WUNRN
MOROCCO - PROGRESS IN REDUCING
MATERNAL MORTALITY
By Juhie Bhatia - WeNews Managing Editor - July 23, 2012
Morocco is on target to be one
of the few countries to meet the U.N.'s goal of lowering maternal mortality by
2015, in part thanks to a strong Peace Corps program and smaller
Pregnant Sookaina Boudraa waits for her turn at
CASABLANCA, RABAT, Morocco (WOMENSENEWS)--Sookaina
Boudraa had been waiting for three hours at the Alwaha health clinic in Sidi
Moumen, an area in northeastern Casablanca known for its slums.
Seven months pregnant, she sat patiently, wearing a brown
djellaba, a long robe with a hood, embroidered in orange and a matching orange
hijab to cover her hair. About 10 other women sat alongside Boudraa in the blue
and white waiting area outside the nurse's examination room. She was expecting
the birth of her first child.
Across the street from the clinic lies one of the area's
many slums, where Boudraa lives. That afternoon kids played in a dirt field in
front of the shanty town's entrance, strewn with garbage and rocks, kicking
more dirt into the already dusty air. Cows ate out of a dumpster, while donkeys
and roosters roamed the field. Makeshift homes, connected with zigzagging
clothes lines, were in the background. Satellite dishes protruded from many of
the tin roofs.
Boudraa was at the clinic to get a vaccine, although she
couldn't say for what. All she knew was that it was supposed to keep her
healthy for her pregnancy, during which time she'd regularly visited a doctor.
She hoped a nurse would see her in 30 minutes.
Seventeen-year-old Boudraa is among the fortunate women
benefiting from her nation's commitment to lowering the number of women who die
in childbirth.
By 2010
This progress means
Lagging Progress
Credit: latigi on Flickr,
under Creative Commons (CC BY-NC-SA 2.0).
For all its progress, however, the country is still far
behind industrialized nations. In
As she waited for the nurse, Boudraa shyly said she'd
heard from those in the neighborhood that women could die if a pregnancy goes
wrong at home. So even though she was born at home, along with three of her
four siblings, Boudraa was making a different choice. She planned to give birth
in a hospital, about a 15-minute taxi ride away.
Fatima Moukaby, one of the four nurses at the 5-year-old
Alwaha clinic, has been working in the field for 21 years and said she's seen a
big shift in line with Boudraa's decisions.
"When I started my job we received few pregnant
women because women were giving birth at home, but now we receive too many
pregnant women," said Moukaby. The clinic's three doctors each see at
least 80 patients a day, she added.
Jean-Benoît Manhes, UNICEF's deputy representative in
"There's a general will to improve maternal health
from the government which does not exist in other countries I've worked
in," said Manhes. "It's an issue of public health and pride."
The effort has included about $157 million (1.4 billion
dirham) in government spending for 2008-2012 on a three-prong strategy of
improved access to care, improving the quality of care and program governance.
That has encompassed disseminating and publicizing pregnancy-related care
information, training midwives and other health workers and expanding and
improving health care facilities and vehicles.
"The most important [thing] is making [obstetric care] free, including
transfusions, C-sections, transportation, all the tests, the delivery, etc., as
it has allowed women to come into the hospital, especially the poor," said
Dr. Abdelghani Drhimeur, head of communications at the Ministry of Health in
Rabat.
Peace Corps Contributions
The country's campaign has also benefited from the
longstanding presence of Peace Corps volunteers, who have been supporting
maternal-related health care here since 1992, said Mostafa Lamqaddam, the
Corps' health program manager in
Volunteers organize trainings for traditional birth
attendants and educate local women about such things as vaccinations, family
planning and healthy pregnancies. They target understaffed, underequipped and
hard to access parts of the country.
The Peace Corps recently shifted its focus in
"Definitely volunteers feel it will leave a
void," said Lamqaddam. "Some associations and Moroccan
nongovernmental organizations have started work in this area, but it's not the
exact same thing. Nobody is doing this work at the grassroots level. But the
need is still out there."
The government has also trained and deployed health
workers. The proportion of births attended by skilled personnel rose to 83
percent in 2009 from 61 percent in 2004, according to the Ministry of
Health/U.N. report.
Menana Boukalouch is a midwife of 30 years who heads the
nursing department at Maternité Des Orangers, a university hospital in
"Midwives do 80 percent of the deliveries. Doctors don't get involved
in normal deliveries, unless there are complications," she said.
"There are doctors, but they don't go into the rural areas. Midwives can
go to rural areas or cities. It's better to have a big number [of midwives] as
they take better care of women from the beginning to end."
Smaller Families Desired
Down the hall from Boukalouch's office, Naima Abit sat
calmly on a hospital bed waiting for her turn in the delivery room. The
29-year-old wore a brown and yellow housedress and solid red henna adorned her
hands and feet; it was for good luck with her delivery, she said. Her water had
broken, but she didn't yet feel any labor pains. Across the room another
expectant mother, Hayat, walked around and winced regularly with contractions.
Abit said none of her friends or family had given birth
at home. Many gave birth in private hospitals, which often have a better
reputation than public facilities, just to be safe. This was her first baby, a
boy. She wanted two or three children at most; most of her friends had one or
two.
Her desire for smaller families reflects a trend in many
parts of
"
To continue to encourage safe motherhood, Ministry of
Health spokesperson Drhimeur said, the government is creating new maternal
health programs. And while
"The Moroccan experience is unique; what we've done
in three years regarding maternal health efforts was not done in the 30 years
before. It's a big effort, a revolution. But a lot has to be done still,"
Drhimeur said.