Maternal deaths in PNG – a national health crisis

Maternal deaths in PNG – a national health crisis
ChildFund Australia reports
ChildFund Australia is an independent and non-religious international development organisation that works to reduce poverty for children in developing communities. The deeper analysis into maternal deaths in PNG by ChildFund has led to the publication of a report titled “A national health crisis: maternal deaths in Papua New Guinea”. The report, published in May 2018, highlighted the high rates of maternal and infant deaths, documented as worsening, particularly in rural areas.
Large proportions of women do not have access to antenatal care and safe delivery. The coverage rates have been low for decades. In some clinics, the number of women attending a proper clinic where there’s trained support, the numbers have reduced in the last five years. The number antenatal care has declined and the situation seem to be worsening, quite the opposite to most of the other countries in the region.
In past years, the government and development partners jointly support MCH interventions including early newborn care, antenatal and postnatal care, childbirth, family planning and maternal death surveillance and response (MDSR) systems. However, implementation has been slow and weak. The challenges of delivering effective MCH interventions are due to a combination of health systems issues and community factors which hinder progress for intended improvements. Poor access to essential health care is fuelled by lack of skilled human resources, poorly maintained and equipped health facilities, lack of basic medicines, poorly managed financial flows, geographical distance between communities and health facilities, and weak leadership and management. In addition, inadequate community knowledge and motivation, and poor health-seeking behaviour contribute to under-utilisation of reproductive health and MCH services. As a result, maternal-newborn services remain sub-optimal in most provinces.
The ChildFund report indicates there is an urgent need for more midwives and better health facilities, particularly in the rural villages and districts where most women are giving birth. Many women end up giving birth at home. Many rural health facilities are often only staffed by volunteers.
The high maternal mortality rate is mainly due to poor access to health care for the large numbers of rural women. This makes common complications such as postpartum bleeding, infection and prolonged and obstructed labour difficult to manage.
Specialist Obstetrician, Dr Mary Bagita, says gaining access to maternity care is tough for rural women where the road conditions are poor, air transport is scarce and facilities like water supply may not exist at their local health centre. She is based in Port Moresby where the hospital also receives referrals from surrounding provinces. Often by the time women reach the hospital, she often is unable to save them.
Access is an important constraint. When women are referred from rural health centres to hospitals for management of life-threatening conditions, they are often too sick to recover and eventually die.  Complex societal issues contribute to poor pregnancy outcomes. In a culture where male dominance is predominant,  poorly educated women can’t speak up for herself. She doesn’t have much control over what she can do. So that adds to problems of pregnant women. Domestic violence has a very negative impact for both mothers and babies as women don’t seek help and feel like there is nowhere for them to go.
Many development partners are in agreement that the challenges can be overcome with sustained effort and sizeable investment at scale. There are many excellent front line health workers who are committed to making a difference in the lives of women and newborn babies. They need so much more support.
The report indicates that while the national policy and strategies are in place, they need better planning, resourcing and co-ordination to deliver health services to the whole country.
To access online copy of the full report, please contact:
ChildFund Papua New Guinea, PO Box 671, Gordons NCD; Tel (675) 3232544; email: admin@childfund.org.pg