By Mustapha K. Darboe
In the recent few years, death of women during birth has made frequent headlines in Gambian newspapers, culminating in the formation of a pressure group called Women’s lives matter. The group holds that maternal death was increasing amidst concerns over poor healthcare delivery.
In September 2021, the pressure group held a peaceful protest calling for the government to do more in protecting women. This was barely 3 months before the presidential elections.
Both the president Adama Barrow and his minister of health Dr Ahmadou Lamin Samateh insisted the available data shows a downward trend in maternal death.
Claims
The Gambia’s health policy, which targets reducing maternal death to 70 and below, recorded 289 deaths per 100, 000 live births. The same figure is referenced in the Gambia Demographic Health Survey 2019/2020.
All other studies by the government that followed either relied on this data or the 2013 Census data which recorded 433 deaths for every 100,000 live births.
In an appearance before parliament in 2020, Dr Samateh claimed a decline in maternal death to 221 per 100, 000 live births in 2019.
Study contest reliability of previous data
As the debate rages over “increasing” maternal death which was largely based on anecdotal evidence by the activists, fact-checking organisations Malagen and Fact-Check Gambia— relying on data produced by the state— validated the government’s position that maternal death was declining.
However, a recent study conducted by Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine (MRCG at LSHTM), the Ministry of Health and the Gambia Bureau of statistics, shows the maternal mortality in 2012 was twice as high as reported.
The researchers relied on data gathered through the 2013 National Population and Housing Census. They found that the pregnancy-related mortality for the country was estimated at 861 per 100,000 live births. Not 433 per 100,000 live births as reported.
Significance
This study has drawn a thick question mark over the reliability of the previously collected data on maternal death.
“This research constitutes the first attempt to estimate mortality among women due to pregnancy-related causes using a nationally representative dataset, the 2013 census,” said the lead researcher Dr Momodou Jasseh.
“All previous efforts were based on small sample surveys or indirect methods of estimation, which rendered their outputs largely flawed, significantly downward-biased and unsuitable for use in national maternal and reproductive health planning.”
Dr Mustapha Bittaye, the director of health services who participated in the study, calls it an opportunity to review their policy documents to reflect their study’s findings.
