Masahudu Ankiilu Kunateh, Ghanaian Chronicle
March 6, 2013
Statistics from the Ministry of Health (MoH), Ghana Statistical Service (GSS) and other international organisations indicate that somewhere in Ghana, almost 60 women die each week from causes related to pregnancy and birth, while 2,700 women die each year from pregnancy or childbirth.
Another staggering data from World Health Organisation (WHO), United Nations Children's Fund (UNICEF), United Nations Population Fund (UNFPA) and World Bank hinted that the lifetime risk of maternal death in Ghana is one in 68.
Amazingly, Ghana's maternal mortality ratio in 2010 was 350 maternal deaths per 100,000 live births. This has decreased from 550 per 100,000 in 2000, and 440 per 100,000 in 2005, according to these international organisations.
Globally, the UNFPA estimates that every day, almost 800 women die in pregnancy or childbirth. Every two minutes, the loss of a mother shatters a family and threatens the well-being of surviving children.
Evidence shows that infants, whose mothers die, are more likely to die before reaching their second birthday, than infants whose mothers survive. And for every woman who dies, 20 or more experience serious complications.
Of the hundreds of thousands of women who die during pregnancy or childbirth each year, 90 per cent live in Africa and Asia.
The majority of women in Ghana and other parts of the world are dying from severe bleeding, infections, eclampsia, obstructed labour, and the consequences of unsafe abortions-all causes for which the UNFPA says have highly effective interventions.
On the other hand, the picture of neo-natal deaths in Ghana is worse than the maternal deaths one, as data churned out by both the local and the international organisations revealed that in 2011, the West African second largest economy recorded 23,000 newborn deaths. This meant that three children died in an hour.
Neo-natal deaths account for 60% of infant deaths in Ghana, while one in every 13 Ghanaian children dies before their fifth birthday.
One may, therefore, wonder what maternal and neo-natal mortalities are.
Maternal mortality is the death of a woman while pregnant, or within 42 days of termination of pregnancy, or its management, but not from accidental or incidental causes. It can be measured in terms of maternal mortality ratio, which is the number of maternal deaths during a given period per 100,000 live births (WHO, UNICEF, UNFPA and the World Bank 2012).
While neo-natal mortality is the death of a child who is born alive, but dies within the first 28 days of life. It can be measured in terms of neo-natal mortality rate, which is the number of deaths per 1,000 live births (WHO 2006).
The hardest pill to swallow is this: that giving life to the country's next generation is one of the biggest killers' of Ghana's women.
More often than not, preventable uncontrolled bleeding, poor medical care and a lack of education still sit at the very heart of this hidden crisis. The world's poorest women are the most vulnerable. But women themselves are not only the victims. The children left behind are more likely to die, simply because they are motherless.
Mamaye's ICT to the rescue
To address the country's maternal and neonatal crisis, MamaYe which is an 'Akan' word meaning (Mother is Good), recently launched its website -www.mamaye.org.gh - a digital platform for maternal and newborn health stakeholders to be educated , empowered, and united in their efforts.
The website features the latest in news, research and development from Ghana. This is part of a continent-wide campaign, which will use digital and mobile phone technology to engage ordinary Ghanaians in the most important fight of all - the battle to save mothers and babies.
Also, MamaYe is a campaign to both educate and encourage communities to take collective and individual action for pregnant mothers amongst them. To add up, the MamaYe Ghana campaigns on a national level to donate blood for mothers and babies, and carry the message out to the people, through the use of technology devices.
Furthermore, it seeks to overcome the ingrained belief that responsibility for maternal survival rests elsewhere: with 'the government', 'the ministry', 'professionals', 'the UN' or 'foreign donors'.
For MamaYe, the active participation of Ghanaians as a whole, is a critical ingredient, the Country Director for MamaYe Ghana, Professor Richard Adadu added.
The technology helps motivate and mobilise people to take direct action to respond to the maternal and newborn crisis in Ghana, he stressed.
MamaYe takes advantage of one billion mobile phones, 167,335,676 internet users, and 51,612,460 Facebook subscribers, estimated for Africa by 2016, to drum home its campaign. Fortunately, in Ghana mobile penetration in the country has exceeded its 24.5 million population, as of December, last year.
People of all walks of life visit www.mamaye.org.gh to find about making a life-saving change for mothers and babies of Ghana. On this website, they find it easy to understand evidence, stories of heroes and heroines, commitments made by the government, and different actions they can take for this important cause.
The MamaYe Ghana campaign, which was launched last month by Evidence for Action (E4A), is being funded by the UK Department for International Development, with local partners such the School of Public Health (SPH), University of Ghana, and the Alliance for Reproductive Health Rights (ARHR).
The country team is supported by external partners, who serve as a Technical Support Unit from Southampton University and the Swiss Tropical and Public Health Institute.
In Ghana, the programme is being rolled out across four regions - Greater Accra, Volta, Ashanti and the Upper West until 2016.
The multi-year programme, which aims to improve maternal and newborn survival across five sub-Saharan African countries: Ethiopia, Tanzania, Sierra Leone, Malawi and Ghana, focuses on using a strategic combination of evidence, advocacy, and accountability to save lives.
'Taxi Doctor' shares experience
When Kobina Essien was told by his family that they could not afford his Junior High School fees, he realised that his dream of becoming a medical doctor was no longer likely to come true.
