Malawi has one of the highest maternal death rate in the world. Here, news of pregnancy is received with a mixture of both joy and anxiety by the mother, family and community.
An estimated 4,200 mothers die every year in Malawi from preventable causes of death, while 38 newborns who could be saved die daily. Complications during pregnancy and childbirth are some of the most common causes such as severe bleeding, infections and eclampsia. Lack of quality health care, access to health facility or funding towards maternal health care, and neglect of maternal health rights are the most common factors affecting maternal health progress negatively.
Today, 11th April 2017 as we commemorate International Day for Maternal Health and Rights, MamaYe Malawi, a campaign for maternal and newborn health in the country, seeks to highlight and appeal to the government, developmental partners in health care and the general public that with concerted efforts, mothers and newborns can live a happy life if maternal health rights are respected. Most of the challenges pregnant mothers go through and make pregnancy a nightmare experience can be overcome when the necessary measures are put in place by ensuring that health facilities are provided with skilled health care and the enablers to ensure quality maternal and newborn health.
For the last five years, MamaYe Malawi has been working in the country advocating for quality improvement in maternal health service delivery through the use of evidence to drive individuals and communities to action. MamaYe Malawi has been using Quality Institutional Care (QuIC) tool to assess the capability of an institution to provide Basic Emergency Obstetric and Newborn Care (BEmONC). With this tool, health facilities have been able to address challenges at a health facility and shortages as such skilled health care providers, shortages of essential drugs and equipment and to mobilise for resources.
According to the 2015-2016 DHS, over 95 percent of women received antennal care from skilled providers. This has been a major contributing factor to maternal deaths as the country now stands at 439 out of 100,000 live births. Despite the country making such strides, Malawi is still off track from achieving the 2035 target of 140 set by the Ministry of Health.
MamaYe Malawi also believes that maternal health can also improve when adequate funds are sourced and allocated towards the health sector and also through accountability of funds. Through MamaYe’s work on Health Budget Advocacy and Transparency, the campaign has been advocating for resource allocation towards maternal health by empowering different stakeholders at district levels in budget consultations with the grassroots, and for the councils to be transparent and accountable in resource use. MamaYe has been developing scorecards for the councils where indicators show where the districts councils have made improvements and where they need to improve in accountability and transparency.
The Commission on Information and Accountability for Women’s and Children’s Health has noted that strengthening accountability is an essential strategy for improving women’s and children’s health and reducing maternal mortality.
Sadly, the Commission describes this strategy as neglected and a setback to improving maternal health, a point which MamaYe Malawi agrees with. During its work on Health Budget Advocacy and Transparency in the districts of Nkhata Bay, Rumphi and Mzimba, MamaYe Malawi has discovered that all the three districts have not been audited for the past three years which may affect improvement on maternal health.
MamaYe Malawi has been working with communities by empowering them with skills and knowledge to hold service providers accountable to provide quality health care by ensuring that the rights and dignity of pregnant mothers are protected. Most women in the rural areas suffer the pain and humiliation as they can’t access quality health care due to lack of transport, bed space-where in some health facilities women have to share the same ward with male patients or a room designed to accommodate 70 women accommodates over 200 women, lack of safe drinking water at health facilities forces pregnant women to walk long distances in search of drinking and bathing water. Looking at these trends, it is very evident that the rights of pregnant mothers and their newborns are being violated by not being provided with the necessary support to make pregnancy a happy experience for the mother, baby, family and community as a whole.
The factors raised above, if not attended to with the at most attention, can lead to preventable deaths of pregnant mothers or newborns. Through adequate health funding, transparency and accountability and skilled providers, and respect for pregnant mother’s right’s, most of the deaths in our health facilities can be prevented. It is also important to realize that for the country to improve on maternal health, women and girls need to have access to comprehensive maternal, newborn, sexual and reproductive health services that includes family planning, essential medicines, skilled health care providers, and rights-based maternity care.
MamaYe Malawi appeals to the government and all citizens of the country to celebrate and recognize this day, 11th April as the International Day for Maternal Health and Rights. Let us make pregnancy a joy for mothers and everyone.