In the market town of Senafe, in southern Eritrea, Fethawi Berhane has just undergone three days of painful labor and complications during child birth that resulted in the death of her baby. Despite the best efforts of a traditional birth attendant her child could not be saved. Luckily Fethawi survived amid the inhygenenic and poorly equipped medical conditions in which she had to give birth.
Fethawi's case is not a unique one in Eritrea, which once had the highest maternal mortality rates in the world with about 1400 deaths per 100,000 births. The main contributor to this was the high incidence of obstructed labour.
The rural nature of Eritrea, with poor communication and transportation infrastructure in the outlying areas, resulted in 80 percent of deliveries occurring without a physician or trained midwife.
Today, however, Eritrea is one of the four African countries said to be on course to achieve Millennium Development Goals five on Maternal Health – reducing by three quarters the maternal mortality ratio and reaching below 350 deaths per 100,000 births by 2015 since 2005.
This drastic positive change in the last few years has come about through a joint collaboration between the UNDP, the health ministry and other UN agencies. Concerted programmes that focus on maternal health campaigns have been intensified. Information and training on community awareness of maternal issues; delivery plans and preparedness for skilled attendants in health is conducted in local languages and in remote parts of the country. Traditional birth attendants have been trained to improve their skills.
Today, each community has trained maternal care givers. Expectant mothers living far from medical centres do not have to risk their lives and travel long distances while in labour. Trained birth attendants visit them in their homes before and after delivery, to ensure that both mother and baby are in good health, as well as to provide medical advice.
Additional funding of US$ 88 million would be required in the next four years to ensure universal coverage of maternal and neonatal health intervention in Eritrea – giving hope to women like Fethawi Berhane that child birth will no longer be a matter of life and death.