By Dan Osman Mwin

The Ministry of Health?s mission is ?to contribute to socio-economic development and the development of a local health industry by promoting health and vitality through access to quality health for all people living in Ghana using motivated personnel?.

The policy thrust of the health sector is ?to reduce inequities in access to care and increase coverage, quality and use of health services so as to achieve a healthier national population?.

Indeed one of the five health sector objectives is ?to improve access to quality maternal, neonatal, child and adolescent health services?.

If the entire above are suppose to be guiding principles guiding the policy framework of the health sector, then one would wonder why there are still reports of maternal deaths in Ghana in both urban and rural communities.

According to the World Health Organization (WHO), maternal death is defined as ?the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes?.

It is a known fact that, generally, there is a distinction between a direct maternal death that is a result of a complication of the pregnancy, delivery or management of the two, and an indirect maternal death that is a pregnant-related death in a patient with a preexisting or newly developed health problem unrelated to pregnancy. Fatalities during but unrelated to a pregnancy, according to obstetrics and gynecology specialists, are termed accidental, incidental, or nonobstetrical maternal deaths.

Causes

As stated by the WHO in its 2005 World Health Report ? Make Every Mother and Child Count?, the major causes of maternal death are; severe bleeding/hemorrhage (25%), infections (13%), unsafe abortions (13%), eclampsia (12%), obstructed labour (8%), other direct causes (20%). Indirect causes are malaria, anaemia, HIV/AIDS and cardiovascular diseases all of which may complicate pregnancy or be aggravated by it.

The report stated that over 90% of maternal deaths occur in developing countries with the most common cause being obstetrical hemorrhage, followed by deep vein thrombosis.

In Ghana one does not need to be a qualified medical doctor to be able to identify some ?plain plain? causes of maternal deaths because they occur in our homes and communities.

For instance, the lack of access to skilled medical care during childbirth and the distance of travelling to the nearest clinic to receive proper care are clear examples. Travelling to and from the health facility is very difficult and costly, especially to poor families when time could have been used for working and providing incomes. Even so, the nearest health centre may not have the capacity to provide decent and professional care because of the apparent lack of qualified health workers and medical equipment.

Prevention

Indeed most maternal deaths are needless and preventable or avoidable, because the health-care solutions/ interventions to prevent or manage complications are well known. All that women need is access to antenatal care in pregnancy, skilled care during birth, and care and support in the weeks after childbirth. It is particularly important that all births are attended to by skilled health professionals, since timely management and treatment can make a lot of difference between life and death.

To improve maternal health, barriers that limit access to quality maternal health services must be identified and wholistically?? addressed at all levels of the health system.

The MOH as a policy maker and the Ghana Health Service (GHS) as an implementation agency must collaborate with the Teaching Hospitals to review all maternal health-related policies frequently to ensure that they are internally coherent, enforce standards on? providers (both public and Private) of maternal health services as well as promote any local/indigenous solutions to maternal health problems discovered through scientific research.

As a nation in the middle income brackets, we must make commitments to improve health infrastructure, transport pregnant women to health facilities, beef up the fleet of ambulances, intensify midwifery education and ensure the availability of family planning centres and commodities.

The author is the Head of Public Relations of the

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