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Access to emergency care slashes maternal deaths - MSF

Source: Thomson Reuters Foundation - Mon, 19 Nov 2012 18:13 GMT
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LONDON (AlertNet) – Improving access to emergency obstetric care could save up to three quarters of mothers who die in childbirth, according to research by a leading medical charity.

Medecins Sans Frontieres said the success of its projects in Kabezi in Burundi and Bo in Sierra Leone show you don't need a large investment or state-of-the-art facilities to save women's lives.

A simple ambulance service together with the provision of emergency obstetric care has cut maternal mortality rates by an estimated 74 percent in Kabezi and 61 percent in Bo, according to an MSF report.

Some 287,000 women worldwide die each year giving birth. For each woman who dies, another 20 suffer chronic ill health or disability following complications.

A baby born to a mother who dies in childbirth is 10 times more likely to die prematurely, and if she already has children they are also more likely to die young.

MSF said the project in Bo cost 1.5 euros ($1.9) per resident per year. In Kabezi, it was 3.2 euros.

Burundi and Sierra Leone have some of the highest maternal mortality rates in the world. Both countries have suffered civil wars that have crippled their health systems.

In Sierra Leone, MSF says just three obstetricians are registered as working for the ministry of health. In Burundi, only one registered obstetrician is working outside the capital.


The MSF projects involved setting up a free 24-hour emergency obstetric service at the hospital, complemented by an ambulance service to reach the wider area.

Before going into labour an expectant mother has the option of staying at a maternity waiting house next to her local health centre in order to be close to a medical facility when she delivers.

If a woman arrives with complications, staff contact the hospital and an ambulance is sent to transfer her to hospital.

“Something as simple as this will reduce maternal mortality by enormous amounts,” said MSF obstetrician Philip de Almeida.

De Almeida, who has spent 25 years in Africa, said he believed four out of 10 emergencies in hospitals in sub-Saharan Africa were due to obstetrical problems.

“When I was training, I thought surgery would be the most important thing in sub-Saharan Africa. But, I was wrong,” added De Almeida in an interview on MSF's website.

“Really, most of the complications and deaths are due to obstetric problems; abortions, bleeding, placenta praevia.”

Reducing maternal mortality by 75 percent by 2015 from countries’ national rates in 1990 is one of the United Nations’ Millennium Development Goals.

MSF estimates indicate that the MDG has been reached four years ahead of schedule in Kabezi. It is also confident the MDG will be met in Bo.

The charity hopes its model could serve as an example for donors, governments and other aid agencies considering investing in emergency obstetric care in countries with high maternal mortality rates. 

The MSF project in Bo will feature in a BBC documentary called Four Born Every Second.

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