A REVIEW of the records in the Western Region showed that over a three-year period, that is, from 2006 to 2008, only 36 per cent of deliveries were conducted by skilled attendants in health institutions and that a total of 3,617 stillbirths were registered.
During the same period, a total of 332 maternal deaths were recorded, giving a maternal mortality rate of 260 per 100,000 live births for 2008; a reduction from 390 per 100,000 live births for 2008 and 341 per 100,000 live births for 2007.
Responding to the huge number of maternal deaths and stillbirths recorded annually in the region, the Regional Directorate of Health Services initiated a Promote Maternal Infant Survival Excellence (PROMISE) conference in 2009 to draw the attention of service providers and other stakeholders to the magnitude of new-born deaths, which had for a long time gone uncounted.
As a result of this intervention, maternal deaths reduced from 99 in 2008 to 79 in 2009.
The goal of PROMISE is to save the lives of women, new-borns and children, and to provide an opportunity for health care managers, policy makers, politicians, health service providers, civil society and the general population to critically examine the systems for delivering care to the pregnant woman and the new-born.
It is also an opportunity for the involvement of all in the development of strategies to implement known cost-effective interventions that would help to reduce maternal and new-born deaths.
PROMISE will give opportunities to mothers and new-borns to survive, irrespective of whether they lived in the Western Region or beyond.
The mission of the project is to promote the survival of pregnant women and new-borns through critical analysis of maternal, new-born, child care reports, resource mobilisation, development of appropriate interventions to address gaps and to conduct research into maternal, new-born and child health issues.
In addition, it has a vision to become an advocate and resource centre of excellence for maternal, new-born and child survival.
The objectives of PROMISE include the continuous assessment and improve facilities for provision of maternal, new-born and child health (MNCH) services, regularly monitor the performance of health facilities against set targets for MNCH and strengthen systems and build capacity to ensure efficiency in MNCH service delivery.
The project will also involve key stakeholders in the provision of maternal, new-born and child health care to achieve the Millennium Development Goals 4 and 5, develop and implement strategies to reduce maternal, new-born and child deaths.
PROMISE will carry out research into maternal, new-born and child care and practices, mobilise resources for implementation of maternal, new-born and child services and develop links with other organisations and individuals involved in maternal, new-born and childcare for future development.
In addition, it will play advocacy role for attention on maternal, new-born and child survival and serve as a resource centre for maternal, new-born and child health.
At the second PROMISE conference in Takoradi, the Western Regional Director of Health Services, Dr Linda Vanotoo, urged stakeholders to discuss the gaps in service delivery and make suggestions on the way forward.
“It is my hope that district directorates will focus on the areas that need to be strengthened in the allocation of the High Impact and Rapid Delivery (HIRD) Fund for the implementation of activities at the district and sub-district levels,” she said.
Dr Vanotoo explained that the HIRD Fund was an opportunity to put some resources into the work being done, adding that some people had been wondering what was the relationship between HIRD and PROMISE.
“The two address the Millennium Development Goals, but the PROMISE does not have funds committed to it,” she stated, adding, “It gives the hospital and the districts the opportunity to take a critical look at the work they are doing and assess the outcomes”.
The regional director said PROMISE provided for a wider involvement of the community and hospital staff.
Dr Vanotoo said the assessment of activities implemented with the HIRD Fund revealed that some districts carried out activities that did not have direct impact on the maternal and new-born survival.
She, therefore, entreated all stakeholders to see the two activities as addressing the same objectives.
Dr Vanotoo expressed the wish that the districts would review their activities implemented with the HIRD funds against the planned activities and the actual needs of the people of their communities.
That, she said, would help to commit funds to areas of need that would promote maternal and child survival.
The regional director said in the past year, her outfit took a critical look at the performance of the various districts in the region and gave feedback.
She added that the districts were encouraged to develop their own plans and strategies to address maternal, new-born and child health activities without waiting to receive specific funds.
Some of the districts, she said, were very active and involved the communities in discussions on how to improve MNCH service delivery.
Dr Vanotoo said staff members were trained in essential new-born care and that brought out the gaps in the care of new-born, which included the need to keep the baby warm at birth and the importance of early initiation of breast feeding.
She said it was observed that those simple effective means of ensuring child survival were not practised routinely in some health facilities.
Dr Vanotoo said important community members such as chiefs, queens, traditional birth attendants and pregnant women were actively involved in some districts to discuss and plan for implementation of strategies to address the Millennium Development Goals four and five.
In an address read on his behalf, the Western Regional Minister, Mr Paul Evans Aidoo, said evidence showed that 800,000 lives could be saved each year if essential interventions that were already in existence could reach 90 per cent of mothers and their new-born babies.
He said the primary health care concept was developed because of lack of basic health care service.
That, Mr Aidoo said, had been strengthened through the Community-based Health Planning and Service (CHIP) strategy.
He stated that awareness had been created since the first conference, adding that maternal deaths had reduced appreciably, but stillbirths were still unacceptably high, with as many as 1,294 babies dying before their births.
The regional minister, therefore, drew the attention of health workers to the unfortunate situation, and called on them to come out with innovative and scientifically proven ways of alleviating that problem.
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