Saturday, May 18, 2024

Botswana makes strides towards achieving MDGs

During his launch, the President of Umbrella for Democratic Change, Duma Boko told his listeners that “We are classified as an upper middle income country but when you look at examples you will realize that women are dying at a high rate. Statistics show that for every 100 000births, about 164 die. This is happening here in the country which is classified as an upper middle income country.”

Perhaps following such concern, Batswana need to go and cast their votes knowing that all is not lost. The Ministry of Finance and Development Planning records show that there is significant improvement in the drive towards achieving the Millennium Development Goals (MDGs) even though the level of progress varies between goals and within each goal.

Much progress, records reveal, has been achieved in goals tracking access such as school enrolment, clean drinking water and sanitation, access to mobile phones while progress has been slow over the past decade in goals focusing on outcomes, such as reducing child and maternal mortalities.

The 2010 MDG status report shows that, “Between 1991 and 2005 Botswana achieved national maternal health target and was on track to achieve the global target. Maternal Mortality Ratio (MMR) dropped from 326 deaths per 100 000 live births in 1991 to 135/100 000, well within the national target of 150/100 000 by 2011 and well within the trend path required to achieve the steeper global target of 82/100 000. It began to rise after 2006.”

Government is currently in the process of producing the 2014 report. ┬áThe Ministry’s executive summary however reveals some highlights.

“Botswana’s national target of reducing maternal mortality ratio (MMR) from an estimated 326 deaths per 100, 000 to 150 per 100, 000 between 1991 and 2011 has clearly been missed and unlikely to be achieved within the remaining period before the 2015 target year ends. The global target of 82 per 100, 000 is also far-fetched for Botswana,” it reveals.

As can be expected, several factors contribute for this. The summary indicates; “While an estimated 95per cent of pregnant mothers attend ante-natal clinic at least four times during pregnancy and 99.5per cent of delivering mothers are attended to by a trained health professional, a contrasting feature is the death of 163 mothers out of every 100,000 live births (Stats Brief 2011) who die during or immediately after birth. Maternal deaths are also concentrated in the childbearing ages of 25 ÔÇô 34 years which account for 56.5%.┬á Data on non-institutional (home) deliveries is also scanty even though there is evidence that they are concentrated in few places within the western districts as Ghanzi 59.6 per cent and Mabutsane 15.4 per cent account for the bulk of┬ásuch deliveries.”

Interestingly HIV prevalence rates among the youth aged 15-24 have shown signs of decline over the years as it is currently at ten per cent down from 20 per cent. HIV prevalence for women aged 15-49 peaked between 1994 and 1998 before it began the downward trend after 2000. New HIV infections also continued to decline, as they reached 2.9 per cent in 2008, out of which females accounted for 3.5 percent compared with 2.3 per cent for males. The current HIV incidence rate of 1.9 per cent translates into 15, 000 new infections every year. However, the persistent stigma associated with the HIV status makes the fight against the virus a challenge.

Currently, there is an emergence of multiple pregnancies among HIV positive mothers, especially those aged 25-49. It is reported that 70 per cent of these women fell pregnant fully aware of their HIV positive status. This underscores the urgent need to intensify behavior change and communications around the HIV and AIDS.

According to the draft Botswana Five-Year Maternal Mortality Report (2007-2011), maternal deaths are attributed to hemorrhage- 28 per cent, followed by hypertensive disorders -17per cent and HIV related infections- 17 per cent. Abortion and medical surgical conditions account for fifteen 15 percent and eight percent, respectively. The major causes of maternal deaths include, excessive bleeding during delivery, infections and AIDS related complications.

It further indicates that, “The emergence of hypertension and diabetes among pregnant women further complicates the country’s efforts to improve the health of delivering mothers. Maternal deaths are also attributed to challenges related to quality of care such as inappropriate management, delayed intervention, late referral decisions,┬ápoor monitoring and delays in seeking care by the expectant mothers.”

The report emphasizes that strong Government policies and programmes contributed to the reduction in the occurrence of maternal deaths over the years. These include the 2002 National Sexual and Reproductive Health (SRH) Programme Framework, the Safe Motherhood Programme of 1992, the Adolescent Sexual and Reproductive Health Implementation Strategy, the National Roadmap for Accelerating Reduction of Maternal and Newborn Mortality and Morbidity.


Read this week's paper