported that Guyana is likely to exceed the MDG maximum limit of 11 maternal deaths this year.

Too many of our women are dying from various complications during childbirth, and while we hear of “thorough investigations” being carried out, more often than not, very little action, if any at all is being taken against those found to be negligent.

We believe that the current procedure employed by the Public Health Ministry as safeguards against the occurrences of maternal deaths has not been very effective and must be reviewed urgently. Our hope is that the Ministry will proceed with greater strictness on this matter to ensure pregnant women and the unborn are looked after in the most professional manner by being given the best medical treatment our systems allows for.