Modifying old tradition towards reducing maternal mortality
Mr Sulemana Imoro, 45, is an opinion leader at Bagurugu in the Karaga District of the Northern Region.
He is dedicated to working towards the modification of an old traditional practice called ‘Pa Prigibu,’ which forbid first time pregnant women from accessing Antenatal Care (ANC) service.
Mr Imoro, who is a leading member of a new initiative known as “Male Maternal Champion’s” (MMC) role, is to sensitise other men to ensure safety of women and children.
The members of MMC in the community formed early this year comprise five elderly men.
Mr Imoro told Ghana News Agency that, together with four other elders, they are working tirelessly to ensure that the old tradition does not prevent young women from accessing antenatal care.
He said a traditional rite is often performed for every young lady who is pregnant for the first time. Within the first six months of the pregnancy if the rite is not performed to announce the pregnancy the expectant woman cannot attend ANC.
“Although communities have a different method of performing the rite, the similarity is that, a day is set by the families of the couple, during which a special meal is prepared for the pregnant woman. The family members and friends dine together and pray for the successful delivery of the expectant mother,” he explained.
The reason for the long held tradition he said, is to confirm the pregnancy and also prepare the lady physically, emotional and psychologically towards motherhood.
“I accepted to be an ambassador of MMC due to the numerous health benefits, which the community stand to gain such as reducing maternal and child mortality and improvement in the general health status of members in the community,” Mr Imoro emphasised.
The MMC is under a project, dubbed: “Live Births: Smiling Mothers Project,” a brainchild of the Northern Sector Action on Awareness Centre (NORSAAC), a Tamale-based gender and reproductive health advocacy organisation.
It is being implemented in 24 communities located in four districts of the region, namely Sagnarigu, Gusheigu, Karaga and Tolon with funding support from STAR Ghana, a multi donor pooled organisation.
The two-year project seeks to use the MMC’s in each project area to convince men to assist their wives to access antennal and postnatal care services, as well deliver in health facilities instead of relying on untrained birth assistants.
Mr Alhassan Mohammed Awal, Director of NORSAAC explained that a baseline survey conducted in six of the project communities revealed that the involvement of men in maternal related issues is high in urban areas and low in rural areas.
“We realised that we cannot make progress in reducing maternal mortality if we do not get the men involved because they play a critical role in the decision making process in their homes and communities.
“So if the men appreciate how important it is for their pregnant wives to visit the hospital regularly, they would take the lead in ensuring that their wives do as required,” he said.
Mr Awal said MMCs are to be supported by community health teams to carry out their activities and also keep proper records of antenatal, delivery and postnatal care activities within the community.
The Regional Health Directorate indicates that the region recorded 112 maternal deaths in 2008, 111 in 2009, 97 in 2010, 131 in 2011 and 250 in 2012.
Dr Akwasi Twumasi, Regional Health Director, said the figure is likely to increase in 2013 if the two key challenges of socio-cultural practice and the road network in the area are not addressed.
“Majority of the deaths are due to excessive bleeding as a result of late arrival of patients…the roads are bad, cars do not ply on these routes and ambulances also spend long hours struggling on the difficult terrain to get to referral health facilities.
“It is culturally acceptable for most men to ask their wives to go to their mothers in the village to give birth without thinking about the woman’s inability to access quality health care and may risk losing her life in case of complications,” he said.
Maternal mortality is a global challenge as statistics from the United Nations indicates that each year, more than 350,000 women in the developing world aged 15-49 die of pregnancy and child-birth related complications. About 2.6 million children are stillborn, and a further 8.1 million die before their fifth birthday, including 3.3 million babies in the first month of life.
Asia and sub-Saharan Africa accounts for 87 per cent (313,000) of global maternal deaths. A woman’s lifetime risk of dying from pregnancy is one in 3700 in North America as compared to 1 in 16 in Africa, according to World Health Organisation.
Ghana is lagging behind in attaining the Millennium Development Goals four and five. This target is aimed at reducing child mortality and improving maternal health.
A recent Ghana Health Service report shows that the country recorded 1,022 maternal deaths in 2011, representing 173 deaths per 100,000 live births, which is an increase from 166 per 100,000 live births in 2010.
Despite the drop from 540 per 100 000 live births in 2000 to 173 per 100 000 live births in 2011, Ghana is unlikely to attain Millennium Development Goal 5 by three quarters in 2015. Hemorrhage, pre-eclampsia, eclampsia and complications of unsafe abortions were among the causes of the deaths, and still births, which accounted for two per cent of all births, recorded in 2011.
The report also indicated that while antenatal care is nearing universal coverage, skilled attendance at delivery, post-natal care, nutrition services, including breastfeeding, appropriate complimentary feeding for infants and young children, appropriate nutrition, particularly for pregnant women and children needs to be addressed.
Madam Faiza Sulemana the third wife of Imoro who expressed joy about the new initiative was quick to add that government should complement the plan by supporting the community with logistics to set up a delivery ward at the health facility, which was built by the community.
“To date we still patronise the service of the traditional birth attendants to deliver. Some women die in case of complications during birth because we have to carry them on motor tricycle to travel about 80 kilometres on un-tarred road to receive care at the Savelugu District hospital,” she said.
Madam Sulemana said the health facility with its limited staff and resource could treat basic ailments such as malaria, headache, cold and cough as well as offers services such as antenatal and post-natal.
Madam Sulemana could not have asked for more, this is because to demonstrate the community’s preparedness to fight the maternal war and improve general healthcare they raised funds to build the structure.
All they need is for government to either build a road to connect the community to Savelugu or support the people with logistics and personnel to set up a delivery ward.
Stakeholders have a role to play lets act now.
By Albert Oppong-Ansah