IMPROVING MATERNAL HEALTH - EFFORTS BY TAMALE TEACHING HOSPITAL (PAGE 11, DG, SEPT 6, 2011)

IMPROVING the health of women remains very crucial to the health of the entire population and this explains why the United Nations includes this in its Millennium Development Goals (MDGs). Goal four of the MDGs is directed towards “reducing by three quarters the ratio of women dying in childbirth.” How each nation is working to attain these goals remains essential because, as the former UN Secretary-General, Busumburu Kofi Annan, once stated: “It is not in the UN that the MDGs will be achieved. They have to be achieved in each of its member states, by the joint efforts of their governments and people.” The Tamale Teaching Hospital (TTH), being the only one of its kind in Northern Ghana is expected to play a key role in reducing maternal and child deaths in the country. Apart from being a major referral point for emergency cases, it also boasts of a number of specialists, including obstetric gynaecologists and paediatricians, who can provide comprehensive maternal and child care. The provision of maternal care at the TTH has, however, encountered challenges over the years and this is evidenced in the situation where mothers and their babies are compelled to use the floor due to the lack of space. In the wake of increased patient numbers, the labour, maternity and gynaec wards have been overwhelmed, leading to some instances of poor service delivery. Recent statistics indicate that the TTH records about 7000 deliveries in a year and about 12-15 per cent are through caesarean operations. In many cases, women with labour and abortion-related complications are brought to the facility when their condition has worsened and not much can be done to save them. In 2007, the hospital recorded 74 maternal deaths. There was a significant reduction in the number of these deaths to 54 and 52 in 2008 and 2009, respectively. In 2010, 33 incidents of maternal deaths were recorded, indicating a considerable decline, in spite of increasing number of births. Eclampsia, unsafe abortion, postpartum haemorrhage, severe anaemia and sepsis and septicaemia have been identified as the main causes of these deaths. Although one can observe a decline in the number of maternal deaths at the TTH, it is still regrettable that women should continue to lose their lives in an attempt to procreate. According to the Chief Executive Officer (CEO) of the TTH, Dr Ken Sagoe, the incidences of maternal deaths have remained a concern for the management. “We are not comfortable with these deaths, which we have been working hard over the years to avoid. Many of them are as a result of delayed referrals,” he lamented, adding that the pressure on the facility keeps increasing thereby distorting any progress made. Dr Sagoe however thinks that the difficulties facing the maternity, labour and gynae wards would minimise greatly when the rehabilitation of the hospital is completed. In May 2010, the rehabilitation and expansion of the TTH commenced after the government secured funds from the government of the Netherlands to support the project. The first phase of the project, which involves the construction of a new four-storey block at the eastern side of the hospital, is at the completion stages. Among the units to be housed at the new block are an improved labour and delivery wards and more operating theatres. “The issue of overcrowding would be no more because there would be adequate space for the labour and maternity wards, as well as more theatres,” Dr Sagoe stated. Unfortunately, the problem with the labour and maternity wards does not only have to do with inadequate space, but also has everything to do with poor attitudes of some of the staffs. Whiles a number of the nurses conduct their duties professionally and show compassion when dealing with clients, a handful of them behave as if they were literally pulled from their comfort zones and forced into the wards. These poor attitudes have repeatedly attracted public displeasure and led to a situation where some clients rush to the press to express their frustrations over the way and manner they were treated. Certainly, the management of the TTH cannot be impressed about the situation where a few bad nuts tarnish the image of the entire nursing flock. “We have noted with concern these grey areas and we have repeatedly sounded a note of caution to our workers to be reminded each time about their unique roles,” Dr Sagoe stated. He said one thing he had learnt over his several years of medical practice was that “the frustrations of a single dissatisfied client can spread faster than the joy of a many satisfied clients.” “We have instituted a number of measures to check the professional conduct of our workers. We have also been holding in-service training to build their capacities to deliver as expected,” the CEO mentioned, adding that “we want our staff to understand that we are now a teaching hospital and must deliver to par.” The head of the labour and maternity wards, Dr David Kolbilla, however, entreats the public to have some considerations for the nurses, noting that they were constantly working under duress. “They are humans and they are bound to succumb to pressure sometimes,” he said. Fortunately for the TTH, it now has about 70 midwives out of over 700 nurses and this is a boost to its efforts to improve maternal care. It is imperative for the management of the TTH to strengthen its efforts towards improving maternal health because the health of our mothers, wives and sisters is inevitably linked to the health of the entire nation.