SOMALIA: Pregnant Women Need More Care

11/12/2010 - Maternal mortality rates in Somalia are much too high. In order to improve maternal and child health, women must be able to better access medical care.
The state of maternal health in Somalia is among the worst—and most difficult to assess—in the world. In this country where women and children are the most vulnerable to death and disease, the maternal mortality rate is 1,600 per 100,000 live births. This rate has actually increased since the early part of the decade, according to information recorded by UNICEF.

Somalia has been engulfed by civil war since 1991, when former President Siad Barr was ousted by various clans. Since the beginning of 2010, there have been at least 7,000 people injured in inter-clan violence in the capital city of Mogadishu. Of these injuries, 20% were children and 30% were women, according to admissions records from three main Mogadishu hospitals.

World Health Organization (WHO) representatives in Somalia have been frustrated by the difficulty in getting accurate data. There is no birth or death registration system in place, which means that health and statistics officials must rely on information from hospitals alone.

Even hospitals are understaffed. For an entire population of 9 million people, Somalia has only 250 trained doctors, 860 nurses and 116 midwives. This is a main reason why the maternal mortality rate remains so high. Only about a third of pregnant women have a skilled health attendant present at the birth of their child. Just over a quarter of expecting women receive prenatal care once throughout the course of their pregnancies, and only 6% receive prenatal care four times.

The health of mothers, of course, directly impacts the health of children. The poor health of Somalia's expecting mothers is evidenced in its infant and child mortality rates: one in ten Somali children die before their first birthdays, while one in five die before their fifth birthdays.

At present, according to the World Food Programme (WFP), there are roughly 2 million people living in Somalia who are in need of emergency relief and food/nutritional aid. Roughly 1.5 million people—more than 16% of the population—have been forced to flee their homes. This makes them especially vulnerable to water-related diseases, as sanitation and hygiene measures in refugee camps are often inadequate for the large numbers of displaced people they house.

The combination of poverty and two decades of civil war has left Somalia unlikely to reach any of the Millennium Development Goals. However, with careful policy changes and funding increases, Somalia could meet the fifth goal to reduce maternal mortality by three-quarters of 1990 levels. Ensuring that mothers have access to regular medical check-ups can greatly reduce the risk of pregnancy-related complications.