The alarming state of maternal health in the region merits attention
The birth of a baby is a momentous occasion for families, and policymakers should strive to make it a positive experience throughout the pregnancy, childbirth and postnatal stages. A growing body of evidence is advocating for a suite of services and interventions across the continuum of care to ensure mothers and babies attain an optimal level of physical and emotional well-being during this delicate period. Research has demonstrated that by supporting mothers, children can reap a multitude of lifelong benefits that maximize their well-being, education and health.
Maternal and child health is considered a priority public health issue in the Middle East and North Africa region. Thanks to the diligent efforts of maternal health advocates, the MENA region witnessed remarkable progress with regard to its maternal health goals, with maternal mortality rates reduced by 56 percent and under-5 mortality rates by 63 percent between 1990 and 2015, according to a World Bank report.
Despite this significant progress, however, a World Health Organization report published last year sheds light on the tragedies still facing mothers and children in the region, with some countries facing more significant challenges than others. The MENA region has the second highest rates of maternal mortality in the world, with 70 percent of these deaths owing to preventable causes. A number of factors contribute to these preventable deaths in the form of pregnancy or delivery-related complications, such as hemorrhage, hypertensive disorders, maternal sepsis and other infections, obstructed labor and abortive outcomes. With half of the Arab population living in rural regions, mothers face substantial challenges, such as limited access to prenatal and postnatal care services or having to undergo procedures out-of-hospital with no attendance by skilled health workers.
Another report published by the UN Population Fund and the League of Arab States indicates that one child out of every 40 children in the Arab region dies in the first year of life from preventable reasons, such as lack of access to healthcare services, poor nutrition and sanitation and unsafe drinking water. Also, 21 percent of births lack the help of a skilled birth attendant, while 17 percent of births receive no follow-up by professionals.
There are numerous potential policy pathways to advance maternal and child health goals in the region and remedy some of these preventable causes of death. Health departments in various countries should invest in high-quality data on maternal and child health outcomes in order to monitor performance and formulate timely solutions. Data will also shed light on much-needed areas of improvement or deficiencies within the care system in order to channel appropriate workforces, equipment, facilities and resources according to different geographical locations.
Healthcare facilities should be upgraded with world-class obstetric units that offer a range of maternal and child health services. Hiring specialized obstetric health workers and continuously training them in the latest evidence-based interventions will also ensure risk factors are mitigated. A sound prenatal care plan should include periodic appointments to conduct ultrasound scans and screening tests that examine the health of both mother and baby and detect any possible diseases or abnormalities. It should also provide expectant mothers with important advice on healthy diets, exercise and labor options. Postnatal care plans should include a general examination of mental and physical health, screening and care for postpartum depression, infant hearing screening, newborn physical examinations and general baby care.
On this note, it is also advantageous to hire skilled midwives, who will be instrumental in providing postpartum care for mothers and guiding them in caring for themselves and their infants. Home-visiting services by midwives can also remedy some challenges related to accessing healthcare facilities during the sensitive postpartum period in rural areas where healthcare facilities are not present. It is imperative to offer universal health coverage for mothers and children as a fundamental right to health and well-being. In a similar vein, mothers and children need to have equitable access to healthcare facilities, no matter their geographical locations.
Partnering with world-class universities and research centers to pave the way for cutting-edge technologies and equipment will empower health workers to rely on the latest innovations and interventions when providing obstetric and child health services. Moreover, investing in research on maternal and child health in the region will also expand the repertoire of evidence-based solutions and help improve overall outcomes in this area. Recently, Singapore’s Integrated Maternal and Child Health Wellness Hub was launched in SingHealth Polyclinics, integrating the latest research in this area to provide a range of services for mothers and children, such as developmental screening, growth monitoring, nutrition advice, lactation support, parenting education and maternal emotional health intervention — with impressive results for the community.
In a broader context, it is also important to highlight other factors that can affect maternal health outcomes. For instance, maternal stress related to financial insecurity can have a notable effect on physical and mental well-being. Therefore, improving the economic security of families via employment opportunities and social protection schemes will ensure that mothers and children can have their fundamental needs met, such as nutritious food, appropriate housing and health services. Moreover, enhancing community design with green spaces, walking routes and overall safety can also improve maternal health outcomes. In this regard, it is also advantageous to engage community advocates, civil society organizations and media outlets to promote public health education programs on maternal and child health.
Moving forward, the MENA region can make meaningful progress in the area of maternal and child health with the implementation of a multifaceted policy approach that tackles fundamental gaps in healthcare systems. Considering the current alarming situation of maternal health in the region, policy change is required without delay.
Published in Arab News.
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