Welcome to Maternity Africa

The high number of maternal deaths in some countries reflects unequal access to health services.  It also highlights the gap between rich and poor.  Almost all maternal deaths (99%) occur in Low Income Countries.  Most of the deaths (83%) occur in Sub-Saharan Africa and South Asia.

The maternal mortality ratio (MMR) in developing countries in 2015 averaged 239 deaths per 100,000 live births.  This compares to an MMR  of 12 in developed countries.  There are also large disparities: between countries, between women with high or low income, and between women living in rural or urban areas.

In Tanzania, where Maternity Africa is based, the MMR in 2018 was 556 deaths per 100,000 live births.

The risk of maternal mortality is highest for girls under 15 years. Complications in pregnancy and childbirth are leading causes of death among adolescent girls in developing countries (2), (3).

Women in developing countries have, on average, many more pregnancies than women in developed countries. Therefore, their lifetime risk of death due to pregnancy is higher. The probability that a 15 year old woman, will eventually die from a maternal cause is 1 in 4,900 in developed countries compared to 1 in 180 in developing countries. In countries designated as fragile states, the risk is 1 in 54, showing the consequences of breakdowns in health systems.

You can read more about maternal mortality here.

Women die as a result of complications during and following pregnancy and childbirth.  Most of these complications develop during pregnancy and most are preventable or treatable.  Other complications may exist before pregnancy but are worsened during pregnancy, especially if not managed as part of the woman’s care.  The complications that account for nearly 75% of all maternal deaths are):

• severe bleeding (especially after childbirth);

• infections (usually after childbirth);

• high blood pressure during pregnancy (pre-eclampsia and eclampsia);

• complications from delivery; and

• unsafe abortion.

The remainder are caused by or associated with diseases such as malaria, and AIDS during pregnancy.

You can read more about why women die in pregnancy and childbirth here.

Poor women in remote areas are the least likely to receive adequate health care.  This is especially true for regions with low numbers of skilled health workers, such as sub-Saharan Africa and South Asia.  In 2015, 89% of births in the richest 20 per cent of households were attended by skilled health professionals.  In the poorest 20 per cent of households only 43% were attended.  This means that millions of births are not assisted by a midwife, a doctor or a trained nurse.

In high-income countries, almost all women have at least four antenatal care visits.  In addition, they are attended by a skilled health worker during childbirth, and receive postpartum care.  In 2015, only 40% of all pregnant women in low-income countries had the recommended antenatal care visits.

Reasons why it is challenging to access good, evidence-based maternal health care include because women are often:

• Relatively far from other maternal healthcare providers;
• Located in rural communities or areas of high urban deprivation where transport infrastructure is poor, expensive and logistically challenging (comprising travelling on foot, by pillion motorcycle rides, using several public minibus journeys or expensive taxis);
• Otherwise served only by poor quality, unprofessional maternal healthcare;
• Economically impoverished;
• Have large families (some already with up to eight or more children), who require their time and attention;
• Affected by other social constraints, such as fear of stigma and low standards of education;
• Live in areas that are subject to poor healthcare governance and accountability mechanisms; and / or
• Potentially otherwise at higher risk of maternal death, or major birth-acquired injury such as obstetric fistula.

Through its base at Kivulini Maternity Centre, Maternity Africa is located specifically to serve such vulnerable and marginalized women.

Most maternal deaths are preventable.  The maternal health care solutions to prevent or manage complications are quite straightforward.

All women need access to professional antenatal care in pregnancy, skilled care during childbirth, and care and support in the weeks after childbirth.

Maternal health and newborn health are closely linked.  Globally, an estimated 2.7 million babies die in the neonatal period annually, and of these, about 0.7 million die from intrapartum-related events. In Tanzania, where Maternity Africa is located, estimates suggest that 51,000 newborn deaths and 43,000 stillbirths occur every year.  Approximately two-thirds of these deaths could be potentially prevented with improvements in intrapartum and neonatal care.  Routine measurement of fetal intrapartum deaths and newborn deaths that occur in health facilities can help to evaluate efforts to improve the quality of intrapartum care to save lives.  You can read more about perinatal deaths in Tanzania here.

It is therefore particularly important that all births are attended by skilled health professionals.  This is because timely management and treatment can make the difference between life and death for both mother and baby.

Severe bleeding after birth can kill a healthy woman within hours if she is not attended by a professional health worker. Medication given immediately after childbirth effectively reduces the risk of bleeding.

Infection can be eliminated if good hygiene is practiced and if early signs of infection are recognized and treated.

Pre-eclampsia can be detected and managed with medication before the onset of eclampsia (convulsions and other life-threatening complications).

To avoid maternal deaths, all women, including adolescents, need education and access to family planning and prenatal, childbirth and postnatal care from professional healthcare workers.  Maternity Africa provides such care.

Sustainable Development Goal 3 aims, by 2030 to reduce the global maternal mortality ratio to less than 70 deaths per 100,000 live births by 2030.  It also aims to ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.  You can read more about Sustainable Development Goal 3 here.

Sustainable Development Goal 5 aims to  ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.  You can read more about Sustainable Development Goal 5 here.

Through its work, Maternity Africa seeks to contribute to the achievement of these goals.