Maternal and Child Mortality: Less talk more action in tackling Africa’s twin evil

Lazarus Sauti

Mothers and children die at alarmingly higher rates in Africa than in any other continent. Mortality rates have not improved as much as they should have either.

Global analysis of statistics from different sources has revealed that children and women are the most vulnerable to the threats of poverty and untimely death.

According to a recent World Health Organisation, (WHO) report, more than 600 000 women have died in recent times due to childbirth or pregnancy-related complications.

While substantial progress has been made in reducing child death, children from poorer households remain disproportionately vulnerable across the African continent. Sadly, most children in the continent continue to die from preventable or treatable causes, with pneumonia and diarrhoea as the two main killers.

Moreover, for every death, approximately 20 women suffer from injury, infection, disease or disability as a result of complications arising from pregnancy or childbirth. While some progress has been made in reducing maternal mortality, the rate of decline is far from adequate for achieving the Millennium Development Goals in 2015.

The African Union Commission’s chairperson, Dr Nkosazana Dlamini-Zuma, once said: “It is a continental duty and a duty to humanity to ensure that women do not die while giving life.

“It is the responsibility of governments to ensure that girls are not married young, because it has an implication on their reproductive health system.”

Accordingly, it is the role of political leaders to put measures that tackle maternal and child mortality if the continent is to ensure that women do not die while providing life.

Basic education is one such a measure.

Dr Coceka Mnyani, Senior Technical Advisor on the Prevention of Mother to Child Transmission (PMTC) at the Anova Health Institute in South Africa says bringing down maternal and child mortality - twin evil that has bedeviled the Africa continent from time immemorial - can start with basic actions (educating the mother about birth spacing) that do not involve great expense to the continent.

“If the mother has several children in a short space of time, we know that the outcomes are poor.” Mnyani said.

More so, other means of reducing child mortality, such as hand washing and breastfeeding, come down to education rather than money.

Dr Mickey Chopra, chief health officer at UNICEF - the UN children’s agency, said, “It is possible to change behaviour and it can be done in a short period of time through education.”

To efficiently tackle maternal and child mortality in Africa, civic organisations and non-governmental organisations must work together effectively even in implementing small initiatives, such as supporting mothers in exclusively breast-feeding programmes.

Child survival intervention, especially immunisation, apart from constituting part of the right of the child, should be acknowledged as a veritable strategy towards achieving the Millennium Development Goals.

The continent needs to empower its communities with the information and knowledge they need to speak and act for themselves and to advocate for policies that make it easier for parents to keep their children healthier.

Dr Rudzani Muloiwa, World Vision South Africa board member, says that balancing the care that children get in urban and rural areas is also key in tackling maternal and child mortality.

“There is an amazing discrepancy between the care that children get in the urban areas and the rural areas in Africa. There is also vast discrepancy between resources in private and public health care institutions,” Muloiwa said, adding, “If we can distribute the kind of resources that we have, both human and material, we would be able to make a huge difference.”

While recognising the fact that infrastructure in most of Africa may not support hospital deliveries and ensure a doctor in every community, Dr Dlamini-Zuma emphasised the vital role of community midwives as a key resource in ensuring that women give birth under skilled attendants.

The most important step African governments should take towards reducing maternal and child mortality level to zero is to build health facilities that will cater for the maternal and child healthcare needs for the people at the grassroots.

Accordingly, these health facilities should be equipped with the latest medical and other facilities to enhance and ensure optimal performance across the continent.

Furthermore, these health facilities should also serve as training grounds for maternal and child care professionals. In the continent-wide fight against maternal, newborn and child mortality, the involvement and empowerment of health workers cannot be underestimated.

Tola Yesufa, medical practitioner in Nigeria said, “Without empowering health care workers in Africa, where maternal, newborn and child mortality is prevalent, the intention of meeting the UN MDG of reducing maternal mortality by three quarters by 2015 remains wishful thinking.”

Furthermore, African governments should decongest secondary and tertiary health facilities in the different African states and regularly give free immunisation to children between 0-5 years against childhood and preventable diseases such as yellow fever, tetanus, tuberculosis, poliomyelitis, measles and hepatitis.

Once more, to successfully embark upon maternal and child mortality in the continent, services for mothers and children should be integrated. Honestly, the continent cannot look after children without looking after their carers – mothers.

The integrated services should cover maternal, neonatal and child health strategy and the purpose in life of the integrated services should be to address the main causes of maternal, newborn and child death at community and health facility levels in the continent.

To show commitment towards the full implementation of the MDGs, African governments should also collaborate with international agencies such as the United Nations International Children Education Fund (UNICEF) and International Children Education Fund through the building of maternal child centres.

The psychological health of mothers, children and families must be addressed too. Joan van Niekerk of Childline said, “The rejection of babies has gone up markedly since HIV hits Africa, not just by mothers who are dying, but mothers who feel utterly hopeless about their situation.”

It is very sad to note that the burden of child health care is still on mothers.

Therefore, to lift this burden, African leader should “create space for fathers so that they can learn and support their spouses”. Consequently, for every programme to be effective, political will and funding are two important ingredients to drive excellent initiatives like the Campaign for Accelerated Reduction of Maternity and Child Mortality in Africa.

If the African continent is to successfully tackle the twin challenge of maternal and child deaths headlong, priority should be given to action while lesser time should be spent on rhetoric.