The World Health organization recommends that a skilled attendant be present at every birth. The WHO recommends lots of things but in reality it is not possible. Yes, the WHO renamed African midiwives to become “traditional birth attendants.” I am ne of those attendants the WHO is taking about. WHO strongly advocates for “skilled care at every birth” to reduce the global burden of 536 000 maternal deaths, 3 million stillbirths and 3.7 million newborn deaths(3) each year.
The WHO recommends two midwives per mother in labour. According to the WHO skilled attendance at birth remains drastically low in sub-Saharan Africa; only about 42% of the childbirths are assisted by a skilled attendant in the Africa region, some countries registering as low as 5%. This is against the target of 80% of births being assisted by a skilled attendant by 2015 if the goal of reducing maternal mortality rate by three quarters (between 1990 and 2015), is to be achieved.
In 2000, the United Nations agreed to reduce the mortality rate for children younger than five with the implementation of the Millennium Development Goals (MDGs). Achieving the health MDGs will be a major challenge but 2015 is around the corner.
The Safe Motherhood Initiative was launched at the Nairobi Safe Motherhood Conference in 1987. This is a global initiative to reduce maternal mortality in developing countries through a collaborative effort of international agencies, national governments, and nongovernmental organizations, but it is 20 years later and little progress has been made to reach that goal. In some countries, the situation has actually worsened. So where do they go wrong? In 1999 with the WHO’s guidance, many countries launched the ” Making Pregnancy Safer” initiative, aimed to reducing te burden of maternal mortality.
Several Maternal health messages have focused largely on the size of the problem of maternal mortality and its human rights dimensions. But what is wrong with the mesage. What has been missing has been clarity about the interventions that work to reduce unsafe motherhood. Too many programmes try to do too much while simultaneously failing to focus on the interventions known to be effective. Most of these programmes have included major international conferences, women’s health advocates, uplifting of health care professionals with the help of donor-funded support. Yet on the whole all these efforts have lacked conviction because there is no political will.
Political leaders are not involve or do not know what is going on, and generally not a priority either nationally or internationally. Everybody writes beautiful papers but nobody really put presure on governments to imporve education of midwves and improve access to health centres. here are very few roads in Africa and most women live in remote areas and walk for days to the nearest healthcare centre. Imagine if better training can be done for the African women by African women designed by African women. What if these traininees can be scattered around the continent to offering good antenatal care and clean safe deliveries with good access to healthcare centres.