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Jamaicas maternal mortality rate is very high
– Reported, February 29, 2012
Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. Over 99 percent of those deaths occur in developing countries such as Jamaica. But maternal deaths only tell part of the story. For every woman or girl who dies as a result of pregnancy-related causes, between 20 and 30 more will develop short- and long-term disabilities, such as obstetric fistula, a ruptured uterus, or pelvic inflammatory disease.
Jamaicas maternal mortality rate continues at an unacceptably high level. While maternal mortality and morbidity figures vary widely by source and are highly controversial, the best estimates for Jamaica suggest that between 1,300 and 1,900 women and girls die each year due to pregnancy related complications.
1 The tragedy and opportunity is that most of these deaths can be prevented with cost-effective health care services. Reducing maternal mortality and disability will depend on identifying and improving those services that are critical to the health of Jamaican women and girls, including antenatal care, emergency obstetric care, adequate postpartum care for mothers and babies, and family planning and STI/HIV/AIDS services. With this goal in mind, the Maternal and Neonatal Program Effort Index (MNPI) is a tool
that reproductive health care advocates, providers, and program planners can use to:
Assess current health care services;
Identify program strengths and weaknesses;
Plan strategies to address deficiencies;
Encourage political and popular support for
appropriate action; and
Track progress over time.
Health care programs to improve maternal health must be supported by strong policies, adequate training of health care providers, and logistical services that facilitate the provision of those programs.Once maternal and neonatal programs and policies are in place, all women and girls must be ensured equal access to the full range of services.
Maternal mortality refers to those deaths which are caused by complications due to pregnancy or childbirth. These complications may be experienced during pregnancy or delivery itself, or may occur up to 42 days following childbirth. For each woman who succumbs to maternal death, many more will suffer injuries, infections, and disabilities brought about by pregnancy or childbirth complications, such as obstetric fistula.2 In most cases, however, maternal mortality and disability can be prevented with appropriate health interventions.
Early marriage is one traditional practice that affects maternal health outcomes. Many women in developing countries marry before the age of 20. Pregnancies in adolescent girls, whose bodies are still growing and developing, put both the mothers and their babies at risk for negative health consequences.
Overall, Jamaicas service capacity to provide emergency obstetric care received a rating of 59 out of 100.Ratings of the capacity of health centers and district hospitals to provide specific services. Administration of intravenous antibiotics (72) is the most commonly available service at health centers in Jamaica. The least available services are use of a partograph to determine when to refer a woman to a district hospital (17) and vacuum aspiration of the uterus (MVA) for post abortion care (17). District hospitals received relatively high ratings for providing a range of health center functions (73) and performing Cesarean-sections (76). Blood transfusions (67) are the
least available service among those assessed at district hospitals in Jamaica. While health center services in Jamaica generally received lower ratings when compared to services in other countries in the Latin America/Caribbean region, district hospital services generally received higher ratings.
Overall, the experts gave maternal and neonatal health services in Jamaica a rating of 69, compared to an average of 56 for the 49 countries involved in the MNPI study. This rating places services in Jamaica second among the 49 countries. Among the 13 developing countries studied in the Latin America/Caribbean region, services in Jamaica rank first. While comparisons across countries should be made with a certain degree of caution given the subjective nature of expert opinions and evaluations in different countries these comparisons may help maternal health care advocates and providers in Jamaica identify priority action areas. It is also important to keep in mind that average scores may mask the differences among provinces within each country.
The MNPI ratings indicate that Jamaica has a relatively strong national policy on safe motherhood, and curricula for training health care providers have been developed to a large degree. The country also does well in terms of urban access and monitoring and research capabilities. The country must now make sure that these efforts are translated into high quality, accessible services and programs at the local level. The ratings suggest that women, overall, have reasonable access to most types of services, particularly newborn care (e.g., immunization scheduling) and some family planning methods (e.g., pills). However, there are disparities in urban and rural access to many services. Moreover, women in all regions need greater access to delivery care, including skilled attendants at birth, postpartum checkups within 48 hours of delivery, and emergency obstetric care. Voluntary counseling and testing for HIV is also limited, which may be a concern since an estimated 1.2 percent of Jamaicas adult population (age 15-49) is living with HIV/AIDS.11 Finally, as in most other countries, maternal and neonatal health care services in Jamaica face resource shortages from both the public and private sectors that hamper expansion of services to adequately meet the needs of women.
Credits: USAID
More Information at: http://pdf.usaid.gov/pdf_docs/PNACR439.pdf
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