Explain what free maternal care entails — Report

Saturday, September 25, 2010 (The Mirror Pg 27)

By Rebecca Kwei
A REPORT on tracking the Millennium Development Goals (MDGs) on health has called for a clearer definition of the ‘free maternal care’ scheme.
This according to the report was to minimise conflicting interpretations of the National Health Insurance Scheme (NHIS) policy and its associated exemptions.
The report said the free maternal care was interpreted differently by practitioners at different locations.
For instance, it indicated that without an NHIS subscription, a mother may be required to pay for various delivery services while in some cases, mothers were required to provide a string of items. Nurses were also reported to have insisted on particular product brands or rejected used sheets and old cloths intended as nappies all of which limited poor women’s access to skilled deliveries at such facilities.
The report dubbed ‘Tracking Health MDGs: Beneficiary Perspectives- Ghana Civil Society MDGs Campaign was launched at a forum “Stand Up and Take Action Against Maternal Deaths in Ghana”, organised by the Alliance for Reproductive Health Rights (ARHR) in collaboration with the Health Platform in Accra.
The content of the report is divided into eight main parts namely child health, care-seeking behaviour, sanitation, immunisation and maternal prophylaxis, treated bed nets, maternal health, HIV/AIDs and tuberculosis and malaria. The report also addresses the identified goals, targets and indicators of the official MDG list as well as priorities indicated in the Ghana Health Service’s current Programme of Work.
The forum comes on the heels of of the 2008 Ghana Millennium Development Goals Report which said that “Maternal mortality rate at 451 deaths at 100,000 live births is high and Ghana is unlikely to attain the target of reducing by three quarters, the maternal mortality ratio between 1990 and 2015, even though maternal health care has improved over the past 20 years.”
Giving a review of the document, the Director of the Local Government Institute, Dr Esther Ofei-Aboagye, said the report focused on five selected districts – Agona East, Bongo, Builsa, Komenda-Edina-Eguafo-Abrem (KEEA) and Kwahu North.
She said the current report also expanded on the previous effort which involved three districts — Bongo, KEEA and Kwahu-North.
Dr Ofei-Aboagye said the low knowledge on the danger signs in pregnancy as shown in the report was a problem on which action must be stepped up.
However, she said the report indicated that more women were participating in ante-natal care was rewarding, while the fact that women recognised the importance of formal facilities in the event of obstetric emergencies was also encouraging.
She said, non-medical factors such as transport challenges to facility-based healthcare institutions in rural areas, attitude of care givers, differential interpretation of the policy on free maternal care and what the National Health Insurance Scheme paid for and what it did were still barriers to maternal health and should not be ignored in discussions aimed at improving maternal health.
The report also recommended a lot of education to counter constraining beliefs shrouding the experience of pregnancy.
At the launch of the report, the Regional Programme Manager of Abantu for Development, Dr Rose Mensah-Kutin, said it was unacceptable for a woman to be pregnant for nine months and then lose the baby or her life and called for concerted efforts to address the situation adding that ‘zero tolerance for maternal deaths should be our target”.
Mrs Elizabeth Vaah, who is also a victim of maternal death, called on policy makers to stop paying lip service to maternal mortality and embark on urgent measures to address the issues.
For her part, the Executive Director of ARHR, Ms Vicky Okine said the apparent sluggish progress in achieving the health-related goals required a new strategy and renewed commitment from both the government and civil society.