Zero Maternal Mortality At Bongo District

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Dr. Koku Awoonor-Williams, Upper East Regional Director of Health Services
Dr. Koku Awoonor-Williams, Upper East Regional Director of Health Services
Dr. Koku Awoonor-Williams, Upper East Regional Director of Health Services
Dr. Koku Awoonor-Williams, Upper East Regional Director of Health Services

Since news of Bongo district in the Upper East region recording zero maternal death in 2013 was reported early February this year, health authorities in the district say they have been inundated with numerous phone calls and emails from people near and far congratulating them for the achievement but also wanting to know how they achieved this.

 

The District Director of Health Services, Madam Juliana Akugre who disclosed this, said weeks after the report she presented at the district annual performance review was carried in the press, she continues to receive calls and messages from her colleague health staff and health partners all commending their efforts with many wanting to know how the district was able to achieve this and what they did differently. ?Since the day the news was reported, people have been calling with others sending text messages and emails most of them my colleague health staff and our various health partners? Madam Juliana hinted.

 

She maintained that the enviable record of no institutional maternal death for twelve months was attained through employing evidence-based practices with solid and collective effort of staff at the district hospital, as well as lower level facilities, support of community leaders and volunteers as well as health partners.

 

?I keep telling people who call or send messages to congratulate me for the achievement that, that record did not come about as a mere coincidence or one person?s effort: honestly speaking no one person can claim to have been the brain behind it all: not even myself as the District Director of Health Services. I only provided the dedicated and motivational leadership and with full support from my staff, we put our best foot forward hence the result that no woman died in the entire Bongo district giving birth or from pregnancy and birth related causes from any health facility in the district for the whole year?.

 

Madam Juliana said based on past experience, the district identified among other things five key areas for strengthening and improving maternal and child health and other indicators. These she noted included Midwives commitment, strict use of partograph, effective emergency referral, effectively promoting family planning and efficient and regular monitoring and supportive supervision.

 

Getting Midwives committed:

Madam Juliana said, rather than worry over the chronic insufficient midwife situation, the Bongo district at the beginning of 2013 decided as a priority to identify ways of getting the few midwives available to make more sacrifices in order to reach out to more women so as to increase skilled delivery. The district, she said then instituted motivation packages for midwives with an intensive orientation on costumer care. She said the decision by the Regional Director to post midwives to CHPS zones also led to significant improvement in access and quality of antenatal and postnatal services.

 

Focusing on emergency referral:

Emergency referral services saw significant improvement in the district following the scale-up of the Sustainable Emergency Referral Care (SERC) initiative under the Ghana Essential Health Intervention Programme (GEHIP). According to the District Director of Health Services, the intervention introduced Motor-King ambulances alongside an emergency communication package and this also contributed tremendously to the zero maternal death record. With twelve Motor-King ambulances placed strategically across the district, it became easy and effective to refer patients to the next level of care when the need arose. During the period a total of 500 cases mostly pregnant women in labour and children under five were successfully referred to next level of care.

 

?Anybody may say the district is lucky to be a beneficiary of the Sustainable Emergency Referral Care initiative but that is only part of the story: My team and I ensured that the intervention was carried out thoroughly. We ensured that from the community level through to the hospital, all staff knew what we wanted and everybody supported the process? Madam Juliana stressed.

 

Intensifying promotion of family planning services:

The district also made strides in promoting family planning thus increasing family planning acceptors by 8% over 2012 period. This improvement was as a result of series of community durbars and training of midwives and nurses to provide long term family planning services.

 

Regular monitoring and coaching:

The District Director of Health said she was highly indebted to the Doris Duke Charitable Foundation for funding support through the GEHIP programme which enabled them to successfully and effectively carry out all planned monitoring and supervision activities in the year.

 

She was glad that the communities appreciate their efforts and said the district will continue to improve on staff attitude, and take advantage of key interventions such as GEHIP, neonatal and newborn care as well as other innovations to improve the district performance in all areas.

 

Commenting on the strict use of partograph, the Medical Superintendent of the Bongo District Hospital Dr. William Gudu said the district came to a harsh conclusion a few years ago that all Midwives must have mastery skill in the use of partograph. He said after a series of training for midwives on use of partograph, the hospital decided that no midwife shall refer a case without plotting partograph to inform the receiving facility on progress of labour. This action, he indicated improved greatly not only partograph use, but also midwives mastery in the application of the tool and ensuring safe delivery.

 

?As I speak to you today, we are talking about 100% partograph use for all labour cases in Bongo District Hospital; that is the record here: a record we are proud has paid off. We have never been so good in our labour management decisions like the past years thanks to our efforts in adhering to the proper use of this time-tested and evidence-based labour management tool? Dr. Gudu revealed.

 

He said the hospital also took serious steps in ensuring there is adequate blood available in the hospital?s blood bank. This made it possible for blood transfusion for all cases that needed blood. ?Last year we had six ?near-misses?: managed two cases of severe eclampsia, successfully repaired three severe cases of cervical injuries and saved a severe asthmatic pregnant woman. In all events the readily availability of blood and our timely responses proved us right?.

 

The Regional Director of Health Services Dr. Koku Awoonor-Williams speaking in an interview commended the entire staff of the Bongo district for their commitment that saved the lives of pregnant mothers in the district. He said the feat achieved by the district is a demonstration that with commitment and concerted efforts, the MDGs can be achieved. He indicated that Bongo will be a learning centre of excellence for the rest of the districts in the region to study and emulate so that together the region can achieve zero maternal mortality.

Source?mathias aboba

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