How painful, to lose lives while bringing new ones into the world! In sub-Saharan Africa, almost every pregnancy is a risk. World Health Organization statistics indicate there are 940 maternal deaths per 100,000 live births. Did you just say Alarming?

Patricia Kamanga is the point person for safe motherhood at the WHO regional office in Zambia. English to Africa reporter Angel Tabe asked her about the causes of maternal deaths in sub-Saharan Africa. “The causes are infection, obstetric labor, hemorrhage, unsafe abortion, malaria, anemia, preeclampsia, and HIV/AIDS.” Kamanga says although these conditions are considered contributing factors, in reality they are usually the direct causes of maternal deaths. But the major challenges to prenatal care are the long distances between the pregnant women and the health facilities, infrastructural limitations, and socio-cultural practices that slow decision-making. “The distances are a major barrier for timely arrival…. Also, issues of funding, multiple referrals, absence of delivery rooms, and then the mother has to wait for the husband to come home to get permission to go to the hospital.”

Although there has been some progress with the provision of ambulances and radio communication, Kamanga says the situation is not yet rosy: “One ambulance may cater for four or five health centers.” Another factor is unsafe abortion, she adds. Among pregnant women who have complications, “eleven percent would be a woman that tried to have an abortion. That causes death as well.”

The prevailing situation, Kamanga notes, is one that leaves women discouraged. “So you find that most women might prefer to deliver at home.” And that’s where Traditional Birth Attendants (TBAs), come in. These are older women who have been performing unskilled deliveries in their communities. “Sometimes they use the same razor to cut the cord and so on.” But because the region has a human resource crisis, with very few nurses and “most leaving for greener pastures in the UK and US, we need to work with the TBAs so that they can sensitize their communities to look at danger signs, while we are training more nurses.”

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