Magnitude and Causes of Maternal Mortality in Tanzania - Essay Example

Student Name: xxxxxx Tutor: xxxxxx Title: Magnitude and causes of maternal mortality in Tanzania Institution: xxxxxx Date: xxxxxx Magnitude and causes of maternal mortality in Tanzania Over the years, maternal mortality rate has been one of the key public health problems within developing countries. According to the World Health Organization (WHO, 2008) about 500,000 mothers are dying every year due to pregnancy and complications allied to pregnancy and childbirth. The World Health Organization Partnership notes that the major direct causes of maternal death are, hemorrhage, abortion and its complications, obstructed labor, sepsis in addition to hypertensive disorders of pregnancy, more so eclampsia. All causes of maternal death can be prevented and efficient interventions are there for managing these conditions. This paper will be analyzing maternal mortality in Tanzania. Hemorrhage is the leading cause of maternal deaths in Tanzania. Basically, Tanzania has one of the highest maternal mortality ratios within sub-Saharan Africa. From the World Health Organization, a projected 13,000 women die annually within Tanzania because of complications allied to both labor and pregnancy. Additionally, more than a quarter million women encounter disabling conditions because of labor and pregnancy complications. Tanzania is ranked as 21st highest maternal mortality rate among African countries. Tanzania is one of the poorest nations globally and 75% of its population lives within rural areas. Transportation in Tanzania is spotty and health-care facilities are in most cases a long distance away from local communities and this makes it very hard for women who undergo pregnancy complications, which can consist of severe hemorrhage, infections, anemia as well as obstructed labor, in accessing skilled health care (Khan et al 2008). Lack of access to obstetric care is one of the key hindrances globally. The Tanzanian Ministry of Healthcare notes that Tanzania has maternal mortalities of 578 per 100,000 births, although the WHO puts the magnitude to be at 950 maternal mortalities per 100,000. Approximately 13,000 women in Tanzania die annually because of causes allied to pregnancy or childbirth complications. Tanzania is one of the poorest nations in the world and hence experience scarcity within numerous areas and this include health personnel, medications, medical equipment as well as infrastructure that highly contribute to maternal mortality within the country. According to New York Times (2010), an obstetrical care at a rural hospital within the country has been profiled. The obstetric care indicates efforts of reducing maternal mortality within the country but the hospital is typified with the shortage of doctors and nurses and also the hospital has shortage of professional having required expertise in performing caesarean section along with other procedures. Numerous women dying during childbirth are young and health and most maternal mortalities can be prevented with essential obstetrical care. Specifically in Tanzania, the major causes of maternal mortality in the country are high blood pressure, bleeding, infection, prolonged labor and complications due to abortions. In maternal mortality, “the three delays” is a major determinant; “the three delays” refers to the delay of the woman in going to the hospital, the time spent in travelling to the hospital and the delay of the hospital in beginning the treatment after the arrival of the woman in the hospital. Even though just about 15 percent of births have risky complications, the problems are nearly unfeasible to project, and ostensibly normal labors can fast progress into severe emergencies. This where the maternal death comes by especially if there is no or inadequate care to handle the birth or resulting complications (UNICEF 2010). In Tanzania, the main cause of maternal mortality is excessive bleeding prior to and after birth, which is known as hemorrhaging. In addition, infection and high blood pressure also cause numerous maternal mortalities. The dangers go beyond the mother to the unborn infant. In most cases, in case the mother is having complications during childbirth, it is not recognized due to lack of skills. The frequently long distances between individual’s homes and health facilities, much less a health facility having medical personnel with required skills of handling emergency surgeries or complications is one of the key weaknesses of the health system in Tanzania and this greatly leads to high maternal mortality in the country. Within the rural regions in Tanzania, it is an average of about five to ten kilometers for a person to trek to the nearby health facility. This is an overwhelming problem; take into account a pregnant woman who is at the same time in labor. The high rate of maternal mortality rate within Tanzania demonstrate the struggle of providing the required care, within the appropriate time to a population that in most cases gives birth at home and is dependent on traditional healers during childbirth. Approximately 53% of child deliveries within Tanzania are handled by unskilled individuals, whereas 47% are handled by skilled health care experts at a dispensary, health center or hospital (UNICEF 2008). Campbell, (2008) notes that delay in reaching a suitable medical facility greatly contributes to high maternal mortality within Tanzania. Major health care facilities are strategically located within Tanzania but even though accessing these facilities if hard, accessing them doesn’t necessarily imply that the expectant women are likely to receive suitable care. At times, utilizing these sits as the entry point to health care services can delay further attempts of accessing the required health care. Efforts of transferring health facilities into an entirely functional elementary obstetric emergency unit can lower the delay that results from transportation time. Additionally, delay in getting prompt and suitable care after hospital arrival contributes to high maternal mortality rate within Tanzania. In Tanzania, most of the women categorized as “near misses” are referred to another health care facility, and this highlights the necessity of differentiating between the women arriving in health in a critical condition and those developing the critical conditions while at the health care facility. Inadequacy within health care can be because of one or a chain of these events: scarcity of medical supplies, lack of equipment, shortage of trained staff, and incompetence of the available personnel. In particular, health system failures have been established as a key contributing element to maternal mortalities (Say et.al 2008). What’s more, prolonged transportation is another element that causes maternal mortality. Long distance, visiting diverse health care facilities, poor conditions of road and vehicle greatly contributes