Malawi Government through the ministry of health says it is striving to improve hygiene conditions in hospitals following a report indicating that infections that emanate from poor hygiene conditions are the leading cause of maternal mortality.
This was disclosed on Monday, 15 January, 2024 in Blantyre during a one-day media advocacy meeting on Reproductive, Maternal, Newborn, Child, Adolescent Health, and Nutrition (RMNCAH+N) and Malaria which was organised by the Reproductive Health Division in the Ministry of Health with support from MOMENTUM Tiyeni Project.
In an interview after the meeting, Deputy Director of Reproductive Health in the Ministry of Health, Dr Owen Chikhwaza, said the country is doing well on reproductive health evidenced by the reduction of maternal mortality ratio from 675 to 439 per 100,000 live births between 2010 and 2016, and the current ratio which is estimated at 381 per 100,000 live births (2017-2020).
“For reproductive health in Malawi, I would say that it’s both positive and a bit of negative, but on average, I would say that we are doing well as a country as estimates are showing that the mortality rates are reducing,” he said.
He, however, pointed out that despite another report showing that 97% of births are happening at hospitals or at medical facilities, the leading cause of maternal mortality has changed from haemorrhage, bleeding, and hypertensive disorders of pregnancy to infections.
Responding to why this is the case when more women are delivering in hospitals, Chikhwaza said this may happen because of unhygienic environment during surgeries He said others are from septic miscarriages while in some cases it is because women do go to hospitals while they are already infected due to different conditions in their homes.
“We have seen that the leading causes of maternal mortality are changing. Now, the biggest leading cause is infection, followed by haemorrhage, bleeding, and hypertensive disorders of pregnancy. It is also our problem that infection is the leading cause of mortality while everybody else is delivering in the hospital.
“We do know that infection is a two-way process. If you have unhygienic environment when surgeries are taking place, because data also shows that the majority of those infections, are from operated cases like scissor section cases. Others are from septic miscarriages and other women would just come from home with infections. For some patients from rural areas, hygiene would not be as good as we would love it to be. Another source of infection would be if the aseptic techniques were not followed through the process of delivery and if they have gone through surgery.” explained Chikhwaza.
Chikhwaza further said the ministry is now relentlessly working on measures to put in place so that infections should no longer be a challenge.
He further highlighted that there are also other things the general population should do on the matter so that the standard development goals should be achieved by the year 2030.
According to the Deputy Director, one of the interventions government is intending to do is to formulate policies which will see hot water being provided in labour wards for pregnant women to take a bath and also mandating doctors to clean birth canals with antiseptic solution before performing any surgery.
“One of the things that we believe we are going to be doing to advocate is that we want to find ways of cleaning our women. If we find a way of our women to shower, to be clean even before you are taking them to theatre or when they just arrive in labour ward, but we realise that most labour ward don’t have hot water.
“We will be talking to our donors to provide hot water in the labour ward so that people can take a bath, and also research has shown that cleaning the birth canal before surgery reduces the rate of infection by caesarean sections. I think this is the time that now we should start considering to actually implement this, to advocate as a ministry, make it a policy that all the doctors that are conducting surgeries, they should be cleaning the birth canal with antiseptic solution before performing the surgeries and also advocate for the availability of the cleaning agents,” he added.
He continued by saying this is a wake-up call for people working in the health sector, both the partners and those in government to make sure that at all the times antiseptic solution is available for the surgeries, admitting that there were many times when surgeries were carried without antiseptic solution.