Maternal mortality in Somaliland in decline but still worrying

Improved healthcare facilities have considerably reduced the rate of maternal mortality in the self-declared republic of Somaliland, but officials say much more still needs to be done.

In 1997, 1,600 out of every 100,000 women giving birth were estimated to die in Somaliland.

Anwar Mohamed Eggeh, Somaliland's director-general in the Ministry of Health and Labour, told IRIN the rate in 2006 was 1,044 per 100,000.

He attributed this to “increasing health facilities in the main towns and remote areas, as well as improvement in living standards. However, the rate is still high, so the Ministry, with the collaboration of UNICEF [the UN Children’s Fund] and EU, is planning to further reduce the rate, establishing new health facilities for the general public.

"There are not enough facilities such as maternal health centres in the country compared to the population, and we want to reduce maternal mortality as we did child mortality, which we reduced by 50 percent,” he added.

Edna Aden Ismail, who set up a maternity and teaching hospital in Hargeisa in 2002, said the facility had contributed to the reduction in maternal deaths.

“We train professional midwives in the hospital, who are now working in the main town hospitals, such as Burou, Lasanod, Borama, Hargeisa Group hospitals,” she told IRIN.

“The other factor is we have enough equipment, professional midwives, nurses and doctors here and the most serious cases are referred to this hospital. Only 32 mothers died in our hospital out of 8,307, and many of them could have been saved if they had arrived at the hospital early enough,” she added.

Antenatal care was still inadequate in Somaliland, according to Ugaso Jama Guled, a midwife and activist fighting female genital mutilation/cutting, which she said was a major contributor to the territory’s high rate of maternal deaths.

She said other factors included pre-eclampsia, hypertension, abortions, pulmonary embolism, ectopic pregnancy and ruptured uteruses.

"Most Somaliland mothers die because of prolonged bleeding, pre-eclampsia, hypertension, infection and malnutrition, caused by lack of a balanced diet," Ugaso said.