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Sierra Leone News: Maternal mortality still a huge problem

In 2009, Amnesty International called the tragic and horrendous status of maternal mortality in Sierra Leone a “human rights emergency”. ”One in eight women die in pregnancy or child birth,” said the Amnesty report in 2009.
In response to international and local pressure, the government of Sierra Leone came up with the Free Health Care Initiative, which included free healthcare for pregnant women, lactating mothers and all children under 5-years. Launched in 2010, this was an effort to address the high rate of maternal mortality and other related health issues.
In 2000, the maternal mortality rate was 2,650 deaths/100,000. In 2008, the maternal mortality rate was 1,730 deaths/100,000, according to WHO, UNICEF and the World Bank.
Maternal mortality rates were falling between 2000 and 2008. World Bank reports the maternal mortality rate dropped by 53% from 2000 to 2008. That’s substantial progress after the civil war.
The Head of Reproductive Health at the Health Ministry, said, “The rate of maternal mortality is dropping.” The Ministry has drafted a strategy to address the problems in maternal mortality rates.
Between 2011, when the maternal mortality rate was 1,580 and 2015, after the Free Healthcare Initiative, the mortality rate was 1,360. Between 2011 and 2015, the maternal mortality rate dropped by only 14%, according to a UNFPA report.
The global trend in maternal mortality, since 2000, was dramatically downward. That trend was also seen in other countries like Ghana, Guinea, Liberia and South Sudan. In Ghana in 1990, the maternal mortality rate was 634/100,000 and in 2015, the rate had dropped to 319/100,000. In Guinea in 1990, the maternal mortality rate was 1,040 and in 2015, the rate dropped to 679/100,000. In South Sudan, a country is real crisis, in 1990 the rate was 1,730 and in 2015 the rate dropped dramatically to 789/100,000.
Across the world, maternal mortality rates were dropping between 1990 and 2015.
The health status of Sierra Leoneans is still among the worst in the world. Life expectancy remains low at just 47-years. Infant and maternal mortality rates remain among the highest in the world.
In 2010, international donors came to the aid of Sierra Leone and offered hundreds of millions of dollars towards improving the healthcare system and making healthcare free for pregnant and lactating women and all children under 5-years.
According to a World Bank report, donors, including the World Bank, DIFID, African Development Bank, Global Fund invested $10-25 million USD per year for five years into the Free Health Care Initiative. DFID spent $40 million USD on reproductive health in 2010-2012. DFID also gave €3.2 million Euros for FHCI drugs and 12 million on workers salaries. The Global Fund also gave $45 million USD towards the initiative. This is a small sample of the millions of dollars and Euros that went into the Free Healthcare Initiative.
HEART report, “Sierra Leone Free Healthcare Financing Implications”, in June 2016, identified overall spending on health to be Le816 billion in 2004. In 2009, healthcare spending increased to Le1,444 billion. However, in 2012-13, government spending dropped.
The introduction of the free healthcare initiative made no difference in the declining trends in maternal mortality. In fact, the rate at which the maternal mortality rate was declining slowed down after 2010.
The ratios of maternal mortality, according to World Bank report, indicates a steady decline but the introduction of the Free Health Care Initiative has made little or no difference in addressing the rates of maternal mortality.
The trend in maternal mortality has being fluctuating and reproductive, maternal and newborn health remain poor, says Elizabeth Gay, UN Women consultant, while engaging stakeholders at the Radisson Blu Hotel, last week.
Gay continued that despite substantial declines in maternal mortality, West Africa still has an alarming rate pointing out the prevalence of pregnancies among adolescent.
By Sylvia Villa
Tuesday May 09, 2017.

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