The launch of UNFPA-supported report “Why Mothers Died”, focuses on recommendations to address maternal mortality in Mongolia.
On February 16, 2017, the national dissemination meeting of the Maternal Mortality Review was held at the National Center for
Maternal and Child Health (NCMCH). UNFPA Country Representative Naomi Kitahara gave the opening speech, which precluded the launch of the official report entitled “Why Mothers Died”. This is the fourth review of the case series and covers the period from 2012-2015.
In her speech, Ms. Kitahara reiterated UNFPA’s global mandate to reduce maternal mortality, especially the critical importance of gathering quality data. Specifically, quality data gleaned from the “Confidential Enquiry for Maternal Deaths,” an internationally-recognized methodology for assessing maternal mortality.
“The Confidential Enquiry is, by design, an approach aiming at improving the health system and the quality of health care by collecting data, identifying shortfalls in health service provision, and suggesting recommendations,” she said. “It forms a basis for key policy and technical-level decisions needed to avert maternal deaths.”
Findings of the review highlighted a decrease in maternal mortality cases from 151 to 118. The direct and indirect causes were registered as 52.5 % and 46.3% respectively in the current study, which showed no significant difference from the past review (54.3 & 44.4%). The main, direct causes of maternal mortality were identified as Septic condition (24.2%), Hemorrhage (17.7%) and Preeclampsia (17.7%).
On this basis, the report provided the following key recommendations: 1) the need for urgent in-depth review of sepsis cases as well as changing the prevailing antibiotics administration regimen to strengthen the current obstetric infection management protocols to meet the international guidelines and standards; 2) improving the skills of the health care service providers and the quality of antenatal care, with particular attention to critical elements of antenatal care such as quality rapid testing, a functional referral system, and outreach programs with health education and counseling services. It was emphasized that these should all be made available at no cost to poorer segments of the population.
As Mongolia now looks towards the global targets set by the Sustainable Development Goals in 2030, specifically in achieving good health and wellbeing for all, these recommendations have become even more crucial if it hopes to replicate its past successes. “It was a proud achievement for Mongolia to be one of only 9 countries in the world in 2015 which met the maternal mortality reduction target of the Millennium Development Goals,” says Ms. Kitahara, “However, the recent increase of the maternal mortality ratio by almost two-fold indicates the fragility of Mongolia’s health system and its vulnerability to external shocks, including economic difficulties which the country faces today. In addition, the effect of violence against women and girls, and especially violence by intimate partner, should not be forgotten, as it is contributing to maternal deaths, and this has to be explored more deeply in the future studies."
Further, the review provides solid data, which could serve as the basis for policy and programme development and implementation. “Globally, we know strong family planning programmes, strengthened emergency obstetric and newborn care (EMONC), and enhanced skilled birth attendance are key to reduce maternal mortality. Mongolia has done well in ensuring skilled birth attendance, but needs to continuously improve the quality of emergency obstetric and newborn care and recalibrate its approach to family planning,” Ms. Kitahara says.
She goes on to emphasize the rationale behind policy and programme environment with a strong family planning agenda at its core goes far beyond ensuring the health of individuals, but addresses a universal principle. “Family planning is a human right, and modern contraceptives must be available for women in need to avoid any unwanted pregnancies. Health care providers should have good counselling skills in family planning, and strong political will is essential to secure sufficient state funding for contraceptives.”
She concluded her speech with continued confidence in the Mongolian government’s ability to overcome the present challenges in the realm of maternal mortality.” It is my firm belief that through the leadership of the Ministry of Health and NCMCH, backed by a deliberate, concerted allocation of the right levels of financial and human resources, a replication of past success in the reduction of maternal mortality is more than achievable in Mongolia.”
With UNFPA’s commitment to be a partner to the Government of Mongolia in this endeavour, assurances were given to fulfill UNFPA’s mandate: to deliver a world every pregnancy is wanted, and every child birth is safe. “Mothers do not need to die, giving birth,” declared Ms. Kitahara.
And the more when there is known about maternal mortality in Mongolia through such undertakings as this report, taken seriously by government through supportive policies and programmes.
A. Esguerra, Dr. Shinetugs B., Dr. Tsednmaa B.
