KIGALI, Rwanda – Women in eastern and southern Africa are still dying during pregnancy and childbirth for preventable reasons, Dr Brian Chirombo, WHO Representative in Rwanda, told a high-level meeting to track progress in ending preventable maternal and newborn deaths.
High-impact interventions are needed “to ensure the provision of quality maternal and newborn health care, from pregnancy, the antenatal period, labor and delivery, as well as the postpartum and neonatal periods”, a- he declared.
Significant progress has been made in improving the survival and health of pregnant women and newborns in the Eastern and Southern Africa region. For example, the maternal mortality ratio (MMR, or number of maternal deaths per 100,000 live births) fell by 49% between 2000 and 2017. However, the MMR remains well above the global average, and the current rate of reduction is not enough to achieve the SDG targets by 2030.
Around 77,000 women die each year during pregnancy and childbirth in the region, according to 2017 estimates by the UN Interagency Maternal Mortality Estimation Group (MMEIG). For a 15-year-old girl, the probability of dying in her lifetime from maternal causes is 1 in 58, compared to 1 in 11,200 in Western Europe.
While the global neonatal mortality rate was 17 deaths per 1,000, in sub-Saharan Africa the rate was 27 per 1,000, according to the 2021 Child Mortality Trends Report. Of the 54 countries off track to meet the SDG target of less than 12 deaths per 1,000 live births, 40 countries are in sub-Saharan Africa.
“The global health agenda has shifted from a focus on reducing mortality to ensuring that all women, newborns, children and adolescents not only survive, but thrive and realize their rights to health standards and well-being possible,” said Dr Chirombo. said.
This paradigm shift requires greater investment in integrated initiatives, as well as quality integrated reproductive, maternal, newborn, child and adolescent health (RMNCAH) interventions that focus on health promotion, prevention and prevention. the treatment of diseases.
To support the implementation of evidence-based guidelines for maternal and newborn health, the United Nations Inter-Agency Team for Eastern and Southern Africa (UNICEF/WHO/UNFPA) convened a meeting this month regional office in Kigali, Rwanda. Led by the H6 coordination team for Eastern and Southern Africa (mainly UNICEF, WHO and UNFPA), the purpose of the meeting was to monitor progress of the action plan frameworks for every newborn (ENAP) and the elimination of preventable maternal mortality (EPMM).
Many countries have developed policies on RMNCAH and implemented them at all levels of the health system, in line with the Global Strategy for Women’s, Children’s and Adolescents’ Health 2016-2030 and setting targets to achieve the SDGs.
The global ENAP, launched in 2014, provides a roadmap of strategic actions to end preventable newborn deaths and stillbirths, and help reduce complications during pregnancy and childbirth.
Countries shared their successful practices and challenges in universal health coverage, emergency obstetric care, midwifery and neonatal health as they strive to accelerate progress towards the targets of the SDGs. Opportunities were identified to scale up high-impact interventions in primary health care, from South-South cooperation to harnessing the power of innovation. This included the use of new digital technologies, such as portable ultrasound, e-learning and mentoring platforms, safe delivery apps, and clinical decision support platforms.
Improving Midwifery Practice in Eastern and Southern Africa
Midwives are key to reducing maternal and newborn deaths and improving their health and well-being. While the region has shown improvements in midwifery higher education and career paths, a shortage of midwives remains. In addition, a few countries lag behind in institutionalizing continuing professional development and recertification of midwives.
These critical points were discussed at a side meeting organized by UNFPA on the State of the Global Midwifery Report 2021 for Eastern and Southern Africa, which was attended by representatives from ministries of health and midwifery associations, and midwifery experts from UNFPA.
Country experiences were shared on developing an enabling environment and equipping midwives with the skills and knowledge they need to ensure healthy pregnancies and safe deliveries. Action plans have been developed to improve the situation of midwifery practice in their respective countries, where UNFPA will play a key role in providing technical support to implement these plans over the next two years. Plans included increasing the number of qualified midwives equipped with the knowledge and skills they need to help reduce maternal deaths and accelerate progress towards achieving the SDGs.