Maternal health reaches crisis stage

National, Normal
Source:

The National,Wednesday 07th December 2011

DECADES of neglect, a failing health system and remote mountainous topography have created a “crisis in maternal health”, according to a government task force in Papua New Guinea.
While progress has been made since the task force released its recommendations in 2009, some 250 women are still dying for every 100,000 live births, according to a 2008 inter-agency estimate.
Maternal mortality rates in PNG doubled from 1996-2006, states the government’s most recent national health survey, which prompted the government-appointed task force to find ways to make pregnancy less deadly.
Inaccessible and ill-equipped health centres, early pregnancies, poor care and ineffective communication are among the reasons health and aid workers cite for the still-high level of maternal deaths.
In PNG, the nearest health clinic might be hours by boat, foot, or in the luckiest of circumstances, local transport from the village, Miriam Lovai, former head of the national midwife association, said.
“On the Sepik River and other rivers they (women) are floated down on rafts consisting of tied banana trees or other logs,” Lovai said.
At least four out of 10 people in parts of PNG cannot access healthcare due to distance or lack of roads, according to the task force.
Even when a woman can access trained medical care, there is still little understanding of when to seek care during childbirth, Grace Kariwiga from the UN Children’s Fund (Unicef) office in the capital, Port Moresby, said.
“The woman, the family or the husband, often delay seeking care because they don’t recognise the danger signals.
“Most give birth at home because there is a lack of money and (transport) infrastructure, so it is difficult for them to come in,” George Manapel,a Health Department representative in Goroka, Eastern Highlands, said.
Nationwide, 53% of women gave birth with a skilled birth attendant in 2006, but access to healthcare in some provinces is worse than others, noted the government task force.
To make it easier for pregnant women to seek care, it recommended transport subsidies.
It suggested expanding local solutions such as a “red card” system in the remote Trobiand Islands of Milne Bay where women in labour can display a red card on the side of the road, which obliges any car to take her to the nearest health centre.
In a recent index of health workers’ impact by the NGO Save the Children, PNG ranked in the bottom 20 of 161 surveyed countries.
Children in those countries, which all fall below the World Health Organisation (WHO) minimum threshold of just over two health workers per 1,000 people, are five times more likely to die, noted the index.
PNG had one health worker (including doctors, midwives, nurses and community health workers) for
every 1,000 residents in 2008, WHO said.
Even when health workers are available to serve a population growing at 2.7% annually, according to the most recent census in 2000, local health centres lacked resources, said Lovai.
Almost nine out of 10 people nationwide lived in rural areas at the time of the 2000 census, but the number of health staff in rural facilities declined by 25% between 1987 and 2000.