Stop stigma, reduce maternal mortality
Maternal mortality is unacceptably high: Ghana’s new-born and maternal mortality is 308 to 100,000 live births compared to the World Health Organisation’s (WHO) standard of 70 to 100,000 live births.
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Globally, about 287, 000 women died during and following pregnancy and childbirth in 2020.
Almost 95 per cent of all these deaths occurred in low and lower middle-income countries. Shockingly, most could have been prevented.
Teen mothers
The WHO estimates that about 21 million girls aged between 15–19 years in developing regions become pregnant with 12 million of them giving birth.
Research shows that adolescent mothers (aged 10–19 years) face higher risks of eclampsia, puerperal endometriosis and systemic infections than women aged 20–24 years.
Babies of adolescent mothers also face higher risks of low birth weight, pre-term birth and severe neonatal conditions.
Preventing pregnancy among adolescents is therefore key to achieving the Sustainable Development Goals (SDGs) related to maternal and new-born health.
Ghana is not immune to this crisis.
Between 2016 and 2020, Ghana recorded 542,131 pregnancies among young teenagers aged between 15–19 years.
Pregnancies at such a young age have a lifelong consequence for the mother and child.
It is undisputable that today’s adolescents are the drivers for the future economic and social development of Ghana.
However, if we stand aloof and watch thousands of our adolescents become pregnant — with some even losing their lives — then we cannot guarantee a sustainable and prosperous future for our beloved country.
This is why Youth Rise International (YoRI) is addressing new born and maternal mortality in a bid to reduce Ghana’s current rate of 308 deaths in each 100,000 live births.
Much has already been done. Successive governments have established radical health promotion policies and programmes in Ghana since the 1990s.
CHPS compound
Key among these is the Community-based Health Promotion Services (CHPS).
Through this innovative health strategy, most rural and hard-to-reach communities now have a CHPS compound — a mini-health centre which operates 24/7 and gives easy access to health care.
These centres are the first entry point for pregnant women, including adolescent or teenage mothers to receive ante-natal care and are a lifeline for the community.
Since 2022, for example, Youth Rise International — in collaboration with the District Health Director and the District Assembly of the Ekumfi District in the Central Region of Ghana — reached out to over 10,000 people to raise awareness.
Through this, it has been able to provide direct quality health care, helping 90 high-risk pregnant women — all geared towards achieving zero home delivery and zero newborn and maternal mortality.
High risk
Today, the YRI has directly worked with over 5,000 high risk pregnant women across the district and embarked on national advocacy to promote such interventions.
Our community discussions have consistently raised the trend of high-risk pregnancy among adolescents as key.
Many reports that such young mothers often encounter systemic discrimination in the healthcare system with unprofessional and unethical attitudes among some healthcare staff.
Teen-friendly facilities
When the health system combines both adult and adolescent girls, these younger mothers often face discrimination in pre-and post-natal care.
The young mothers do not find the CHPS welcoming – instead, they avoid these services and turn to unapproved and unauthorised herbal medicines.
This worsens the already vulnerable and high-risk situation they find themselves as adolescent or teenage mothers - especially those from very deprived and rural grassroots communities.
We need a teen-friendly and trauma-informed health system that supports our vulnerable mothers.
The WHO research shows that “care by skilled health professionals before, during and after childbirth can save the lives of women and newborns”.
But consider the story of 17-year-old teen mother Grace, a recent beneficiary of our ongoing zero newborn and maternal mortality project in the Central Region.
Grace already has a one-year-old child and is currently seven months pregnant.
Grace told our team how, during her first pregnancy, her antenatal visits were marked by series of rebukes as well as insensitive and traumatising interrogations from adult pregnant women and healthcare professionals at the health centre she visited.
Even though she had heard about family planning and birth control through the radio, she was afraid to ask for this support at the clinic.
A second unplanned pregnancy was the result.
This time, she felt too traumatised to even attend the antenatal clinic – putting herself and her unborn child at risk.
Access to health
Access to health is a right. The government of Ghana — having ratified the UN Convention on the Rights of the Child in 1990 — also has an obligation to promote and ensure the health, protection and well-being of adolescents.
We call on the Ministry of Health (MoH) and the Ghana Health Service (GHS) to retrain health workers across the country on the patient charter -- focusing specifically on non-discrimination, inclusion and trauma-informed care.
We need to ensure that health workers serve teen or adolescent mothers with high levels of professionalism and ethical standards.
This must then be supported with teen-friendly and trauma-informed care clinics or service delivery days that cater for young women.
In this way, teen or adolescent mothers will not be hindered by ostracism, stigma, derogatory and non-dignifying comments and unnecessary interrogations from adult clients.
We must create a welcoming environment so that they will feel motivated to visit health facilities and increase their chances of a healthy birth.
We owe it to our young mothers and children.
We owe it to Ghana.
The writer is the Founder & Executive Director of Youth Rise International