One of the major health indicators to show that a country’s health sector is doing well is the maternal mortality ratio (MMR).
Until the deadly Ebola virus disease (EVD) outbreak in March 2014 in Liberia, the country had scored some success reportage on MMR.
Stakeholders in the health sector were reporting that the 994 figure per 100,000 live births, which had been around for more than five years, had dropped to a little over 700 per 100,000.
This means that out of every 100,000 women who went to deliver their babies in Liberia, sadly, 994 died in childbirth.
The Liberian government, through the Ministry of Health, scored a big success in reducing the 994 mortality ratio to a little over 700, and was even poised to further reduce the figure.
However, the Ministry of Health’s 2014 Report, following the Ebola crisis, disclosed a grim picture of the nation’s MMR.
It stated: “Liberia is among countries with dire maternal mortality rates at 1,072 deaths per 100,000 live births. To ensure that this undesired rate tumbles, the health sector has elaborated a maternal and newborn mortality reduction roadmap with cost effective interventions.”
The Ministry went on to list factors that have contributed to the high MMR, including limited access to basic emergency obstetric services, low utilization of family planning services, low coverage of antenatal and postnatal services, insufficient number of skilled birth attendants, delays in referrals, and weak referral systems.
It went further to state that despite the under-reporting of maternal deaths by health facilities for fear of been investigated, criticized and punished, and the lack of verbal autopsies, maternal deaths remain very high.
According to the Health Ministry, maternal deaths recorded for 2014 indicated that for every 1,000 live births there were two maternal deaths; and counties that reported high maternal deaths were Gbarpolu (12 deaths per 1,000 live births) and Maryland (5 deaths per 1,000 live births).
It also said that a majority of maternal deaths in Liberia is due to postpartum hemorrhage, obstructed or prolonged labor, complications resulting from unsafe abortions, eclampsia, malaria and anemia.
The Ebola Virus Disease outbreak in Liberia killed 184 health workers, leading to a spike in maternal mortality rates in a country which already had one of the world’s highest rates. The government and health partners are piloting a new training approach to try to boost maternal health capacity.
According to a recently-published World Bank report, the loss of health care workers to Ebola led to a spike in maternal mortality rates, with the government recording an increase of 111 percent in May 2015, when compared to the same period in 2013. Liberia’s maternal mortality rate was already extremely high in 2013, with 1,072 deaths per 100,000 live births, according to the 2013 Liberia Demographic and Health Survey (LDHS), conducted by the Liberia Institute of Statistics & Geo-Information Services (LISGIS). In other words, Liberian women have a one in ten chance of dying in childbirth, compared to one in 8,000 on average, in developed nations.
LISGIS is an agency of the Liberian government which conducts surveys and censuses.