Saturday, 26 April 2008

Why more mothers die during child birth in Malawi !!!




Malawi has being quoted to have the highest maternal mortality (highest number of mothers dying in child birth) in the world, with more than 1000 women per every 100,000 dying during child birth. This figure is quite alarming, but when you visit some of the Health centres in rural Malawi and take note of the conditions there; you understand why this figure may be an underestimation.
A classical example is Namphungo Health Centre, a government run health centre in Mulanje District, southern Region of Malawi .My team recently visited this place for our eye research . It takes about an hour to drive on the dusty bumpy road from Mulanje District hospital to the Health centre .The population catchments area for the Health centre is 40,255 and there are 53 villages surrounding the centre. In terms of infra -structure there is a nice facility with a separate maternity unit which has about 6 beds, even though the unit is not functional.
Staff wise- there is only one medical assistant at the centre who sees general cases; and there is no nurse to attend to maternity cases hence the closure of maternity unit. There are 21 health surveillance assistants (HSA’s) who do health promotion but most of these are untrained. Recently the ministry of health have recruited more HSA’s with intention of having one HSA per village but this has not been achieved for Namphungo.

Unfortunately during our visit, the only medical assistant was away from the centre so there was no one to attend to patients; but we believe the untrained HSA’s were attending to patients and prescribing even though they are not allowed to do so.
A highly pregnant mother who has started labour walks into the centre only to be attended by untrained HSA. Due to our presence she is advised to go to the nearest health centred where there is a nurse so that she can deliver; and my enquiry reveals that this centre is Namilenga Health centre and the woman will have to walk there for at least an hour -that is if she doesn’t deliver or collapse on her way.
The critical shortage of health staff (nurses, doctors, paramedics) is much worse in Malawi that the Government would like to admit –imagine no nurse in a highly fertile population of 42,000! The brain drain and influx of medical staff to the West continues; with the west continuously paying a blind eye to the health problems in Sub-Saharan Africa.

Now you understand why more women die in childbirth in Malawi than anywhere else in the world.

Well , I am only a researcher and an eye doctor so I can only communicate this information for authorities to know how to address the situation.

What do you say?
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