Factors That Contribute to Maternal Mortality in Sierra Leone

Introduction

The happiest times in a woman's life are her wedding day and during her pregnancy and child birth. No one thinks of maternal death during the nine months of her pregnancy. After the birth of the child people are cooing and admiring the baby but forget the mother. Maternal death can happen at any time during labor or after the delivery. Mothers occasionally tend to relax and feel that all is well after the delivery but in actuality it is the beginning of all ailments that can occur if one is not careful. As they say in our local parlance in Sierra Leone "Way woman born en grave don open" when translated into English it means that after a woman's birth she is open to all and any ailments or death.

Maternal mortality or obstetrical death is the death of a woman during pregnancy or forty-two hours of termination of pregnancy (World Health Organization, 2010). Maternal mortality has been an underlying factor of the depreciating health care system in Sierra Leone, it is a known fact that many women die during pregnancy and child birth. At present Sierra Leone's maternal mortality rate is one of the highest in the world, about 2,000 mothers die per 100,000 live births in Sierra Leone. (Bakke, 2009).

There are several factors that contribute to maternal mortality in Sierra Leone. Although several births are attended by a licensed practitioner such as physicians and midwives, it is only 50% of those births. The rest are attended by untrained local personnel. Prenatal care in the rural areas especially is none existent (Wachuku-king, & Stanley, 1994). These traditional birthing attendants help to fill the places of trained professionals, they play a very important role in health care delivery in Sierra Leone (Edwards, 1987).

Many factors complicate the health care delivery system in Sierra Leone, and for maternal health it is even more complicated due to the believes of local, cultural and social ideas. Another local saying in Sierra Leone is "Na belly nor more eh get" Meaning she is only pregnant. Forgetting that within that woman's body lives another human growing using up all her energy nutrients etc. Sierra Leone does not have any system in place to provide assistance with nutrition as in the USA with WIC (Women Infant and Children Nutritional Supplements). These and other factors such as transportation which leads to the lack of emergency obstetric service, inadequacy of resources in many facilities such as no vitamin supplements, and socioeconomic variables also lead to higher maternal mortality (Wachuku-king, & Stanley, 1994).

Sierra Leone has set many goals within the health care system and with money provided from foreign entities she should be adequately prepared to meet those goals. In 1980 Sierra Leone's primary care program, which was established in the 1980s, was to reduce maternal mortality by 30% by the