One death resulting from complications of pregnancy is one death too many. It is an ultimate sacrifice, a woman dying in the process of bringing another life into the earth. In many developing countries many women die needlessly and/or lose their babies.
My high school WhatsApp chat room discussion kept me up most of the night writing these sticky notes. What can we do about it? Most people I know have become immune to the problem. I have recently been learning about tackling tame and wicked problems and there is a role for everyone.
I wonder what would happen if every Obstetrician and Gynaecologist from sub-Saharan Africa especially those in the Diaspora ‘adopted’ one Obstetric Unit in a Primary Health Centre or District General Hospital. Charity begins at home and you may choose a health facility in your own community or be altruistic and look further afield.
The photograph above lists some of the factors that influence maternal mortality, long before the woman gets to hospital. Would you like to test a change by spending quality time to plan a small change, do (make it happen), observing and learning from the study and deciding what changes are required before the next phase of the act. You can work with others to effect these little changes along the process while still finding time to enable your colleagues at the deep end swim ashore.
I believe people in the non-health sector even have more to contribute to reducing Maternal Mortality. Intervention can take place at one or more of these levels, ideally an inter-sectoral approach involving the public, private, community and voluntary sectors. Local, state and central governments still have a majority role to play in terms of implementing health policies. Corruption at all strata of governance is another wicked problem. This list below (top of my head) is food for thought in deciding on area(s) of intervention:
- Family: Tackling poverty and ignorance in the woman, man and Girl-Child
- Community
- Religious leaders – church, spiritual home
- Traditional Birth Attendants
- Schools: Pupils, Teachers, PTAs
- Community leaders – Politicians, Traditional Rulers (Kings), Council of Chiefs, Community Development Councils, Women Groups, Youths
3. Health Policy
4. Health Services: Primary, Secondary & Tertiary Services
- Public Health Education
- Pre-pregnancy services
- Hospital fees
- Referral system
- Obstetric services: Antenatal, Maternity services, Emergency services, Postnatal services
5. Health Professionals: Doctors, Midwives, Nurses, Community Health Extension Workers
6. Patient experience – the story of many mothers who survived childbirth.
A paradigm shift is needed in the way Maternal Mortality is tackled in developing countries. Jack Canfield said, “One individual can begin a movement that turns the tide of history. Martin Luther King in the civil rights movement, Mohandas Gandhi in India, Nelson Mandela in South Africa are examples of people standing up with courage and non-violence to bring about needed changes.”
Are you the one to turn Maternal Mortality belly up?
Abiye Hector-Goma
Partner, Allerton Medical Centre, Leeds, U.K.
