Maternal Health an Intersectional Issue in East Africa — There is Still Work to Be Done
In today’s blog, we’ll be taking a closer look at the disease burden of maternal health in East Africa as well as its overlap with other related topics. Maternal health is addressed in the Millennium Development Goals (MDG’s), as the 5th goal: ‘Improvement of Maternal Health’.
At a glance, major advancements have been made in nearing the 5th MDG in the past two decades, by reducing the average Maternal Mortality Rate (MMR) in Sub-Saharan Africa by 49%. Unfortunately, that statistic may come as misleading for it isn't entirely representative of the region as a whole. By having used the averages, much of the disparity between regions in terms of progress of maternal health isn’t mentioned. The 49% statistic reasons that an average of 990 deaths per 100,000 live births has been reduced to 510 deaths per 100,000 live births. This is statistically coherent, but it fails to communicate the opposite extremes of the regions.
For an example, in a country such as South Sudan, where initially, there had been an MMR of over 1700 per 100,000 live births, there still remains an MMR of over 1100. Which at a novices rough calculation only equates to a 35% difference of MMR.
Many countries with a history of struggling with the existing disease burden of HIV have made little to no progress in maternal health previously, because their efforts were directed towards combating HIV. They are only now, recent positive reverse developments in maternal health for those countries most affected by HIV. This is because there have been increased Antiretroviral (ART) treatments and HIV testing (our HIV blog for details), easing the HIV disease burden, which has now allowed greater efforts to be directed at maternal health.
Not to mention the many overlapping factors, such as poverty, which have also proven to be a hurdle in the way of increasing maternal health and nearing the MDG’s. Poverty having had the effect of being a causal factor of maternal mortality, as it prevents many women from getting or receiving proper and adequate medical attention due to an in-affordability of antenatal care.
If you were to have a spare 15 minutes, there is a topical and partly relevant TED Talk by Elizabeth Howell- exactly about how preventable MMR can be, and yet how it still remains to be, a significant issue in most places. The continental context is different, because Howell speaks of the United States, as well as her suggested interventions largely rely on existing health care infrastructures that can’t be claimed to exist in all other contexts.
Nonetheless, she brings information which transcends basic geographical context. One of the main calls for action for increasing maternal health are the requisite for quality of care throughout a woman’s reproductive years: before, during and after pregnancy. By providing access to safe and reliable contraception. Preconception care, through early screening and identifying potential issues. During pregnancy, through high quality prenatal and delivery care. After pregnancy, through postpartum and inter pregnancy care. These practices are increasingly important and should be aspired to be practiced in the East African contexts too, where for some less than half of the women in their reproductive years make even one antenatal visit (like in Ethiopia).
Concluding, it is difficult to approach a topic such as maternal health and poverty in a place as diverse as East Africa. A region where solely relying on average statistics can be misleading, due to different regions being historically affected by differing degrees of other disease burdens. As well as being along varying stages in healthcare development and as maternal health’s extensive overlap in economic factors. What this implies, is that aspiring to maternal quality care is inter-sectional as well as complex, but demonstrates the need for more work to be done in its establishment.
