Melinda Gates and safe motherhood in Malawi: The retrospective angle

On June 27, 2015, Melinda Gates, wife of US billionaire, Bill Gates, met with President Peter Mutharika at Kamuzu Palace in Lilongwe. The agenda was to discuss the promotion of safe motherhood and maternal health in Malawi.

It is commendable that President Mutharika seems to havematernal health and safe motherhood amongst his health sector priorities. However, there is no doubt that matters of maternal health and safe motherhood have not received the deserved attention over the past year as was the case during the previous administration.

Retrogressive trend

Official statistics indicate that between 2009 and 2012, 675 women died per 100,000 live births; between 2012 and mid-2014,425 women died per 100,000 live births; and that between mid-2014 and to-date the figures have swollen to 465 deaths per 100,000 live births.

The UN believes that 90% of maternal deaths are preventable and it has thus provided varied support to governments and organizations to ensure that mothers are saved.

According to the UN Millennium Development Goal 5, it was envisaged that between 1990 and 2015, maternal mortality may have been reduced by three quarters.

It is unfortunate that pregnant women, once again,face the danger of dying while giving birth courtesy of a lack of political will under President Mutharika. There is deafening silence on matters of maternal health. All we hear about today is ‘beauty’.

Bill and Melinda Gates Foundation’s work is philanthropist in nature. They do not go into a country based on the prevailing politics. They bring workable interventions to lessen the suffering of poor and disadvantaged populations.

So, Melinda Gates’ sojourn to the ‘Warm Heart of Africa’ was highly appreciated. It is now up to the current leadership to take advantage of the Gates’ generosity and assistance to promote maternal health and safe motherhood in Malawi. This was her second visit following her earlier one in December 2012 during the reign of former President Joyce Banda.

Joyce Banda’s legacy

Former President Joyce Banda and her People’s Party (PP) administration were widely credited for their unprecedented achievements in improving maternal health and safe motherhood. During her reign, between 2012 and 2014, former President Banda took an extra mile to curb avoidable deaths of both mothers and babies during pregnancy and childbirth.

Former President Banda believed that the provision of quality maternal and neonatal health care services to completely end maternal and neonatal deaths was of paramount importance in Malawi’s development agenda. On ascension to the High Office in 2012, President Banda established the Presidential Initiative on Maternal Health and Safe Motherhood, which championed efforts to fight maternal mortality.

The Initiative intensified community mobilization and training of chiefs, construction of maternity waiting homes and training of community midwives.

Achievements

At the time President Banda left office in May 2014, the Presidential Initiative on Maternal Health and Safe Motherhood had built 20 maternity holding shelters at various hospitals across the country. The African Union (AU) reportedthat Malawi had moved from 675 to 460 deaths per 100,000 births that time. The African Union gave the Malawi Government an Award at its headquarters in Addis Ababafor improvements in maternal health.

These achievements were as a result of political will prevailing at that time coupled with dedication and hard work by the Initiative’s personnel led by renowned and veteran nurse, Dorothy Ngoma; the department of Maternal and Reproductive Health at the Ministry of Health; and the committee of chiefs headed by Chief Kwataine of Ntcheu.

The private sector is credited for financially supporting the construction of 20 maternity holding shelters (one holding shelter in Area 25 in Lilongwe was donated by Melinda Gates following Government’s request).

The Ann GloagFoundation of Scotland supported the Presidential Initiative on Maternal Health and Safe Motherhood to train 100 community midwives. Under this special training programme, the Joyce Banda Foundation also facilitated the training of 50 community midwives.The Ann Gloag Foundation has also been supporting the Bwaila Hospital Fistula Centre for many years.

So, Gates’ latest visit was probably a follow-up on the earlier visit when she discussed a number of innovative interventions to halt maternal deaths with President Banda.

Since the new regime came in 2014, 380 women have died over the last six months, according to official statistics. The Presidential Initiative was abolished and staff sacked. The President engaged his sister-in-law to implement maternal health and safe motherhood initiatives, instead. The committee of chiefs has since been abolished and not one maternal holding shelter has been built since last year.

To compound the situation, media reports indicate that the health system in Malawi is on the verge of collapse and there are allegations K6 billion ($12million) worth of hospital drugs have been lost through theft.

Borrowing leaf

President Mutharika must borrow a leaf from his predecessor. He must retain his predecessor’s bold plan to improve maternal care countrywide. The vast majority of births in Malawi still happen under the care of traditional birth attendants, who are often unequipped to deal with potentially lethal complications. This cannot continue if authorities genuinely wish to build a better and healthier nation!

 

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