Photo by Melissa Askew on Unsplash
by Adetayo Adetokun
African women deserve better.
African women of reproductive age deserve better.
African mothers deserve better.
Maternal health stands as a vital pillar of public health, crucial not only for the well-being of mothers but also for the future generations they nurture. Yet, across Africa, women confront alarming disparities in maternal health outcomes that underscore deep-seated systemic inequities demanding immediate attention and holistic solutions. These disparities not only impact individual health but also reflect broader socio-economic challenges that hinder progress toward achieving equitable healthcare access.
In many African countries, maternal mortality rates remain among the highest globally, with high rates of stillbirths that starkly contrast with high-income countries. Countries like Nigeria, Ethiopia, and the Democratic Republic of Congo bear a significant burden, plagued by inadequate healthcare infrastructure, limited skilled birth attendance, and pervasive socio-economic disparities. Addressing these challenges is not just a matter of health equity but a fundamental human rights issue, ensuring that every African woman has the opportunity to experience pregnancy and childbirth safely and with dignity. This blog illuminates the critical state of maternal health for black women and underscores the urgent need for targeted interventions to improve outcomes and ensure universal access to quality maternal healthcare services.
Key Facts and Figures
- Maternal Mortality Rates: The maternal mortality rate in Sub-Saharan Africa is 542 per 100,000 live births, compared to 11 per 100,000 in high-income countries. Countries like Nigeria and the Democratic Republic of Congo contribute significantly to these numbers, with Nigeria alone accounting for nearly 20% of global maternal deaths.
- Skilled Birth Attendance: Only about 60% of births in Sub-Saharan Africa are attended by skilled health personnel, compared to over 99% in high-income countries. This lack of access to skilled care during childbirth significantly increases the risk of complications and death.
- Antenatal Care Coverage: While there have been improvements, only about 52% of pregnant women in Sub-Saharan Africa receive the recommended minimum of four antenatal care visits. Inadequate antenatal care can lead to unmonitored high-risk pregnancies and preventable complications.
- Health Infrastructure and Resources: Many African countries face critical shortages of healthcare facilities, medical supplies, and trained healthcare providers. In rural areas, the lack of infrastructure, such as roads and transportation, further hampers access to maternal health services.
Maternal mortality remains a critical issue across Africa, influenced by a complex interplay of socio-economic, health system, and cultural factors. Understanding these contributing factors is crucial for effective intervention and policy formulation.
- Healthcare Access and Quality: Limited access to skilled birth attendants, emergency obstetric care, and essential maternal health services significantly contribute to maternal deaths. In many regions, health facilities are understaffed, under-resourced, and poorly equipped to handle obstetric emergencies, leading to delays in receiving appropriate care.
- Infrastructure and Transportation: Poor road networks, inadequate transportation options, and long distances to healthcare facilities pose significant challenges, especially in rural areas. Women often face delays in reaching facilities capable of providing emergency obstetric care, increasing the risk of complications and death.
- Socio-economic Factors: Poverty exacerbates maternal mortality through barriers such as the inability to afford transportation, medical costs, and loss of income during pregnancy. Limited education and low literacy levels also impact women’s ability to seek timely and appropriate healthcare services.
- Healthcare Financing: High out-of-pocket healthcare costs deter women from seeking antenatal care and skilled delivery services. Inadequate health insurance coverage and lack of financial protection mechanisms further constrain access to essential maternal health services.
- Cultural and Societal Norms: Deep-rooted cultural beliefs and practices often influence maternal health-seeking behaviors. These may include traditional birth practices conducted by unskilled attendants, preference for home births, and harmful practices such as female genital mutilation which increase maternal health risks.
- Political and Governance Challenges: Weak health governance, corruption, and inadequate policy implementation contribute to poor maternal health outcomes. Insufficient allocation of resources to maternal health programs and inadequate monitoring and evaluation systems further impede progress in reducing maternal mortality rates.
- Conflict and Humanitarian Crises: Regions affected by conflict or humanitarian emergencies experience heightened maternal mortality rates due to disrupted healthcare services, displacement, sexual violence, and lack of access to safe reproductive health services.
Strategies For Improvement
Moving forward, addressing maternal mortality in Africa necessitates a multifaceted approach integrating health system strengthening, community engagement, policy reform, and sustainable development initiatives.
- Health System Strengthening: Enhancing healthcare infrastructure and workforce capacity is pivotal. For instance, Rwanda’s successful reduction in maternal mortality rates was partly attributed to its extensive deployment of community health workers (CHWs) who provide essential maternal health services at the grassroots level. Investing in training and equipping CHWs across Africa could replicate similar successes by improving access to prenatal care and skilled birth attendance in remote areas.
- Community Engagement: Empowering communities to advocate for maternal health is crucial. In Ethiopia, initiatives like the Health Extension Program have trained local women as health workers, facilitating community-based education on maternal health practices and encouraging facility-based deliveries. Such programs foster trust in healthcare services and promote culturally appropriate maternal health practices.
- Policy Reform: Strengthening policies to prioritize maternal health is essential. In Senegal, the “Zero Maternal Mortality by 2015” initiative implemented policies that subsidized maternal health services and increased the number of skilled birth attendants in rural areas. Aligning policies with international standards, such as those outlined in the Maputo Protocol, can ensure comprehensive maternal healthcare coverage and improve health outcomes.
- Education and Awareness: Promoting maternal health literacy is critical. In South Africa, the MomConnect program uses mobile technology to deliver maternal health information and support to pregnant women, empowering them to make informed decisions about their health. Scaling up such initiatives and integrating digital health solutions can enhance access to timely information and support throughout pregnancy and childbirth.
- Research and Innovation: Investing in research to identify context-specific challenges and innovative solutions is imperative. In Nigeria, research initiatives like the Maternal and Child Survival Program (MCSP) have identified barriers to maternal health and implemented community-driven interventions to improve access to quality care. Supporting similar research efforts and fostering partnerships between academia, governments, and NGOs can drive evidence-based policy formulation and program implementation.
Addressing maternal mortality in Africa is not merely a health challenge: it is a moral imperative that demands our unwavering commitment. At Shades of Us, we understand that behind every statistic lies a story of a life cut short, of families shattered, and communities deprived of a promising future. The impact of maternal mortality extends far beyond healthcare systems: it underscores deep-seated inequalities and systemic failures that must be confronted with urgency and resolve.
Our dedication to this cause is rooted in a vision of equity and justice. It compels us to advocate for comprehensive healthcare access, empower communities with knowledge and resources, and advocate for policy reforms that prioritize maternal health.
Together, we can create a continent where every woman receives the quality care she deserves, where childbirth is safe and celebrated, and where maternal mortality becomes a relic of the past. Shades of Us remains steadfast in our commitment to this vision, driven by empathy, solidarity, and a profound belief in the inherent dignity and rights of every woman.
