Interview: “New strategy ongoing for combatting mortality”

Dr. Martina L. Baye, Coordinator of the National Multi-sector Programme for Combating Maternal, Newborn and Child Mortality, Ministry of Public Health, talks about the situation of infant/maternal mortality in Cameroon.

Q: What is the situation of maternal and infant mortality in Cameroon?

A: The maternal and infant mortality situation in Cameroon as at now, to say the least, is unacceptable. It is unacceptable because maternal mortality and to a certain extent, infant mortality, generally indicates the level of development of a country.

Considering the development level of our dear country, one would expect the situation to be better. That said, according to the 2011 Demographic and Health Survey (DHS), out of every 100,000 live births, it is estimated that 782 women die.

In real figures, this means that in 2013, Cameroon lost about 7,000 women, considering that the total number of deliveries was estimated at 900,000.

Concerning infant mortality, for every 1,000 live births, we lose 62 children by the age of one year, and that is too much.

Q: What explains the high mortality rate?

A: Causes or better still, factors that influence maternal mortality in Cameroon are multi-dimensional. To name a few, the first one is underutilization of eligible services for pregnancy follow-up and delivery.

In Cameroon, at least four out of every 10 women are said to deliver out of a health facility setting, meaning that when complications occur in those cases, they may die due to lack of proper timely assistance.

Secondly, some women or some families seek medical care quite late during delivery. You may want to ask why a woman who is in labour would not seek care on time.

In my humble opinion, this could be linked to lack of correct information on the risks they run. It is established that 15 out of every 100 deliveries will end up in a complication; the most severe of which is excessive bleeding.

Thirdly, we cannot refute the problem of unsatisfactory quality of care in some health facilities due to insufficiently qualified staff, lack of basic equipment, material or consumables.

Fourthly, birth spacing is very insufficient in Cameroon. Inadequate birth spacing exposes the woman to various complications, some of which could be life-threatening. Still in line with this, unwanted pregnancies and dangerous abortions end up in several complications.

Q: What efforts have been made by the government to improve maternal and child health in the country?

A: The good news is that the government has decided to “take the bull by the horns” as far as reduction of maternal and child mortality is concerned. That is why the Campaign for the Accelerated Reduction of Maternal and Infant Mortality (CARMMA) was launched in Cameroon in 2010.

Ongoing actions within this campaign consist of capacity-building of health personnel in charge of obstetric and newborn care and the training of midwives that was suspended some years back has been revamped.

So far, 10 midwifery schools have gone functional and the first batch of midwives will soon be recruited and posted to various health units to improve the quality of care. There is renovation and equipping of maternity and neonatal wards. Maternal death review is also being instituted, while delivery and caesarian section kits are pre-positioned in health facilities in order to reduce the delay of women in accessing care.

Family planning services are equally being revamped so as to respond to the unmet needs in this area and also stimulate demand for birth spacing aimed at improving the health of mother and child.

Several other activities are being initiated, notably conveying correct information to women, families and the general public about pregnancy and delivery-related care so that people can make informed choices that reduce the risk of dying from childbirth-related complications.

In November 2013, given the persistent gravity of the situation, and following instructions from the Head of State, the National Multi-sector Programme for Combatting Maternal, New-born and Child Mortality, was set up as a platform for coordination, promotion and expansion of multi-sector engagement aimed at fostering synergy to improve the situation.

Apart from the Ministry of Public Health, other ministries will each play a key role in mobilising and educating the population targeted by the programme, including youths, women and men.

The civil society also has a very important role to play, including social mobilisation, advocacy, community mobilisation and service delivery. The support of technical and financial partners is fundamental and the role of the private sector is essential within the framework of public-private partnership.

Q: Any advice for women as far as maternal and infant mortality is concerned?

A:Women should know that three things contribute to preventing delivery-related deaths.

Firstly, every delivery should be assisted by a qualified person in an appropriate milieu so as to minimise complications. Secondly, delivering in the appropriate place is crucial because in case complication occurs, it can easily be dealt with.

Thirdly, multiple and very close pregnancies should be avoided as they are a potential source of life-threatening complications. That’s why after delivery, it is important to adopt a method of contraception for birth spacing so as to enable the body to rebuild its capacity and be ready to go through another pregnancy and delivery with little or no risk.

The above three factors are also favourable for proper child health. In addition, every baby should be taken regularly for vaccination, which is free of charge in Cameroon. Mothers should ensure regular attendance of well-baby clinics where guidance on appropriate nutrition is given and where growth monitoring is carried out.

All children, especially those under the age of five, should sleep under insecticide-treated bed nets to avoid malaria, which remains the number one baby killer in Cameroon.