Behailu Shiferaw, Editor-in-Chief, Lambadina Institute
Yengene Lope is not only ‘rich’ with children. She is also the pride of her husband and her family. No man except her husband has ever had sight of her private parts even during giving birth. A Mezjenger in Yeki district of Southern Nations Nationalities and Peoples’ Region, Yengene lived in a society where women deliver inside the jungle so that no one would steal a look between their legs.
“When I felt the labor coming, I hid out inside the jungle. And when the babies came thrusting forward, I did everything on my own. I pushed the baby out, cut off the umbilical cord using small knife or the sharp edge of sugar cane.”
That happened two decades or so ago. And technologically speaking, the world has gone very very far away from where it was twenty years ago. But the situation of mothers in Ethiopia has not traveled with such a speed. Still, only six percent of Ethiopian women give birth assisted by trained birth attendant.
Infants are dying a threatening deal. Women are dying giving life. And sadly they are all dying from avoidable complications.
In a country with a population size of more than 75 million, 673 in every 100,000 pregnant women die from pregnancy related complications and many many more acquire disability. Yengene was just a piece of luck away from having the same fate.
In fact, the problem is not exclusively Ethiopian. Various documents show that over 99 percent of maternal deaths occur in less developed countries, particularly in Asia and Africa. High-quality and accessible health care has made maternal death a rare event in the developed world.
Seemingly drawing on this staggering figure, Dr. Kesetebirhan Admasu, representative of the Ministry of Health (MoH) of Ethiopia stated, in a panel discussion organised by UNFPA, WHO and International Confederation of Midwives, that reducing maternal mortality was a ‘daunting task.’
However experts such as Mrs. Dorothy Lazaro, Midwives specialist with UNFPA responded on the same occasion that countries with limited resources at their disposal such as Seychelles, Zimbabwe and Sri Lanka had managed to curb their maternal mortality rates very much. She said that these countries registered remarkable success by training their midwives instead of depending heavily on physicians and specialized obstetricians. Seychelles, according to 2007 Unicef Report, for example, has one of the lowest maternal mortality ratios in Africa of 57 per 100,000 live births. Mrs. Lazarro said, ‘Seychelles has managed to do so with only three obstetricians.”
Ethiopia trained its first group of midwives in 1953. However, the growth has been so slow that the country has been graduating an average 13 midwives each year. Only 1,275 midwives are currently functioning in the second most populous country in the continent. This in turn translates to 1 midwife for 57,960 people which is way way below the WHO standard of 1 midwife per 5,000 people.
With all this grim facts, however, there is good news as well. Sophisticated hospitals and specialized doctors are not a must. Well-trained nurses, midwives, nurse-midwives and midwife assistants can perform most functions at Basic Emergency Obstetric care (EmOC) Facilities and increase birth attendance coverage by up to 40% by 2015.
By scaling up the service sector, Ethiopia can reduce maternal mortality. But for this to happen, the nation must act now.
UNFPA Executive Director, Thoraya Obaid, said, “Putting in place the health workforce for scaling up reproductive, maternal, newborn and child health services is an urgent task, and we believe that the support of health professional organizations will be crucial.”
WHO Report of 2006 indicates that the world needs 300,000 midwives in order to achieve MDG 5. Likewise, Ethiopia needs more than 15,000 midwives right now. Doesn’t Ethiopia need more midwives now more than ever?
