Liberia’s Maternal Health Services Under Stress Amidst COVID-19

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This baby mother is one of those for whom UNFPA is supporting the Liberian government’s Health Sector 

Korto, 20, is in the last month of her pregnancy. She says she is worried about the outcome as it is her first time. “My last pregnancy check-up is due, but I don’t feel safe going to the hospital during this coronavirus [pandemic],” said Korto.

As of July 11, 2020, the number of confirmed COVID-19 cases in the country had reached 1,010, according to the National Public Health Institute of Liberia (NPHIL).

The pandemic has put people of all ages and genders at risk, but pregnant women face particular challenges.

It is no secret that Liberia’s health sector before the Covid-19 outbreak had some major challenges including constant reports of drug shortage, low incentives for healthcare providers, absence of healthcare workers at some facilities and the long distance some of the population have to travel before accessing the nearest health facility, among others. The high maternal mortality ratio of 1072 per 100,000 live births is also an issue. This means that every 100,000 mothers who go to give birth in Liberia, at least 1,072 of them die in child birth.

But the Liberia Demographic and Health Survey 2019-20 released in May this year, speaks of some improvements in the country’s health data as about 80 percent of births occurred at health facilities; and 87 percent of women had four or more prenatal care visits.

Nevertheless, the COVID-19 pandemic seems to be reversing this gain. A recent assessment conducted by the Ministry of Health indicates a decline of 40 percent in access to health services including maternal and newborn health services in Montserrado County, which is the most urban and populated region of the country.

According to UNFPA, the United Nations Population Fund, “Sexual and reproductive health is a significant public health issue during epidemics, and safe pregnancy and childbirth depends on functioning health systems and strict adherence to infection precautions.”

“To support Liberia’s effort to contain the COVID-19 pandemic and keep its health system functional, UNFPA is strengthening the capacity of Liberia’s health system to respond effectively to COVID-19 and to deliver quality sexual and reproductive health services as well as dignity kits for women who are homebound or under quarantine,” said UNFPA Representative Dr. Bannet Ndyanabangi.

This specialized UN organ has provided funding to the Liberian Government, through the Ministry of Health, for the training of traditional midwives as well as those attending formal midwifery institutions around the country.

These contributions are reflected in the recent 2019-2020 Liberia Demography and Health Survey (LDHS) report. It speaks of the progress that Liberia had made before the outbreak of Covid-19.

In section 3.12 under Maternal Care of the LDHS report, the Liberia Institute of Statistics & Geo-Information Services (LISGIS), which produced the report in partnership with other agencies, including the Health of Ministry, states that 98 percent of mothers had reported receiving prenatal care from a health professional at least once for the most recent birth in the five-year period before the survey. According to LISGIS, this is slightly higher than the 96 percent reported in 2013. “This indicator is almost uniformly high among mothers, regardless of background characteristics,” the LDHS further said.

As with most crises, this pandemic has severely disrupted access to life-saving sexual and reproductive health services and hampered authorities’ ability to respond to gender-based violence, at a time when women and girls need these services.

Notwithstanding the present challenges, UNFPA has not wavered in its support to the health sector.

On Monday, April 13, 2020, UNFPA donated a US$400,000 assortment of medical supplies and equipment to the Government of Liberia. The items included delivery beds, reproductive health kits, newborn resuscitation machines, digital ultrasound scanners, fistula repair kits, gynecological gloves and hepatitis B vaccines.

UNFPA has also set up a maternity unit and an operating theater at the 14 Military Hospital, which is the nation’s main COVID-19 treatment center. The unit is staffed with skilled personnel.

There are reports that pregnant women are vulnerable during this outbreak. In trying to help solve the problem, the UN Agency has also put together a team of roving healthcare providers, including trained midwives, to provide care for quarantined pregnant women.

But with the upsurge in the Coronavirus cases in Liberia coupled with the level of denial and poor health infrastructure, getting the likes of Korto, a resident of Todee, rural Montserrado, to deliver at a health facility would require more efforts.

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