Ethiopia most successful in Africa at cutting maternal deaths

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Addis Ababa, 6 May 2014 (WIC) - Pregnancy-related deaths in Ethiopia have fallen by nearly two-thirds, making it the African country that has most successfully lowered its maternal mortality rate thanks to its lifesaving investment in female health workers and girls’ education, Save the Children said on Tuesday.   

Ethiopia’s maternal deaths have fallen from one in 24 women dying due to pregnancy in 2000 to one in 67 today, Save the Children wrote in its annual report State of the World’s Mothers.   

Out of 178 countries included in the report, Save the Children ranks Finland as the best place to be a mother or child and Somalia as the worst.   

Care For Woman By Women

A decade ago, the Ethiopian government hired 30,000 basic health workers to provide preventive and curative health care services across the country. There is a health post, staffed by two health workers, for every 5,000 people.

All of the health workers are women because it is easier culturally for them to talk to other women about family planning, healthy pregnancies, clean delivery and childcare. The health workers also connect those who need more sophisticated care with larger health centres and hospitals.

As a result, the number of women receiving antenatal care has risen from 27 percent in 2000 to 42 percent in 2011, said Metasebia Gizaw Balcha, Save the Children’s regional health adviser.   

“They work with the pregnant woman on birth preparedness,” she told Thomson Reuters Foundation at the Save the Children office in Nairobi. “If it’s a delivery that’s known to have risks, definitely she would plan to have it in a health facility.”   

Common risks include becoming pregnant before the age of 16 or after 35, and having less than two years between deliveries, as well as anaemia, sexually transmitted diseases like HIV/AIDS, and eclampsia, a complication marked by high blood pressure that can lead to seizures.   

Most maternal deaths occur during labor, delivery or soon afterwards.

Key to reducing maternal mortality is for women giving birth to have a doctor, midwife, or nurse present in case they need skilled assistance, such as the use of forceps, administration of drugs or surgery.   

In Ethiopia, skilled assistance at delivery has increased from 6 to 10 percent in the last six years, according to government statistics.   

Most women still deliver at home, with 57 percent helped by a relative and 28 percent by a traditional birth attendant, but now women are more educated about the risks.   

“Traditional birth attendants do not know how to detect complications or conduct clean deliveries,” Gizaw Balcha said. “They usually did not clean the umbilical cord and used to apply some other herbs or even cow dung on it. They used to delay women at home even if there were complications. That will not happen now with health extension workers.”   

A woman who becomes pregnant more often also faces greater chances of dying, so improved family planning can improve rates of survival.

Ethiopia’s fertility rate has dropped from 5.5 children per woman in 2000 to 4.8 in 2011, and contraceptive use is up from 8 to 29 percent. (Thomson Reuters Foundation)


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