Low-Cost Health Interventions Drastically Reducing Maternal Mortality in Sierra Leone and Burundi

Maternal Death Rates Plummet By Up to 74 Percent With Expanded Access to Emergency Obstetric Care

Ensuring pregnant women have timely access to emergency obstetric care has reduced maternal deaths by as much as 74 percent in parts of Burundi and Sierra Leone.

Burundi 2012 © Sarah Elliott

Mateso Emilienne, 25, was picked up by MSF ambulance the previous day from Gatumba Health Center. Her baby was delivered via Caesarean section.

BO,SIERRA LEONE/NEW YORK, NOVEMBER 26, 2012—Ensuring pregnant women have timely access to emergency obstetric care has reduced maternal deaths by as much as 74 percent in parts of two African countries, the medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) announced today.

Medical data gathered in 2011 from MSF projects in Bo, Sierra Leone, and Kabezi, Burundi indicate that the introduction of ambulance referral systems, together with the provision of emergency obstetric services, can significantly reduce the risk of women dying from pregnancy-related complications.

“You do not need state-of-the-art facilities or equipment to save many women’s lives,” said Vincent Lambert, MSF’s medical advisor for Burundi. “MSF’s experience can serve as an encouraging example for donors, governments and other NGOs considering investing in the improvement of access to emergency obstetric care in countries with high maternal mortality rates.”

The research, published in the paper, “Safe Delivery: Reducing maternal mortality in Sierra Leone and Burundi,” is the first of its kind to quantify the impact of such a model of care on maternal mortality in an African setting.

The comprehensive emergency obstetric services at MSF hospitals in Bo and Kabezi is provided 24 hours a day, seven days a week. All services are free of charge. The total annual operating costs of the programs are equivalent to just under two dollars per person in Bo and $4.15 per person in Kabezi.

MSF’s data indicate that maternal mortality in Burundi’s Kabezi district has fallen to 208 per 100,000 live births, compared to a national average of 800 per 100,000 live births, a 74 percent decrease. In Sierra Leone, MSF figures for the same year indicate that maternal mortality in Bo district has decreased to 351 per 100,000 live births, compared to 890 per 100,000 in the rest of the country, a 61 percent reduction. MSF is the only emergency obstetric care provider in Kabezi and Bo.

Sierra Leone and Burundi both suffer from extremely high maternal mortality rates due to lack of access to quality antenatal and obstetric care, which are linked to shortages of qualified health staff, a lack of medical facilities, and health systems that have been shattered by years of civil war.

“Giving birth in Sierra Leone is often a life-threatening endeavor for many women,” said Betty Raney, an obstetrician with MSF in Sierra Leone. “In my 25 years as an obstetrician, I have never seen such a level of severity among the patients. Had they not had any access to care, many of them would die.”

Using the United Nations Millennium Development Goal (MDG) of reducing maternal mortality by 75 percent by 2015 as a point of reference, MSF’s estimates indicate that the maternal mortality ratio in Kabezi is already below the MDG level. MSF is confident that the mortality ratio will have dropped by 75 percent in Bo by 2015.

Some 287,000 women worldwide die each year giving birth, leaving behind children ten times more likely to die prematurely as a result of their mothers’ deaths.

In 2011, MSF provided life-saving emergency obstetric care to a total of 3,647 women in Kabezi and Bo districts. MSF has been providing access to emergency obstetric care services in Burundi since 2006 and in Sierra Leone since 2008.