NAIROBI - Hepatitis E is currently the leading cause of maternal mortality in Namibia.
The virus mostly kills pregnant women, said Dr Bernard Haufiku, special health advisor to President Hage Geingob, last week at the International Conference on Population and Development (ICPD) 25 Nairobi Summit in Nairobi, Kenya.
Haufiku was part of the panel discussing the topic ‘Policymakers dialogue on ending maternal deaths.’ He said nearly half of the people dying from hepatitis E are pregnant women or those who have delivered babies.
According to the situation report (SITREP) of the Ministry of Health and Social Services on the outbreak of the hepatitis E virus (HEV) in Namibia, by the end of July a total of 199 cases were reported countrywide. The majority of cases were reported in Khomas region with 135 (69 percent), Omaheke region with 15 (8 percent) and Erongo at 14 (7 percent) during the reporting period.
The report said the national Case Fatality Rate (CFR) was 53 (0.9 percent). Of the 53 deaths, 21 (39 percent) were maternal deaths.
“One of the challenges are we are sitting with now is the outbreak of hepatitis E which is causing the high mortality among pregnant women and immediately after delivery. We are now battling with hepatitis E as an indirect cause of maternal mortality,” he said during the panel discussion.
He said pregnant women or those who just delivered stand at 43 percent of everyone dying of hepatitis E. “It is a very serious thing, that is why we are intensifying our campaign of identifying pregnant mothers or anyone who plans pregnancy so that they are on the system from the word go and so that we don’t lose the person out of the system,” said Haufiku.
Overall the mortality has come down to 265 deaths per 100 000 live births. Haufiku said it was 441 deaths per live births in 2000.
According to the report, hepatitis E cases have been reported mainly from informal settlements such as Havana and Goreangab in Windhoek, DRC settlement in Swakopmund and similar settings in other regions where access to safe water, sanitation and hygiene is limited.
Most cases from less affected regions have a history of travelling to the above-mentioned informal settlements in Windhoek or Swakopmund. Haufiku said interventions are providing sanitation and clean water in the informal settlements.
Furthermore, on the issues of ending maternal deaths and giving birth with skilled care, Haufiku said that 84 percent of deliveries happen in health facilities.
He said the vastness of the country is still a challenge and certain cultures like people from the north-western part of the country, in Kaokoland, don’t believe in delivering in health facilities. “Our plan is to deploy mobile clinics that go into the community and attend to people at community level,” he said.
Integrated service delivery
Haufiku also formed part of panel that discussed integration inspiration: identifying solutions for integrated sexual and reproductive health and rights (SRHR). Haufiku said they started providing integrated services at seven primary care facilities across the country. He said to their surprise it really worked.
They started with HIV and SRHR whereby they trained nurses to do integrated service. He said that in the past patients had to be screened, allocated a number and go to the consulting room but with integrate service when a patient enters a room it does not say it is for HIV or tuberculosis – it is just a consulting room.
He elaborated that when a patient now enters a consulting room no one knows they are going for HIV testing, antenatal screening or pregnancy testing. “It works and increased the uptake and confidence in the system. The patients build relationships with the caregivers,” he said.
He said 157 out of 360 primary care facilities are doing integrated service. “We are rendering services in one room. It really addresses the issue of stigma and discrimination.”
2019-11-18 07:56:27 | 4 months ago