Far-flung maternal healthcare facility shows how it is done

But over the past five years, the municipality which caters for almost 140,000 people has recorded zero cases of maternal mortality during childbirth; a record for the area and for many parts of the continent.

According to the United Nations, globally, a woman dies of pregnancy-related causes every two minutes, with most of thedeaths preventable. In 2020, the maternal mortality rate in Africa was 531 deaths per 100 000 live births, with the continent accounting for 69% of global maternal deaths.

For Daniel Konka, Sunyani West's Municipal Health Director, this is a situation that can be rolled back with the right kinds of intervention. Most important, he believes, is the availability of medical personnel.

"We have been able to lobby the region to get the needed staff in terms of doctors and midwives. These healthcare professionals were strategically placed in rural communities to provide quality services to the residents," he explained.

Maternal mortality was a major concern for the health directorate of the municipality in the past. According to Konka, this was turned around through the strategic placement of personnel, along with the establishment of continuous training programmes to improve staff skills. Over the last five years, there have been 8,001 deliveries in the community, without a single maternal death recorded.

"We also train our staff in maternal obstetric care, where they provide comprehensive services to pregnant women. The municipality has also focused on... providing a range of services to pregnant women," he explained.

"Given that a significant portion of the population resides in rural areas, community health nurses and midwives have been empowered to conduct home visits, ensuring that pregnant women receive the necessary care. This approach enables the identification of high-risk cases, which can be promptly referred to obstetric specialists."

To address the issue of adolescent pregnancies, the municipality established a Safety Net Programme. This programme aims to counsel pregnant adolescents and provide comprehensive abortion care for those who do not wish to continue with the pregnancy. By offering safe alternatives to illegal abortions, maternal deaths can be prevented.

"This targets the adolescent who becomes pregnant. We counsel them to ensure they deliver safely. Those who do not want to keep the pregnancy have comprehensive abortion care where they can go for medical abortion so that they will not engage in illegal abortion which may lead to maternal death," Konka added.

Dr Prince Yeboah Agyemang, a Medical Superintendent at the area's Nsoatre Polyclinic, explained that in addition to physical presence and training, communication has also played a key role in preventing maternal deaths during childbirth.

"Well-trained midwives at the health facility ensure that pregnant women receive excellent care and adhere to prescribed medication. The use of a dedicated phone to communicate with pregnant women has also contributed significantly to improving care and has led to five years without any recorded maternal mortality cases."

Agyemang explained that Nsoatre Polyclinic has adopted a home visit strategy, reaching out to rural communities to provide care for pregnant women who may have difficulties accessing antenatal care due to financial constraints. This proactive approach prevents maternal deaths by ensuring pregnant women receive the necessary support and medical attention.

Cecilia Nkansah, a 30-year-old from the region expecting her second child, said that the childbirth experience was no longer frightening, thanks to support from the region's healthcare system.

"The midwives are good; they treat us with respect and educate us on what to do and what not to do. This has really helped me and I believe when my time is due, I will deliver safely."

Konka emphasised the need for improved mobile connectivity in the municipality. This would better enable community members to access healthcare services using their National Health Insurance Scheme (NHIS) cards. Enhanced connectivity would facilitate even smoother operations, he said, and enable residents to avail themselves of further healthcare benefits more conveniently.