Examining Maternal Mortality in Sub-Saharan Africa
I am working on a project for maternal health at the World Bank in Washington, D.C. I developed this project to try and find an answer to the question of why maternal mortality remains high in sub-Saharan Africa in spite of high rates of maternal health care utilization. In certain countries of Africa, the majority of women seek antenatal care during pregnancy and deliver in health facilities. Yet maternal mortality in Africa is higher than in any other region of the world, including South Asia, where maternal health care utilization is much lower.
On a recent trip to Malawi, I visited the home of Violet Chamba, a 20-year-old woman who had recently died in childbirth. Her unborn child died, too. In a conversation with her mother, who had lost two daughters, including Violet, to pregnancy-related causes, we learned that Violet had a normal full-term pregnancy. She never intended to deliver at home or with the help of a traditional birth attendant. She walked to the health center when the labor pains started, but could not get proper medical assistance to deliver there. After being kept waiting for four hours for an ambulance that was busy elsewhere, she was taken to the district hospital, where she died within an hour. No one in her family knew why, as she did not experience any complications during pregnancy or up until she was ready to deliver. Her tragic story highlights the ways in which the health system may be failing to prevent unnecessary deaths and save women's lives.
Based on the premise that the quality of services at health facilities may affect maternal mortality, we are conducting a survey of health facilities in three countries, including Eritrea, Malawi and Niger. The data will provide insights into the quality of care provision for maternal health services and suggest approaches for strengthening health systems for reducing maternal mortality.
Mona Sharan currently works with the World Bank on a research study on maternal health in sub-Saharan Africa, and she has worked in programs and research for reproductive and child health in South Asia.
