Speaking at the World Health Commemoration Day in Gaborone recently, Sinvula pointed out that over the past four decades, Botswana has fought hard to turn the tide on maternal mortality. He said in 1980, they faced a maternal mortality ratio (MMR) of 400 deaths per 100, 000 live births. However, he explained that through strategic interventions like free maternal health services, increased antenatal care, and strengthened emergency response the number declined significantly, reaching 127 per 100, 000 live births by 2015. However, he said that progress had not always been steady. He said between 2016 and 2019, maternal mortality stagnated at 144 per 100, 000 live births but then came COVID-19, it reversed hard-won gains, pushing MMR to 240 per 100, 000 live births in 2021. He pointed out that 240 mothers, 240 families were shattered and 240 dreams extinguished in the moment that should have brought new lives. “This is not just a statistic, it is a call to action. Maternal mortality is preventable, yet it continues to claim lives due to three major causes such as postpartum hemorrhage causing excessive bleeding after childbirth, responsible for 30% of maternal deaths; hypertensive disorders, including preeclampsia and eclampsia claiming 15% of maternal lives and lastly infections, including sepsis contributing to 12% of deaths,” he said.
He also explained that the deaths do not happen in an instant; they are the tragic result of three delays. He said those delays include delay in seeking care caused by fear, cultural norms, or lack of awareness that prevent women from going to a health facility; delay in reaching care attributed by distance, poor roads, and transport challenges turn a manageable complication into a fatal one and delay in receiving quality care saying overburdened facilities and resource shortages prevent timely interventions. Furthermore, he explained that the ministry will not recount despair, but declare a new era of hope, action, and commitment. He also stated that at the grassroots level, community health workers were the first line of defence as they were the bridge between families and the healthcare system, the hands that comfort, the voices that educate, and the guardians of maternal well being. He added that their work in early detection, prenatal guidance, and emergency preparedness must be recognised, reinforced, and resourced. “When a mother survives, a family thrives. When a mother is healthy, a nation prospers. Yet, for too many women, the journey to motherhood is still fraught with danger. We envision a Botswana where no mother hesitates to seek care because of cost, distance, or stigma; every village has trained community health workers monitoring expectant mothers; digital health solutions alert health workers to high-risk pregnancies in real-time and emergency obstetric care is swift, efficient, and accessible. We have the knowledge. We have the resources. We have the will. Now, we need to act,” Dr Sinvula emphasised.
For his part, the Assistant Minister of Health, Lawrence Ookedits,e said the theme for this year’s World Health Day emphasises the importance of maternal and newborn health, a fundamental pillar in building a healthier society, is “Healthy Beginnings, Hopeful Futures.” He added that it was not only relevant, but appropriate, as it reminded them, not only of the need to actively pursue prioritisation of women’s long-term health and well-being; but also resonates well with the government’s will and determination to constantly strive for strengthening Botswana’s healthcare system. The recent move to relocate primary health care functions to the Ministry of Local Government and Traditional Affairs was hailed as a move that will, in no doubt, improve the local settings to undertake, for instance, initiatives such as domiciliary services for maternal and new-born health. “Although our country has made significant progress in pursuing universal health coverage, expanding healthcare facilities, and improving access to essential medicines, something that will certainly improve with the commencement of the National Health Insurance, we still experience serious maternal mortality challenges,” he said. He further committed his ministry to ending those preventable deaths through targeted interventions like, amongst other things: strengthening antenatal and postnatal care, enhance public health campaigns, capacity building in healthcare and strengthening collaborations with their strategic partners.
