Now the country is turning its focus on the rate of mortality among mothers; currently, women face a 1 in 40 risk of dying in their lifetime from complications to do with pregnancy and birth. Each year, around 25,000 women lose their life because of childbirth, while a further half a million are estimated to suffer from long-term disabilities afterwards.
Studies have shown that many of the complications which cause death or injury – such as a ruptured uterus, sepsis, postpartum haemorrhage and preeclampsia – could be tackled by skilled health professionals. However, Ethiopia currently suffers from a severe shortage of skilled birth attendants. This means that for every 1,000 births, there are fewer than 2 midwives (a coverage rate similar to countries such as Afghanistan and the Democratic Republic of Congo).
Health officials in Ethiopia have recognised that obstetric care must become a much greater priority. The government has therefore committed to increasing the number of midwives from just over 2,000 to nearly 9,000. This should help to raise the number of births attended by a skilled health professional from less than 20% to 60% in the near future. At the same time, the Ethiopian Midwives Association is working alongside officials to build capacity and improve the quality of education and training.
Work is also underway to ensure that emergency obstetric care is available in all health centres and hospitals. However, once care programmes are in place, there are also cultural issues to tackle, particularly in rural areas, where women expect to give birth at home (where a large proportion of maternal deaths occur). In rural regions, many women like to follow traditional practices, such as having certain ceremonies performed or a neighbour present at the birth. Some health workers belief these practices need to be integrated into the care offered by health facilities as a way of persuading mothers to deliver at hospitals and clinics.
Speaking to the news agency IRIN, a representative of the US Agency for International Development (USAID), one of Ethiopia’s major health partners, said he was optimistic that further improvements in health care would save many lives and spoke of a significant reduction in maternal deaths as being totally “achievable” in Ethiopia, just as the drop in child deaths has already been achieved.