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CAMEROON - CHALLENGES TO REDUCE MATERNAL MORTALITY

 

By Chi Yvonne Leina - WeNews correspondent - June 5, 2011

BAMENDA, Cameroon (WOMENSENEWS)--Ngwa Amos, who earns a living by taxiing people from town to town on his motorbike, is now a single father of four.

His wife died in labor on a recent morning at the Bamenda General Hospital in northwestern Cameroon.

He says the hospital staff asked him to go and bring money for his wife to be operated on because she needed a Caesarian section. He spent two hours searching for money to borrow for the operation, he says.

The midwife in charge of the delivery says the baby couldn't be born normally because it was breech, or feet-first, in the birth canal. Neither Amos nor his wife knew this because they couldn't afford antenatal care for the last three months of the pregnancy. The couple also couldn't afford a Caesarian section.

Bih Sylvia, a nurse at the hospital, says the hospital has incurred enormous losses in the past for taking on emergency cases without payment so patients are obliged to pay upfront.

When Amos returned to the hospital, he could no longer hear sounds of his wife in labor.

"I thought the baby had been born," he says. "I am shocked to be informed now that she and the baby passed away 30 minutes ago."

The African Union, along with government and nongovernmental organizations, have pledged to reduce maternal deaths in this region, but Cameroon is moving further from that goal.

Global Goal of Fewer Deaths

Goal No. 5 of the Millennium Development Goals – a U.N. initiative agreed to by countries around the world – aims to reduce maternal deaths by 75 percent by 2015.

Cameroon's maternal mortality rate was 550 deaths for every 100,000 births in 1990 – the reference year for the goals. Since then, the key figure has risen to 1,000 deaths, according to the latest U.N. statistics.

About 9,000 women die during childbirth every year in Cameroon, the Ministry of Public Health reported in 2010.

Amid the worsening outlook for pregnant women, health officials say they are determined to curb the number of women who die during childbirth before 2015.

They say the government is training and employing more health personnel and improving the working conditions of those already working in the industry in order to meet this goal.

The African Union launched in 2009 the Campaign on Accelerated Reduction of Maternal Mortality in Africa, which Cameroon's government launched on a national scale last year.

Cameroon has also increased its budgetary allocation to health care to about 5.6 percent, but that's still far below the 15-percent minimum agreed to by African Union members in a 2001 declaration.

Eighty percent of maternal deaths are preventable and could be avoided with access to essential maternity and basic health care services, according to UNICEF.

Cameroon's government attributes its maternal mortality problem to the absence of adequate maternal care before, during and after pregnancy.

One reason for this absence is poverty, as many families can't afford to pay for the care they need. More than 30 percent of the population lives below the international poverty line of $1.25 per day, according to UNICEF.

Skilled Birth Attendants Lacking

Another reason is the lack of skilled birth attendants. A global forum earlier this year named the critical shortage of skilled health personnel in the world a major obstacle to meeting the Millennium Development Goals by 2015.

About 63 percent of births are assisted by skilled attendants in Cameroon, according to UNICEF. This percentage is high compared with other countries, says a regional health official, but attendants are hobbled by a lack of equipment and low pay.

Health facilities are particularly scarce in rural areas, making it not uncommon for babies to be born on the side of the road.

Janine Ngum, 23, says this happened to her.

"I had my first baby by the roadside as I was trekking to the health center, and the second was almost born the same way," she says.

Now pregnant with her third child, Ngum says she is determined to deliver in a health center.

"For this third baby, I plan to go the health center three days before the due date and wait," she says.

Ngum says she goes for antenatal consultation the last Wednesday of every month at a health center two hours away. To reach it by 9 a.m., she wakes up at 5 a.m. to fetch water for her household, cook the day's meal and prepare her children for school. She starts the two-hour trek to the clinic at 7 a.m.

"It is very strenuous for me, but I must attend [the] clinic so that I will have no problem when I want to deliver my baby," she says.

Fomuso Mary, a retired family planning expert at the Bamenda General Hospital, says very few married women use family planning methods.

"Most of the women are still very skeptical about the idea, and so child spacing continues to pose a challenge to childbearing women," she says.

Less than 30 percent of women in Cameroon between 14 to 49 who are in unions with men use contraceptives, according to UNICEF's latest statistics.