Due to better access to health services, particularly family planning and antenatal care, the maternal mortality rate dropped by half over the past years to 408 per 100,000 live births. But this means that still around 22 women die every day in Mozambique from pregnancy and childbirth related causes. In hospitals, maternal deaths occur in as many as one per cent of deliveries, primarily as a result of late referrals. The clinical causes of death are infections contracted during birth, malaria, haemorrhages, convulsions, obstructive labour and high blood pressure that women can suffer from during the final months of pregnancy.
The still very high mortality rate in Mozambique is caused by the fact that more than half of all deliveries occur without any assistance from skilled health workers. Referral systems are limited and transport to take pregnant women from remote communities to village health posts or hospitals is extremely difficult. Another contributing factor is the high number of teenage pregnancies. About 40% of Mozambican women fall pregnant before the age of 20. The risk of death amongst pregnant teenagers is four times higher than for women above the age of 20.
In 2001, the Government launched the Maternal and Perinatal Mortality Reduction National Operational Plan 2002-2005 (the MMR Plan). So far, the plan has been implemented in 10 out of 11 provinces in partnership with UNFPA, USAID, WHO and UNICEF.
Major activities supported by UNICEF
… in Tete province
UNICEF now also supports the implementation of the MMR Plan in Tete, the only province that had not yet been covered by the plan. This is being carried out using participatory community approaches to promote delivery in health facilities and the development of preparedness plans for emergency evacuation of women with obstetrical complications. Support will also include training for health staff.
…in Cabo Delgado province
During the last three years UNICEF and partners have been supporting the MMR Plan in the northern province of Cabo Delgado. Twenty maternity wards were upgraded to provide basic emergency obstetric care and four hospitals to offer comprehensive obstetric care. Health professionals including physicians, nurses and midwives, received professional training in obstetric care. Health centres were equipped with necessary equipment and materials, and 7 ambulances and 24 communication radios were provided to respond to emergencies. To raise community awareness, 80 reproductive health activists and a theatre group were trained on community mobilisation.
As a result, more and more women have begun delivering in health facilities. Institutional deliveries increased from 25.5% in 2002 to 29.4% in 2003. The number of deliveries assisted by traditional birth attendants (TBAs) increased from 3,935 to 5,600 during the same period. Also, the number of maternal deaths in Cabo Delgado decreased from 19 to 10, which could be due to the fact that TBAs have been trained to recognise high-risk pregnancies and to promote safe delivery methods.