Leaning against a coconut tree, he closes his eyes and remarks: "I always liked their white outfits; it made them look so knowledgeable. It still hurts having never achieved that, but life goes on."
Now the 36-year-old the Central Region native runs a successful taxi business in Ajumako Techiman, and says he is happy with the path his life has taken.
His face breaking into a broad smile, Kobina's eyes light up as he explains how he realised that even though he didn't have a degree, he could still help save the lives of mothers and their newborns.
"In 2009, I attended a workshop held for the Ajumako Ghana Private Road Transport Union by health workers from the Cape Coast and Ajumako district hospitals on how we could contribute to maternal and newborn health," he narrated.
"They made us aware of some of the challenges pregnant women go through. They said that we could help if we use our taxis to convey pregnant women and their babies to hospital."
Kobina tells of how, after the workshop, he was determined to put these lessons into action. "I was driving around 11:00 a.m., when I had a phone call that a woman was in labour 6 kilometres away. I was already carrying a passenger, but I managed to convince him to alight, and drove as fast as I could to Essiam. On our way to the Ajumako District Hospital, the woman delivered," he said.
"I was very scared, I kept praying in my head for God's intervention, as the woman's screams and pains were unbearable."
Despite his fears, when both mother and baby made it safely to the hospital, the nurses commended Kobina's effort, even saying the child should be named after him.
Kobina says the experience made him realise that every person can be involved in helping improve maternal and newborn health with the help of Information Communication Technology (ICT) tools.
"I get calls, sometimes around 12:00 a.m. when I'm sleeping, to take pregnant women to health facilities. I am happy doing that, because like a medical doctor, I am also, through my job, helping to save the lives of pregnant women and their unborn babies."
Kobina Essien is one of the many taxis drivers in Gomoa Ajumako-Enyan- Essiam who, over the past decade, have been contributing to saving the lives of pregnant women and their unborn babies, by conveying them in their taxis for safe and supervised delivery.
As narrated by Kobina Essien, the MamaYe Ghana campaigners are using the power of ICT tools, including mobile phones, to encourage Ghanaians to help pregnant women and mothers to attend clinics and hospitals for prenatal and postnatal check-ups.
Road to MDGs' target
In the last couple of years, Ghana has seen an increasing number of efforts among various stakeholders to improve maternal and child survival.
A significant number of international and global commitments have been implemented to work towards the Millennium Development Goals (MDGs) 4 and 5 - to reduce child mortality by two thirds, and maternal mortality by three quarters, from 1990 to 2015.
Clearly, the recognition by the global community to improve the health of children and mothers cannot be over emphasised, and indeed, Ghana has seen numerous efforts to accelerate progress and achieve our commitment to the MDGs, Ghana's Minister of Health, Sherry Ayittey, stated at the launch of MamaYe in Accra.
According to her, programmes by the Ministry of Health such as the MDG Accelerated Frame Work (MAF); High Impact Rapid Delivery (HIRD), Safe Motherhood, the free maternal health care initiative, and recently, a bold attempt to include Family Planning under the National Health Insurance Scheme (NHIS), all seek to position Ghana on track to achieving the two MDGs.
Similarly, various programmes and campaigns by civil society organisations and other stakeholders have also contributed to keep Ghana on track. The former first lady, Mrs. Naadu Mills, tirelessly launched the Campaign for Accelerated Reduction of Maternal Mortality in Africa (CARMMA) throughout the country, and was a strong advocate for MDG 5.
Madam Ayittey noted: "The programme has culminated in gains in health delivery in Ghana. There have been increases in the number of Community-based Health Planning and Services (CHPS) zones across all the 10 regions of the country."
"Implementation of functional CHPS has doubled from 868 in 2009 to 1,675 in 2011, coupled with correlated increase in the number of community health officers," she stated.
The average doctor/ population ratio for Ghana improved slightly in 2011, compared to 2010. Trends between 2009 and 2011 reveal that the population-to-nurse ratio decreased to 1,240 clients per 1 nurse, in comparison to 1,489 in 2010, and 1,497 in 2009.
Similarly, the population-to-doctor ratio has improved from 10,483 per 1 doctor from 2010 to 10,032 in 2011. The proportion of OPD attendance by insured clients increased from 55.81% in 2010, to 82.11% in 2011, with CHPS contributing approximately 5% to the total attendance countrywide.
These factors have contributed to increased access to maternal health services in Ghana. Ante-natal visits increased from 92.1% in 2009 to 94.4% in 2011. The national rate of skilled delivery has continued to improve from 45.6% in 2009 to 52.2% in 2011.
This increased access has contributed to improve the health outcomes among Ghanaians. According to the Ghana Demographic Health Survey 2008, under five mortality rate has declined to 80 per 1,000 live births, compared to 1998 levels of 122 per 1,000, representing about 28% decline.
The infant mortality rate declined from 64 per 1000 in 2003 to 50 in 2008, however, although maternal mortality ratios have also seen some improvements, currently estimated at 350/ 100,000 live births, it is unlikely that Ghana will achieve the MDG target 185/ 100,000 by 2015.
One cannot overemphasise the crucial contributions of initiatives such as the MamaYe campaign, the Maternal Health Channel series, the MDG Accelerated Frame Work and others to improve maternal and child survival in Ghana.