Thursday, February 9, 2023

Botswana fails to meet global threshold for maternal mortality

Latest maternal mortality data reveals that Botswana failed to meet the Sustainable Development Goal (SDG) of reducing Maternal Mortality Ratio (MMR) to less than 70 deaths per 100,000 live births.

This is contained in a fresh report compiled by Statistics Botswana entitled “Botswana Maternal Mortality Ratio 2020”.

The Stats Brief which covers the MMR for the years 2014 to 2020 using data provided by the Ministry of Health and wellness notes that: “76 maternal deaths were reported in 2020 from 58,244 live births yielding a MMR of 131 maternal deaths per 100,000 live births”.

Maternal mortality ratio is defined as the annual number of maternal deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy, childbirth, or within six weeks of termination of pregnancy, per 100,000 live births per year. This indicator reflects the capacity of health systems to effectively prevent and address the complications occurring during pregnancy and childbirth.

The World Health Organisation (WHO) has five strategies toward ending preventable maternal mortality (EPMM) to be achieved by 2025 if the SDGs are to be met. The strategies are for 1) 90% pregnant women to attend four or more antenatal care visits (towards increasing to eight visits by 2030); 2) 90% births to be attended by skilled health personnel; 3) 80% women who have just given birth to access postnatal care within two days of delivery; 4) 60% of the population to have access to emergency obstetric care within two hours of travel time; 5) 65% of women to be able to make informed and empowered decisions regarding sexual relations, contraceptive use, and their reproductive health.

The report notes that Botswana surpassed strategy 2 as a large proportion of births were attended to by skilled health personnel. “We continue to note a high number of mothers delivering in health facilities. The brief shows an overwhelming 99.8 percent of all births are estimated to have occurred in health facilities supervised by a skilled health professional,” notes the report.

The report also notes that the leading direct cause of maternal deaths “was Genital tract and pelvic infection following abortion and ectopic and molar pregnancy,” while among the indirect causes the most common causes of maternal mortality were diseases of the circulatory system complicating pregnancy, childbirth and the puerperium. Puerperium is the time period following childbirth when the mother’s uterus shrinks.

Among other things, the report notes that the maternal mortality ratio declined steadily from 156.6 per 100,000 live births in 2016 to 133.7 in 2018, then increased to 166.3 in 2019 and fell to 131 in 2020. “The highest maternal deaths were reported among age groups 30-34 years (28.9 %), followed by ages 35-39 years and 25-29 years at 19.7 percent each,” states part of the report.

Of the 58 244 live births registered in 2020, sixty one per cent took place in General

Hospitals, as compared to twenty percent in primary hospitals and nineteen percent in clinics respectively. “This pattern has been consistent from 2017 to 2019,” states the report.

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