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January 23, 2013

Maternity Mortality Remains High in Ghana

by Joana Mantey

In Ghana, government policy allows pregnant women access health care and skilled delivery services, but deaths due to pregnancy and related causes remain high. 

Lack of professional assistance

Talata, a 38-year-old housewife in the Upper East region was being assisted to deliver her eighth child at home when she started having difficulties.  All of Talata’s babies were born in a home setting so she never sought help from professionals when labor started.  Unfortunately she suffered retention of the placenta and her life ended while trying to bring life into the world.

Like Talata, many other Ghanaian women have suffered similar fates, for every 100,000 Ghanaian women who go into labor, 350 die while giving birth.

Free maternal care and other government programs are achieving results in some areas of the country.  In the Kwabre District of the Ashanti region for example, no woman died in childbirth in the early part of last year.

The situation in the Northern, Upper east and Upper West regions are different.  These are areas identified with low levels of assisted births by health workers.  

Causes

Also, cultural and religious myths play significant roles in the lives of expectant mothers.  The situation is further worsened by limited educational opportunities for women in these places.

Gloria Quansah-Asare is a medical officer and director at the Ghana Health Service.  She says failure to recognize symptoms of danger during pregnancy is one of the factors leading to maternal deaths in rural communities. “Some women do not know that when the feet are swollen, and she is having headache and blurry vision and her whole face is swollen, it does not mean she is going to have boy or twins.  It means she is having some problems and has to be seen,” she explained.

Traditional beliefs are fostering misconceptions.  
 
Chairman Jonathan Adabre of the Ghana coalition of Non-Governmental Organizations in Health in the Upper East region, says there is some sensitization on the importance of prenatal care in the three regions, but people still go along with traditional myths surrounding proper nutrition during pregnancy.  

“Pregnant women are not allowed in some communities to take eggs because [of the belief that] when you eat eggs and give birth, the child can become a thief in future," Adabre stated. "In some communities women are not allowed to take chicken.  We are educated so you will think that is not important, but for the community members it is an issue”

Male partners

Another challenge is lack of women’s empowerment in the affected areas.  Decisions about health-care choices are often left in the hands of male partners, and most Ghanaian women also find difficulties negotiating safe sex or asserting their reproductive rights.

Adabre says sometimes, a male partner consults a soothsayer to make pronouncements on the outcome of an expected delivery before a woman in labor is sent to a clinic to deliver.  That may delay efforts in seeking professional care and could end with disastrous consequences.

“Now the father who has the responsibility in consulting the soothsayer comes back and says the gods have decreed that this delivery should not be done outside.  It means you cannot go to the health center to deliver," Adabre noted. "And usually at a community level, they don't have the proper timing of the pregnancy.  So at the time the woman is experiencing labor, this is the time that he now picks to consult the ancestors."

Even for those cleared by soothsayers to seek professional help, bad roads and other geographical barriers serve as major hazards especially in the Yagaba Kubori area, and Sandema in the Upper East region.  These places are inaccessible to vehicles during the rainy season and women due for childbirth are ferried across rivers in canoes.  

Rituals

Other rituals such as confining mothers in a room for three days after childbirth can lead to infection and possible death.

Adabre says there is need for active community involvement and management in ongoing programs on maternal health.  Community Health Committees for example, have been established to compliment the work of health care providers.

Unfortunately, Adabre says most of them lack sufficient resources.  He says activating these groupings would help community leaders to deal effectively with issues of taboos and soothsaying.  That would also help Ghana achieve a significant reduction in the number of women who die as a result of childbearing.