Cameroon has been unable to meet its goal with regard to maternal health as more and more mothers lose their lives during childbirth.
Ngwa Amos would now need to raise his four children without a mother after he lost his wife and mother of his four children as she was giving birth to their fifth child at Bamenda General Hospital in northwestern Cameroon.
“We arrived [at] the hospital at 4 a.m. yesterday morning, and my wife got into the labor room,” he says. “Since then I have not set eyes on her. However, I could hear her voice as she groaned about three hours ago.”
He says the hospital staff had indicated that he would need to pay some money for a Caesarian section to be performed on his wife since there were some complications. Since he hardly had any money with him he had to run around for almost two hours to get the required cash for the operation.
“When I returned, she was no longer groaning,” he says. “I thought the baby had been born. I am shocked to be informed now that she and the baby passed away 30 minutes ago.”Amos says that he does not know what had caused the death of his wife and baby.
The midwife who had seen the patient says that it was impossible for a normal delivery and the patient did not have the means to undertake a Caesarean section. The baby was breech – when the feet enter the birth canal first instead of the head – but the couple did not know about this since they had not bothered with taking antenatal care for the last three months of the pregnancy because it was too costly for them.
Bih Sylvia, a nurse at the hospital, says the hospital has been having huge losses in the past for doing such emergency surgeries without payment and is hence asking patients to pay upfront.
Amos, who is a motorbike taxi driver now faces the major responsibility of being a single father of four children. Outside the maternity ward, his wife’s family members are crying out of grief and anger and point fingers at Amos of sacrificing their daughter for money.
Just next to the grieving family, a taxi stops and a teenage girl is carried out of the vehicle in a stretcher straight into the labor room. People around are aghast to see blood dripping from her body at every step.
Observers feel that the girl tried to do an abortion on herself, but the hospital staff are adamant that they will not look after her until she admits the truth. If she bleeds to death, this will be the second woman to die in an hour in the hospital because of child birth and related issues.
Sylvia says she does not know what happened in this case, as it’s neither ethical nor part of hospital to ignore suspected abortion cases.
Inadequate funding, unskilled birth assistance and poorly facilitated health centers across Cameroon are the reasons why so many young mothers in the country face the risk of death during pregnancy and childbirth. There are also people who opine that inadequate family planning is also a reason behind the high rate of maternal mortality here. The African Union, AU, government and nongovernmental organizations, NGOs, have promised to bring down maternal deaths in the region, but shortage of funds still continues to keep Cameroon from achieving the 2015 global goal.
Cameroon is badly lagging behind the goal to bring down maternal deaths by 75 percent by 2015 – goal five of the Millennium Development Goals, MDGs, a U.N. initiative agreed to by countries around the world. There are currently 1,000 maternal deaths per 100,000 births in Cameroon, according to the United Nations. About 9,000 women die during childbirth every year in Cameroon, as the Ministry of Public Health statistics in 2010 indicate.
According to UNICEF, 80 percent of maternal deaths can be prevented is the mothers were given the access to adequate maternity and basic health care services. Indeed, the Ministry of Public choses to blame the lack of adequate maternal care before, during and after pregnancy on the high incidence of maternal deaths.
One reason for this is poverty, since a lot of families do not have the means to pay for the care they need. More than 30 percent of the population is still below the international poverty line of $1.25 per day, according to UNICEF.
There is also a serious shortage of trained and skilled birth attendants. A global forum earlier this year stated the vital shortage of skilled health personnel in the world a major hurdle to achieving the MDGs by 2015.
About 63 percent of births are aided by skilled attendants in Cameroon, according to UNICEF. An official at the North West Regional Delegation of Public Health, the regional representative of the Ministry of Public Health, says this percentage is better when compared with other countries. But the official, who did not want his name to be revealed for job security reasons, says Cameroon also has a high maternal mortality rate, which he says is because most hospitals do not have proper frontline tools and health workers are given meager pay packages.
Reports show that doctors often move out Cameroon to work in countries where working environment and salaries are better. Meanwhile, some say that most of the traditional birth attendants are retired or getting older.
Another reason for the absence in care is a inadequate number of health centers in rural areas. Pregnant women here would need to walk long distances before getting to the nearest health center. As a result, it is quite a common thing here that babies are born on the side of the road.
Janine Ngum, 23, relates a story that confirms this.
“I had my first baby by the roadside as I was trekking to the health center, and the second was almost born the same way,” she says.
Now carrying her third child, Ngum says she would definitely want to deliver this time in a health center.
“For this third baby, I plan to go the health center three days before the due date and wait.”
Ngum says she visits the Akum Health Centre for antenatal consultation every last Wednesday of the month. It is the one that is nearest to her village. Alatening, another one would take two hours of travel. To get to the health center by 9 a.m. for her appointments, she says she has to get up at 5 a.m. to get water for her household, cook food, get the children ready for school so as to start the two-hour walk to the clinic at 7 a.m.
“It is very strenuous for me, but I must attend [the] clinic so that I will have no problem when I want to deliver my baby,” she says.
Inadequate knowledge of family planning techniques is also a reason behind the maternal deaths.
Fomuso Mary, a retired family planning expert at Bamenda General Hospital, says not many married women employ family planning methods.
“Most of the women are still very skeptical about the idea, and so child spacing continues to pose a challenge to childbearing women,” she says.
Less than 30 percent of women between 14 to 49 years of age use contraceptives, according to UNICEF’s latest statistics.
Ministry of Public Health officials say they are doing their best to put a tab on the number of women who die during childbirth before 2015. They say the government sensitizing and recruiting more health personnel and putting in place measures to improve the working conditions of those who are already employed in the industry in order to meet this goal.
The AU inaugurated in 2009 the Campaign on Accelerated Reduction of Maternal Mortality in Africa, which Cameroon’s government launched on a national scale last year.
Last year, the Ministry of Public Health also started the Cameroon Maternal and Child Health Handbook Pilot Project. The handbook aims to deploy a standardized approach for maternal and child care across Cameroon and to enhance record keeping, according to a project newsletter. The project is currently in the second phase of testing the handbook, which was taken from the Japanese health system, in two health districts in the country.
Cameroon has also ramped up its budgetary allocation to health care to about 5.6 percent, but it’s still much lesser than the 15-percent minimum agreed to by AU members in 2001 in the Abuja Declaration, according to the World Health Organization.
But the North West Regional Delegation of Public Health official says the government doesn’t have an adequate budget for health. He estimates that it allocates just 4.9 percent of the annual budget to health and only a portion of that money goes toward fighting maternal mortality.
Dr. Patrick Mbah Okwen, health adviser for SNV Netherlands Development Organization, a nonprofit international development organization, says that NGOs in Cameroon have the drive to bring down maternal mortality but that the issue is money. He says they get minimal funding – just 2 percent – from international donors in the health sector to look at maternal mortality.
“NGOs have therefore focused on capacity development, which is more sustainable,” he says.