There are many ways to improve availability of pregnancy and childbirth care services in our communities. These services should be readily available, 24-hours a day, seven days a week. It is essential that these services be accessible in remote areas, as well as in cities where there are no health facilities. Additionally, a well-functioning prenatal care system should be able to meet the needs of all pregnant women, including those who are unable to deliver their babies.
The conflict and displacement of the health workforce in Syria resulted in a severe shortage of healthcare providers. Furthermore, the recurrent attacks on health facilities have led to a decline in access to healthcare. A lack of healthcare facilities and skilled birth attendants has resulted in a rise in maternal mortality rates, which have increased dramatically in the past few years. Insecure environments can increase the risk of C-section, a procedure that is not always necessary.
Despite the availability of skilled healthcare workers, many countries in the world still struggle to ensure access to such services. For example, in Syria, 96% of women had a skilled birth attendant, and 88% had at least one antenatal visit. Consequently, the MMR was 52 per 100,000 live births in 2009, and it has since risen to 68/100,000 in 2015. As a result, the United Nations and WHO have set a goal of reducing the MMR to 45 per 100 thousand by 2030.
While it may seem simple to make improvements in these services, these changes often result in a lack of quality. In addition to insufficient access, the conflict-ridden environment has also affected the quality of care. In Damascus, women reported inaccessibility to the hospital because of security risks. While women were self-referred to small hospitals, these providers were unable to provide the care they needed. As a result, they were often unable to receive the specialized care they needed to deliver their babies.
Despite the conflict in Syria, efforts to ensure the safety of pregnancy and childbirth care services were continued. During the war, women were still unable to access healthcare facilities, and many women were forced to give birth at home instead of being transported to hospitals. Moreover, despite these obstacles, it was important to improve the quality of pregnancy and childbirth care services in Syria. The Syrian population’s MMR increased during the conflict, while the population-level indicator remained stable.
Accessibility of pregnancy and childbirth care services in conflict-affected areas is critical. However, women in Syria often experience difficulties in delivering their babies, such as inaccessibility and lack of healthcare workers. In a conflict-torn region, the availability of care is also often limited. During the war in Syria, there were no facilities, despite having medical personnel. Insecure settings resulted in high C-section rates.
The availability of community-based midwives in Syria was an essential part of the Syrian health care system. The program was crucial to ensuring skilled birth attendance. In addition, midwives were required to sign birth registration forms, which were vital for ensuring the safety of the newborn. In addition to providing skilled care, midwives were trained to refer women to hospitals when obstetricians were unable to deliver a baby.
A large number of authors have documented access to care in conflict-affected countries. The accessibility of care in Syria was also a significant issue, with a reported lack of access to medical services. Despite the lack of health facilities, women in the conflict-affected country reported poor access to health facilities. The situation created high pressure on women and the health systems. Insecure environments also compromise the quality of care.
In Syria, women in Damascus reported insufficient access to care. In addition, women in Damascus were forced to self-refer to small hospitals for treatment. Despite the insecurity, these small facilities were often not equipped to deliver babies. After they delivered, they were transported to a large teaching referral hospital by ambulance. While these delays affected their health, they did not allow them to undergo a Caesarean-section.