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Table of Contents   
EDITORIAL COMMENTARY  
Year : 2017  |  Volume : 10  |  Issue : 4  |  Page : 801-802
Training and deploying midwives to reduce the incidence of maternal deaths in Somalia


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India

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Date of Web Publication5-Oct-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Training and deploying midwives to reduce the incidence of maternal deaths in Somalia. Ann Trop Med Public Health 2017;10:801-2

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Training and deploying midwives to reduce the incidence of maternal deaths in Somalia. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Nov 19];10:801-2. Available from: http://www.atmph.org/text.asp?2017/10/4/801/196517
The rates of maternal mortality are extremely high with more than 800 women losing their lives to pregnancy of delivery-associated complications on a daily basis across the globe.[1] It is really alarming that almost all of these deaths have been reported from poor-resource settings and most of them are easily avoidable.[1],[2] In fact, the lifetime risk of death due to pregnancy is 27 times more than that of women from developed nations.[1] However, the maternal mortality rates become extremely high (1 in 54) among women living in nations with a damage to the public health-care delivery system.[1]

The infrastructure and resources of Somalia have been extensively damaged by the brutal conflict which has extended for more than 2 decades and has accounted for the displacement of thousands of people and even compromised the chances of the general population to avail basic health services.[3] There is no doubt that the quality of life of people from all walks of life have been affected; nevertheless, the extent of damage has been enormous among the vulnerable sections of the community.[2],[3] The estimates from the nation suggest that only one-fifth of the women have an access to skilled birth attendant at times of childbirth, while 94% of women do not have access to modern contraceptive methods.[3],[4]

Further, the nation has the third highest rates of maternal mortality across the world and presents a life-threatening scenario for the pregnant women.[3] Another, shocking trend of the nation is that in excess of 95% of women and girls have been subjected to the unethical practice of female genital mutilation, which not only violates their basic rights and cast serious psychological trauma, but also even significantly enhances the probability of complications and death during childbirth.[3],[4]

Even though, different factors have been held responsible for the high maternal deaths in the nation ranging from poor governance, health sector shortcomings (viz., infrastructure constraints, resource or logistics shortage, etc.), community attributes, sociocultural attributes, the most crucial factor is the shortage of skilled birth attendants or midwives to supervise the childbirth.[3],[4],[5]

Midwives are acknowledged as the backbone for the delivery of sexual and reproductive package of the health-care services in the region. In order to improve the trends of maternal mortality, the United Nation Population Fund has started an initiative to ensure delivery of skilled care to the pregnant women during their childbirth by training midwives across the nation.[4] Owing to the constant efforts, more than 1,000 midwives have been trained and have been deployed in various settings in the nation.[4] The encouraging sign is that the local women are beginning to realize the importance of trained midwives in having a healthy pregnancy outcome, and at the same time the risk associated with untrained traditional birth attendants.[4],[6]

In addition, these trained midwives are playing a crucial role in putting an end to the practice of female genital mutilation by conducting counseling session of the family members and other stakeholders, and in improving the access and acceptance to the modern contraceptive.[4],[6] However, even now the maternal mortality ratio is still very high and a lot needs to be done and the program has to be expanded further to ensure that none of the childbirth remains unattended.[2],[4]

Thus, there is a great need to invest in quality training, provide healthy working conditions, and opportunities for their professional growth to ensure that they continue to exercise their duties even in future.[1],[2],[4],[6]

To conclude, the midwives contribution toward the improvement of the sexual and reproductive health in the nation can be significantly enhanced. The need of the hour is to have a more coordinated effort between the local government and external agencies to strengthen and expand the program to the entire nation.

Acknowledgement

S.R.S. contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

P.S.S. contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

J.R. contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
World Health Organization Maternal mortality-Fact sheet No 348; 2015. Available from: http://www.who.int/mediacentre/factsheets/fs348/en/. [Last accessed on 2016 July 10].  Back to cited text no. 1
    
2.
Shrivastava SR, Shrivastava PS, Ramasamy J. Reduction in global maternal mortality ratio far from expectation: So what next? J Curr Res Sci Med 2016;2:58-9.  Back to cited text no. 2
  [Full text]  
3.
Devi S. Somalia calls for greater coordination in health assistance. Lancet 2016;387:1263-4.  Back to cited text no. 3
[PUBMED]    
4.
Midwives on the frontlines of fighting maternal death in Somalia; 2016. Available from: http://www.unfpa.org/news/midwives-frontlines-fighting-maternal-death-somalia. [Last accessed on 2016 July 10].  Back to cited text no. 4
    
5.
Warsame A. Opportunity for health systems strengthening in Somalia. Lancet Glob Health 2014;2:e197-8.  Back to cited text no. 5
[PUBMED]    
6.
Hajizadeh S, Ramezani Tehrani F, Simbar M, Farzadfar F. Effects of recruiting midwives into a family physician program on the indices of maternal health program in the rural areas of Kurdistan. Glob J Health Sci 2016;8:535-9.  Back to cited text no. 6
    

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Correspondence Address:
Saurabh R Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute,Ammapettai Village, Thiruporur, Guduvancherry Main Road, Sembakkam Post, Kancheepuram, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.196517

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