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How has Ghana fared in attaining MDGs 4 and 5?

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MotherandchildSome health personnel are refusing postings to areas where their presence could help save lives and hinterlands in the Bunkpurugu-Yunyoo District of the Northern Region are no exception.

The reasons are quite simple. The facilities are not there to save the lives of pregnant women and their fragile unborn babies.

Ms Dennia Gayle, Immediate Past Deputy Country Representative of UNFPA, diagnosed the problem with the explanation that the geographical distribution of health workers like midwives and nurses in the country could be a major contribution to the increasing maternal mortality rate.

She says the unfavourable conditions at some health posts have become a hindrance for health personnel most of whom refuse to be posted to such facilities.

“However we can do things like deciding to prioritize making investment in ensuring that women deliver in safe health facilities to secure their lives and that of their babies”, Ms Gayle said.

Speaking at a media engagement on the Sustainable Development Goals (SDGs) for members of the Media and Communications Advocacy Network (MCAN) in Accra, Ms Gyale said there is the need for stakeholders in the health sector, to put resources together to reduce the rate of maternal mortality.

MCAN, is a UNFPA supported voluntary association of individual media practitioners and communications workers, interested in promoting and advocating population and development towards the promotion of reproductive health.

Giving the overview of the SDGS, Ms Gayle stated that since many countries including Ghana could not achieve all the eight MDGs, particularly, the health related goals ; there is the urgency, plus more ambitious plans to ensure the attainment of the objective.

The SDGS adopted globally has 17 goals with 160 targets comprising various socio-economic programmes and activities agreed upon for implementation to improve the living standards of people, especially the marginalised and the vulnerable members of the society within the next 15 years.

Among the various indicators, the SDGs indicator 3.7 states that by 2030, all countries should ensure universal access to sexual and reproductive healthcare services, including family planning, information and education, and the integration of reproductive health into national strategies and programmes.

It is truism that Ghana, like many other countries has been unsuccessful in achieving MDGs 4 and 5, which are: “Reducing Child Mortality (under-five mortality rate) by two-thirds, from 1990 to 2015; and “Improving Maternal Health by reducing the maternal mortality ratio) by three-quarters, from 1990 to 2015.”

Statistics shows that in 2010, Ghana’s maternal mortality ratio (MMR) was 350 maternal deaths per 100,000 live births contrary to the MDGs requirement that indicated that countries should reduce maternal mortality to145 cases per 100,000 live births by close of 2015.

According to the “Trends in Maternal Mortality: 1990 to 2013” a report released  in 2014 by the Maternal Mortality Estimation Inter-Agency Group (MMEIG) of the United Nations, MMR in Ghana has declined by 49 per cent from 1990 to 2013.

The report is an analysis by the United Nations agencies, led by MMEIG, which comprises the World Health Organisation (WHO), the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), the United Nations Population Division and the World Bank, together with a team at the National University of Singapore and University of California at Berkeley.

It indicated that while Ghana’s MMR has reduced from 760 in 1990 to 380 in 2013, reflecting a decline in MMR by 49 per cent between the same period, there remains a substantial amount of effort to reach the MDG 5 target of 185 deaths per 100,000 live births.

The report estimated that 3,100 women died from pregnancy related complications in Ghana from January to December 2013. These are deaths of women which resulted from maternal related complications.

A MMR is the annual number of female deaths per 100,000 live births from any cause related to or aggravated by pregnancy or it management excluding accidental or incidental causes.

The MMR includes deaths during pregnancy, childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, for a specified year. (Source: CIA World Factbook).

Globally, maternal mortality has reduced by 45 per cent from 1990 to 2013. In 2013 an estimated 289,000 women died due to complications in pregnancy and childbirth; down from 523,000 in 1990.

The MMEIG report, seventh in the series, said Sub-Saharan Africa is still the riskiest region in the world for dying of complications in pregnancy and childbirth. The region has the highest MMR (510), accounting for 62 per cent (179,000) of global maternal deaths.

However, Ghana is also considered as one of the countries in Sub-Saharan Africa “making progress” towards the MDG 5 target.

From 2007 to 2012, Ghana reported maternal mortality ratio of 450 deaths per 100,000 live births (this figure was estimated at 350 deaths per 100,000 by UN agencies/World Bank in 2010).

As Ghana’s maternal mortality rate is three times higher than the given target, it is unlikely to achieve MDG 5 by 2015, some experts have argued.

The MDG also stipulates that 100 per cent of births must be attended by a skilled health professional, but from 2007 to 2011, the figure stood at 68 per cent, an indication that more work needs to be done.

To achieve the targets for the reduction of child mortality, (MDG 4), Ghana should reduce under-five deaths per 1,000 live births to 43, and increase measles immunisation to 100 per cent by 2015.

In 2012 under-five mortality stood at 72 deaths per 1,000 live births, and measles immunisation at 98 per cent.

From the look of things, Ghana has not fared too bad in attaining MDG 4 and 5 but the country needs effective health systems that respond to the health needs of mothers and children.

The efforts, which Ghana put in place to ensure that it attained the MDG targets of halving poverty and providing potable water for people without access to safe drinking water well ahead of time, as announced at the launch of the 2015 MDG Report in Accra, is commendable.

The country therefore need to put in the same zeal, while amassing the support of  development partners like the UNFPA, USAID and DFID, and civil society organisations, who have demonstrated commitment towards the development of the nation in meeting the socio-economic needs of Ghanaians.

Ms Christine Evans-Klock, the United Nations Resident Coordinator in Ghana, one of the personalities who have also parted Ghana on its back for making progress has asked the Ghanaian government to change its strategy during the post-2015 era to fast-track progress on health-related goals.

Health experts are calling for full implementation of the commitment of Ghana to double the number of Community-based Health Planning and Services (CHPS) compounds from 1600 to about 3200 to meet the needs of under-served rural communities.

Such experts have argued that government should prioritise primary health care within the context of the CHPS initiatives focusing on prevention and health promotion programmes.

Government is also being urged, to help address the chronic problem of delays in the disbursement of funds to the Health Ministry and its agencies to make the health budget relevant to improving the health status of every child, mother and all citizens.

Urgent action is surely needed to address the situation in the face of a world vision recent report that disclosed that more children and mothers are likely to die from preventable diseases such as malaria, diarrhoea and pneumonia if government fails to invest more into health service delivery, particularly in primary health care.

Dr Gloria Quansah Asare, Deputy Director General of Ghana Health Service, said achieving positive results in maternal and child health demands a multi-sectoral approach that remains favourable to achieving the MDG 4 and 5.

As a matter of necessity, Ghana should do  all it could to sustain the gains of the MDGs 4 and 5 even as 2015 closes to help in the sustenance of mothers and their babies for posterity.

Ms Gayle has noted that attaining the SDGs should be a national priority through the mobilisation of stakeholders and resources towards common goals.

“This is beyond health, this is about development and economic prosperity,” she said.

“Strong principle on ‘equity’ that cuts across almost 75 per cent of the SDGs means that all countries; not only the poor countries, should work to improve the lots of women, children and men everywhere by 2030,” Ms Gayle said.

By Lydia Asamoah

Source: GNA

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