Too many deaths show lack of govt support

DISTURBING figures were released last week showing Papua New Guinea as having the lowest number of skilled birth attendants and needing 6000 more to meet global standard.
And a 2019 maternal and newborn health task force report says high maternal and newborn mortality in the country is partly the result of the country not having enough midwives or skilled birth attendants.
The report adds there were so many factors contributing to 2000 women dying yearly during pregnancy or after giving birth, which is one of the highest rates in the world.
The numbers are shocking.
PNG has insufficient midwives or skilled health workers to assist an estimated 1.8 million reproductive-aged women who give birth to approximately 220,000 babies every year. Only around half of these births occur in the formal health system.
And so we ask why the numbers are high.
Although it is a complex issue, the primary obstacles to reducing maternal mortality in PNG include the inaccessibility of adequate maternal healthcare facilities and the lack of socio-cultural awareness of the difficulties women endure during pregnancy and childbirth.
One of the most devastating facts about maternal mortality rates is that the majority of deaths can be prevented.
One can better understand the reduction in maternal mortality in all locations if one focuses on the major causes of maternal death and the interventions used to reduce mortality from those causes.
University of PNG Medical School’s Professor Dr Glen Mola, speaking at the task force consultative workshop, said midwifery training schools have increased to five and 394 new midwives were educated between 2012 -2015 but “more needs to be done, including up-skilling community health workers and nurses around the country”.
Mola said midwifery was included in the health workers’ training curriculum, but institutes lack the capacity to train enough because of poor government support.
Our partners are ready to assist training and up-skilling whatever resources we have and they require 100 per cent government commitment. For example, deaths from sepsis – a serious condition resulting from the presence of harmful microorganisms in the blood – have been reduced by the prevention of infection through the increased use of sterile fields for delivery, hand-washing, and the use of sterile gloves.
Then we have haemorrhage (an escape of blood from a ruptured blood vessel) which is often complicated by pre-existing anemia (a condition in which there is a deficiency of red cells or of haemoglobin in the blood, resulting in pallor and weariness) which is a major killer of pregnant women.
Challenges in medicine and equipment supply, the availability of infrastructure and antenatal and family planning contributes to this.
These deaths were mainly caused by the rapid loss of blood (haemorrhages), sepsis or infections and high blood pressure.
The deaths of newborn infants were often due to the lack of quality care around delivery leading to infection and loss of consciousness due to interruption in breathing.
Supervised deliveries by health professionals reduce the risk of the mother or baby dying.
To effectively reduce maternal mortality in any location, the circumstances under which pregnant women are dying and the proportion of those deaths that are avoidable should be known.
It seems there is slight understanding of the role of midwives. The common expectation is that all health workers have the necessary skills to manage childbirth – that anyone can deliver a baby.
From our readings, not all health workers have the necessary skills or knowledge to manage complications, especially when it comes to dealing with mothers during delivery which has led to some mothers dying.
We concur with Dr Mola that the government should support midwifery education to improve maternal and neonatal health in the country. And the support should include scholarships to help nurses become midwives, capacity building and assistance to improve the standard of midwifery teaching and practice.