WINDHOEK – A report on the prevalence and contributing factors of facility-based maternal and neonatal deaths in five regions of Namibia in 2010 and 2012 shows that HIV/AIDS was an indirect cause of more than half of the reported maternal deaths.
The report reveals that HIV positive women are at higher risk of maternal death because of complications of HIV/AIDS and other direct causes such as infection and severe anaemia.
The report also shows that during the period in question, 57 maternal deaths were recorded. Of these deaths, 59 percent were a result of HIV. “Approximately 60 percent of all mothers who died were known to be HIV positive, but in only 15 of these cases was the maternal death determined to be directly or indirectly [linked] to HIV,” reads the report.
The report further indicates that 47 percent of these women were on highly active antiretroviral therapy (HAART) at the time of death.
The audit data on HIV-related maternal mortality was also reflected in the verbal autopsy responses, which suggested that fear and stigma around HIV/AIDS continue to limit care seeking and compliance to HAART treatment and other appropriate interventions for HIV positive pregnant women, the report further reads.
In 2010, the World Health Organisation (WHO) estimated that 59.4 percent of maternal deaths in Namibia were attributed to HIV/AIDS.
The Deputy Minister of Health and Social Services, Petrina Haingura, sadly noted that the fact that some of these HIV positive women died because of lack of care is tantamount to stigma.
“HIV/AIDS needs to be quickly addressed. We want to see a reduction in HIV,” Haingura said.
“If we work very hard on the issue of HIV/AIDS there will be a reduction seen in maternal deaths,” added Haingura.
Direct causes of maternal deaths include postpartum haemorrhage (the loss of blood following childbirth), which amounts to 35 percent; preeclampsia (a condition in pregnancy characterised by high blood pressure), 21 percent; puerperal sepsis (a condition that occurs when a new mother experiences an infection related to giving birth, 16 percent; and obstructed labour (a condition in pregnancy characterised by high blood pressure), which accounts for 11 percent.
The delay in accessing antenatal health services, health professionals delaying in attending to expectant mothers and not attending antenatal services by some mothers were found to be contributing factors to maternal deaths in the country, the report also reveals.
It recommends “the care needs of HIV positive pregnant women should be addressed to assure compliance with HAART and safe and respectful childbirth practices for women with HIV/AIDS.”
It also recommends that women need to be linked up with appropriate high-quality antenatal care services through community health workers.
“Although often recommendations particularly focus on the needs of rural or uneducated women, this study demonstrated that a high proportion of women who died a maternal death lived in urban areas and had secondary education. This supports the reality that all women are at risk and need access to appropriate services,” it reads.
Dr Peter Sikana of the United Nations Population Fund (UNFPA) stressed that recommendations should be implemented noted “15 to 20 percent of pregnant women will develop complications.”
He also noted maternal and neonatal health remain major challenges worldwide but specifically in developing countries.
“Please let us look at the recommendations made in the report to reduce maternal deaths,” he said.
Haingura also noted that maternal mortality remains a challenge in Namibia. “The overall progress still remains far short of the Millennium
Development Goals number 5, which targets to reduce maternal deaths by 75 percent by next year,” Haingura said.
Data in the report (of the Ministry of Health and Social Services) was collected at state facilities and the regions featured are Erongo, Hardap //Karas, Khomas and Omaheke.
By Alvine Kapitako