Morocco aims to reduce maternal mortality

Policy-makers and civil society groups call for action on rising deaths in childbirth in Morocco.

By Sarah Touahri for Magharebia in Rabat – 22/11/10

The Moroccan government seeks to curb the rising maternal mortality rate by implementing a variety of measures throughout the country. With 132 deaths per 100,000 live births, the country is facing a real crisis as many women give birth without medical supervision, particularly in rural areas.

At a November 7th meeting organized by the Socialist Union of Popular Forces (USFP) in Rabat, parliamentary adviser Zoubida Bouayad said that the lack of infrastructure and human resources made the problem worse. She stressed the importance of boosting efforts to address the problem, notably by recruiting qualified doctors and setting up mobile maternity units.

Nadia Belkari, who oversees health provision in the Gharb-Chrarda-Beni-Hssen region, said that deaths among mothers and infants were also due to socio-cultural factors, particularly the close family circle.

"Poverty and distance to the nearest hospitals mean that many Moroccan women do not have any access to medical care or supervision during pregnancy and labor. Many of them continue to give birth at home, calling on the services of the traditional midwives, who have received no formal training," said sociologist Samira Kassimi.

According to Kassimi, there has certainly been progress in Morocco in terms of developing the hospital infrastructure. Still, there is a lot to do to reduce the maternal and infant mortality rates. For her, the fight to combat poverty is a key part of achieving the goal.

Samira Rouhani has painful memories of her sister Souad's death during labor. "It was her first pregnancy. She didn't receive any medical check-ups because she was living in a remote douar in Beni Mellal. Her husband could not get her to the hospital. She had to rely on the midwife, who could do nothing to help her. She should have had a Caesarean. She died at the peak of her age in front of her mother's eyes," she said.

"Of course we need to fight poverty and improve the hospital infrastructure. But we must also combat a fatalistic attitude where pregnant women are concerned. In some circles, there is the feeling that medical supervision is of no consequence, given that everything is in God's hands. So they don't make much of an effort to get their women to a medical center," said Soraya Adimi of the "Hand in Hand" association.

She added that civil society is making a considerable effort to support women, particularly in rural areas, through both education and the provision of resources.

Meanwhile, Health Minister Yasmina Baddou admitted that there is still a great deal of work to be done to reduce maternal and infant mortality rates and to improve levels of medical care for mothers and new-born infants.

According to Baddou, Morocco has managed to provide medical supervision of more than 455,000 women in labor in the public sector, which is a 19% increase since 2007. The aim for 2012 is to have 500,000 births taking place within a properly monitored environment. In the longer term, the national plan is to reduce maternal mortality to 50 deaths per 100,000 live births.

"There has been a very significant rise in the number of Caesarean sections, and the target of 7% for this procedure has been reached," Baddou said.

The Health Ministry has already waived charges for medical care during labor, Caesarean sections and transport to maternity units. Special obstetrics care by the Emergency Medical Assistance Service (SAMU) will be extended to 24 provinces by the end of the year.

"This new scheme should help us reduce delays in care access in more than 1,500 localities. In rural areas, 143 mobile maternity units have been put on the road," Baddou said.

Furthermore, there will be additional programs to train midwives. Since 2007, only 700 midwives and 63 obstetricians have been appointed. The minister promised to reduce maternal mortality by more than 75% and infant mortality by around two-thirds.

Source: Magharebia.com.
Link: http://www.magharebia.com/cocoon/awi/xhtml1/en_GB/features/awi/features/2010/11/22/feature-01.