Maternal mortality rate questionable

IT is a slap in the face of many hard working Papua New Guineans who have devoted time and energy to work aggressively and restlessly to im­prove the health of our women only to learn we still have a high maternal mortality rate.
The causes of maternal deaths are not new and that those of us who commit our lives to the call, duty and cause of restoring and upholding women health in this country, we do so with the purpose of one common and noble goal, that is, to prevent mothers from dying from pregnancy, delivery and complications of pregnancy and delivery.
But again we do so under extreme conditions.
Worldwide, more than 600,000 or so mothers die each year from pregnancy and pregnancy-related complications.
On the maternal death clock, every minute there is one mother dying somewhere in the world.
More than 96% of these deaths occur in the less fortunate and impo­verished countries of the developing and underdeveloped countries, including ours.
In PNG, the 1996 national demographic survey showed that the maternal mortality ratio (MMR) was 370 per 100,000 live deliveries.
I am, therefore, amazed as to how the 2006 MMR figures of 773 per 100,000 live deliveries came about, and was circulated.
I, for one, question the credibility of this figure.
As one of the care providers, I have devoted to not preserving the health of women in PNG only but also worked tirelessly like my other colleagues and peer health workers across the nation.
From the audits I conducted at Goroka Base Hospital, Wewak, Port Moresby and Mt Hagen general hospitals, the statistics are better and superior and reflected well with our efforts and on-going commitment to preserving and improving the health of PNG women.
To show the discrepancy, the audit I did at Mt Hagen GH for 2006, the MMR was 26.6 per 100,000.
In 2007, it was 17.3 per 100,000 and in 2008, 8.2 per 100,000 live deliveries.
In 2008, we had three deaths related to pregnancy at the hospital.
Two maternal deaths were death on arrival as the ambulances that brought these mothers came from the rural health centres in Western Highlands.
The MMR audit for Mt Hagen GH clearly showed we are equal or better than the MMR in the tertiary Australian hospitals or some of the hospitals in the developed and industrialised nations.
What one should appreciate is that in provinces like WHP, EHP and Chimbu, the transport network and health centres or aid posts are interlinked as it depends on how fast an ambulance is able to reach the provincial hospitals.
The MMR audit of Mt Hagen GH is good reflection of the performance of the general health service in the province.
This is because any complications in the periphery are usually brought to the hospital because of the availability of ambulance at each health centre.
This is a crude but realistic evaluation of the MMR of WHP.
My other professional colleagues who are involved directly in the promotion and restoration of women health have the prerogative and are at liberty to do so as to the originality and patency of MMR of 773 per 100,000.
I am very sure that the provincial hospitals in PNG has MMR far better than what is reported as 773 and this has been the reflection of the input to the women health at the provincial hospital, which is more or less as a crude measure of the MMR of the provinces.
It is imperative that there is a proper audit as to how the MMR of 773 came about and who actually provided this audited figure for the country.
I am saying this because I have not seen any officer performing audits at the hospital and health centres.
Therefore, the credibility of their work is questionable.
The national MMR rate for PNG should be somewhere between 100 and 150 per 100,000 live deliveries, better than the 773 per 100,000 when we take into consideration the dilution factors of the worst MMR of certain pro­vinces particular Gulf, Western, Northern, East and West Sepiks, Central and Milne Bay.
Somebody has to clear up this ambiguity for the sake of national interest and pride.

Dr Samuel Maima
Via email