to prolonged travelling time. For example, within Mbulu district in rural Tanzania, a husband detailed that his pregnant wife had been admitted within a hospital for a fortnight and then discharged. On going back home, a distance of 85 kilometers from the hospital, she lost conscious. She was taken to a village health care and was transferred to another health facility, 20 kilometers away and then transferred to the hospital, 60 kilometers way where she spent a few hours at the hospital and died. This clearly indicates that poor transportation in Tanzania contributes to maternal mortality (Say et.al 2008). Furthermore, several maternal deaths occur in Tanzania within areas where HIV is rampant. Even if programs of preventing mother-to-child transmission of HIV have stretched out considerably within Tanzania, most expectant women within high prevalence regions do not have access to HIV testing, and the HIV status of several expectant women, leave alone those who die is not known. HIV has an effect on expectant women in numerous ways; HIV infection within expectant women increases the risk of obstetric complication, diseases allied to HIV like anemia or tuberculosis may be intensified by the pregnancy, pregnancy may raise HIV frequency or HIV progression maybe worsened by the pregnancy itself. Since the HIV incidence in Tanzania is high, this has also contributed to the maternal mortality within the country (Wojdyla 2006). According to the latest maternal mortality information collected by the government of Tanzania, 578 women died within 2006, per each 100,000 live births, and that rate has risen from 1999. On the other hand, the data from World Health Organization lists worse rating; WHO has listed the maternal mortality rate at Tanzania for 2008 at 950 for each 100,000 live births. This is in comparison to the US which has 11 maternal mortalities for each 100,000 live births within 2006, and this paints a bleaker picture of the high mortality rate within Tanzania. Further, the data indicated that for every woman who dies due to pregnancy or childbirth complication in Tanzania, an additional 20 women suffer grave or chronic health consequence (UNICEF, 2010). Generally, the age of a woman as well as parity have an effect on her chances of dying within childbirth. Health risks allied to age and parity can be classified as too young, too old, too many, too close jointly. Normally, first births and births after the fourth birth are more risky as compared to the second birth through fourth births. Lifetime risk is the likelihood that a woman will die due to pregnancy and childbirth complications. Therefore, within a high-fertility set up, a woman has the risk of maternal death multiple times, and hence the lifetime risk will be higher as compared to a low-fertility set up. A study carried out in indicated that the lifetime risk of maternal mortality within the developing countries was 1 within 120, as compared to the developed countries with about lifetime risk of 1 in 4300. Among the developing countries, women within Tanzania were found to be facing the highest lifetime risk of 1 in 31(WHO, UNICEF, UNFPA & World Bank 2010). Besides, Tanzania being a developing country chronic illnesses and malnutrition leave numerous women not being in a position to meet the physical needs of pregnancy. For instance, anemia, in most cases an outcome of poor nutrition has a negative effect of about 60 percent of pregnant women within Tanzania. In addition, malaria, sexually transmitted infections as well as infectious hepatitis also cause grave complications for numerous pregnant women and, unless treated, may result to the death of the expectant or child-bearing mother. Due to the poor status of the health care in the country, these are major contributors to the high maternal mortality rate in Tanzania. For example within the villages, there are only dispensaries and no hospitals. Therefore, for example if an expectant woman is hemorrhaging, they are transferred to a hospital, with the aim of seeking better services, but at times they die before leaving the dispensaries or at times they die on their way to the hospitals (Campbell 2008). In general, maternal mortality rate is high in Tanzania mostly because the expectant women have no or limited access to health care or due to the poor quality of health services within the health care facilities. These women die because of hemorrhage, sepsis, hypertensive disorders, unsafe abortion in addition to prolonged labor; these are complications that can be treated successfully with a health system providing skilled personnel facilities for handling emergencies when they take place and post-partum care. This gives emphasis to the significance of having skilled attendance during delivery within Tanzanian health care facilities. Research studies have indicated that about 80% of maternal mortalities could be prevented if women are successfully able to access fundamental maternity as well as fundamental health-care services (Mills 2010). Conclusion Tanzania is one of the nations with the highest maternal mortality rate, globally. Within Tanzania, maternal mortality information differs by urban to rural location. There are significantly many maternal deaths per live births. The maternal mortality rate has not declined for a long time and there has not been statistically significant decline in maternal mortality rate. The major factors leading to high maternal mortality rate in Tanzania include, many births being attended by unskilled staff because just 47% of births are handled by skilled attendants, improvements are required within health care infrastructure to make sure adequate access to health care, the status of Tanzanian women within the society limits their access to information and their autonomy over reproductive health decision making, further worsening inaccessibility to reproductive as well as other health care services and also HIV and AIDS has further increased maternal mortality in the country. Lastly, studies have indicated hemorrhage and eclampsia are the major causes of maternal mortality within the country. This illustrates the necessity of improved antenatal and obstetric care, in particular for women aged, thirty years and above, in addition to the implementation of health care delivery approaches. Bibliography Campbell, O., et al., 2008, National maternal mortality ratio in Tanzania between 1999–2008, Bull World Health Organ, MEDLINE, Vol. 83: 462-472. Mills, M., 2010, Maternal deaths drop by one-third from 1990 to 2008: a United Nations analysis, Bulletin of the World Health Organization, Article ID: BLT.10.082446. Khan, S., et al, 2008, WHO Analysis of Causes of Maternal Deaths: A Systematic Review, The Lancet, 2006 Vol. 367/ 9516.   Say, L et.al, 2008, The prevalence of stillbirths: a systematic review, Reproductive Health, Vol. 3/1. New York Times, 2010. 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