NAMIBIA: Namibia Races to Cut Down Maternal Deaths

An estimated half a million women die each year following complications during pregnancy and childbirth, a report launched in September 2010 showed.

The report, ‘Trends in Maternal Mortality', an international look at the state of maternal and infant health globally, indicated that while maternal mortality decreased by 34 per cent between 1990 and 2008 overall, Namibia's rate of maternal death has remained static, showing no signs of improvement during the past 20 years.

In Namibia an estimated 180 mothers die during or after childbirth for every 100 000 births, the same number of deaths recorded during the assessment in 1990.

United Nations Population Fund (UNFPA) Country Representative in Namibia, Fabian Byomuhangi, said there “cannot be cause for celebration, there is more work to do if we have to improve the maternal health situation”. He said despite similar figures in 1990 and 2008, the rate of deaths in 2006 spiked at 449, decreasing significantly afterwards.

Speaking at the launch of a month long Emergency Obstetric and Neonatal Care training of trainers workshop in Windhoek yesterday, Byomuhangi said that the workshop is timely, especially in light of the recent report and a 2006 assessment completed in Namibia on the needs for emergency obstetric care.

The 2006 assessment revealed that in Namibia only “four out of 34 hospitals provided comprehensive emergency obstetric care”.

The report also showed that the “main reason for health workers not carrying out [life saving functions] was inadequate training”. In addition, the assessment found that “no health centres” provide basic emergency obstetric care.

Byomuhangi emphasised the need for emergency obstetric care being included as part of a comprehensive family planning strategy in Namibia as it “not only provides an opportunity for women to have the number of children they want, but that it also has a direct health benefit for the mother by reducing the risk of unwanted pregnancies that are likely to lead to abortion, including unsafe abortion”.

The training programme is being conducted as part of the Ministry of Health and Social Services's “roadmap for accelerating the reduction of maternal and newborn” deaths.

Diana Beck, from the American College of Nurses and Midwives, the lead coordinator and instructor at the workshop, said yesterday that the ‘Life Saving Skills' (LSS) training programme focuses on the “major killers” of women and babies and places heavy emphasis on “developing skills and competence to deal with threats to mothers and babies”.

The programme is “hands on” and is aimed at providing “clinical experience” to the 26 participants from eight regions taking part, Beck explained.

Dr Richard Kamwi, Minister of Health and Social Services, acknowledged yesterday that despite marked improvements in the field, Government is “aware that challenges are there when it comes to midwives”.

Dr Kamwi said although more than 80 per cent of pregnant Namibian women give birth at health facilities “our maternal and neonatal deaths are not showing a declining trend”.

In Namibia, three quarters of infant deaths at health care facilities occur in the first seven days of life, Dr Kamwi said.

The main factors that contribute to the majority of deaths are a result of “obstructed labour, bleeding, infection, eclampsia and prolonged labour”.

These are issues we need to address. There is no need why some of these women should be dying. There is no need for these babies to die,” Kamwi said.

He expressed hope that the training workshop, which will equip health workers with the tools to handle emergency situations before, during and after birth, will reduce maternal and infant mortality “that are associated with sub-optimal care” in the field of midwifery.

The course is aimed at training trainers in emergency obstetric and neonatal care in “order to scale up the training in their respective regions,” Kamwi noted.

Kamwi promised that health workers are receiving the full support from government, from international health agencies and from his ministry.

We are in good hands. We just have to go for it,” he pleaded.

According to Dr Magda Robalo, the World Health Organisation Representative in Namibia, “no country in Africa is on track to achieve maternal mortality reduction and very few are on track to achieve the Millennium Development Goals related to child health”.

Speaking on behalf of Robalo yesterday, Dr Desta Tiruneh said that each year more than half a million mothers die during the process of pregnancy, childbirth and postnatal periods.

Four million newborns die and another four million are still born.

Africa, having only 10 per cent of the world population is contributing to more than 90 per cent child deaths and more than 40 per cent of maternal mortality,” he added.