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In the era of humanitarian crisis, young women continue to die in childbirth in Mali

Страны
Мали
Источники
BioMed Central
Дата публикации
Происхождение
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Pierre Coulibaly, Clémence Schantz, Brehima Traoré, Nanko S. Bagayoko, Abdoulaye Traoré, Fanny Chabrol & Oumar Guindo

Abstract

Maternal mortality occurs mostly in contexts of poverty and health system collapse. Mali has a very high maternal mortality rate and this extremely high mortality rate is due in part to longstanding constraints in maternal health services. The central region has been particularly affected by the humanitarian crisis in recent years, and maternal health has been aggravated by the conflict. Sominé Dolo Hospital is located in Mopti, central region. In the last decade, a high number of pregnant or delivering women have died in this hospital.

We conducted a retrospective and exhaustive study of maternal deaths occurring in Mopti hospital. Between 2007 and 2019, 420 women died, with an average of 32 deaths per year. The years 2014–2015 and the last 2 years have been particularly deadly, with 40 and 50 deaths in 2018 and 2019, respectively. The main causes were hypertensive disorders/eclampsia and haemorrhage. 80% of these women’s deaths were preventable. Two major explanations result in these maternal deaths in Sominé Dolo’s hospital: first, a lack of accessible and safe blood, and second, the absence of a reference and evacuation referral system, all of which are aggravated by security issues in and around Mopti.

Access to quality hospital care is in dire need in the Mopti region. There is an urgent need for a safe blood collection system and free of charge for pregnant women. We also strongly recommend that the referral/evacuation system be reinvigorated, and that universal health coverage be strengthened.

Background

Maternal mortality occurs mostly in contexts of poverty and health system collapse. In 2017, 295,000 women died in childbirth worldwide, 196,000 of them in sub-Saharan Africa. Mali has a very high maternal mortality rate (562 women dying per 100,000 live births), and this extremely high mortality rate is due in part to longstanding constraints in maternal health services. Even though there has been progress worldwide, including in Africa, we would like to communicate the alarming figures of our retrospective study of maternal deaths in Sominé Dolo Hospital in the Mopti region over the course of a decade. Most of these deaths occurred among young women and could have been avoided if the health system had been strengthened and the region stabilised.