The goal of sustainable development is the agenda of the Millennium Development Goals post-by the world's experts that will be implemented in the next 15 years to 2030. It has seventeen goals and 169 overall targets in which SDG 3 deals with ensuring a health life and improving welfare for all age. The Goals for Sustainable Development3 has nine targets and four sub targets related to various health areas. One target target of 3.1 is the target to achieve a reduction in the global maternal mortality ratio to less than 70 per 100,000 live births. Maternal death is defined as "The death of a woman during pregnancy or within 42 days from termination of pregnancy, regardless of duration and location of pregnancy, from any cause related to or aggravated by pregnancy or management, but not from accident or incidental causes.
Health in Ethiopia has risen from the past decade to then through a major accomplishment in the provision of healthcare by making health systems accessible, affordable and acceptable at different levels for beneficiaries and putting different efforts to provide quality health care services. Improvements in infrastructure, resource mobilization and leadership and governance in the health sector and in the country as a whole have an important contribution to the achievement. Maternal health is one area where attention is given and different efforts and initiatives are being implemented with strong political will and commitment
Video Maternal health in Ethiopia
Maternal health situation in Ethiopia
Following the MDGs targets, Ethiopia develops Health Sector Development Programs (HSDPs I, II, II and IV and performance monitoring and health service evaluations.The main focus of HSDP is to improve the provision of primary health care services for mothers and children and the prevention and control of diseases contagious to achieve targeted outcomes Maternal and child health are key areas and targets where different efforts and contributions have been made since the start of HSDP I. According to the IV Health Sector Development Plan (HSDP IV) implemented from 2012 to 2015 the performance evaluation of 2013/14 shows progress in achieving coverage of family planning services, coverage of prenatal care services, institutional delivery and coverage of post-partum services, and access to emergency obstetric care in the reduction of maternal deaths during pregnancy and childbirth through provision of Basic and Comprehensive EmOC and Emergency Obstetrics is an area in ma na main concern has been given and improvements have been observed.
The number of health centers and hospitals providing Basic Emergency Obstetric Care (BEmOC) and Comprehensive Emergency Obstetric Care (CEmOBC) increased over time (Figure 1). There are 25 functional regional blood banks with 30 mobile satellite teams that collect blood from people on a daily basis. Blood banks are located within a radius of 150-200 km from their catch where both private and public health facilities can obtain safe blood
Maternal health indicators
Community-based home surveys conducted in Ethiopia show that trends in maternal health care process indicators including maternal mortality reduction have increased over time (Table 1). Maternal Mortalation Ration (MMR) is one indicator that should be measured every five for tenyears that it is difficult to estimate changes in maternal mortality due to the use of a live birth born infant instead of the number of pregnant women because impossible calculations are impossible with certainty especially in low-income countries and intermediate in which the maternal mortality rate is very high. However assessment of a number of process indicators is recommended and used to track changes and improvements. Common process indicators used are coverage of antenatal care, trained birth, postnatal care and family planning. Table 1. Maternal health indicators in Ethiopia 2014, Addis Ababa, Ethiopia
EDHS: Ethiopian Demographic and Health Survey EMDHS: Ethiopia Mini Demographic and Health Survey
Human resources
The availability of major health care providers, especially midwives and obstetric gynecologists is very important in the provision of maternal health services and in the management of complications. In 2012, the number of midwives and obstetricians and gynecologists are 6925 and 147 respectively (Ref.State of World Midwifery). Consider the shortcomings of obstetric gynecologists in state ministries of health designed and initiated mid-level health care provider training; health workers to improve the provision of emergency obstetrics and surgical services at the primary hospital level since 2009 where 163 of them graduated and have been deployed at various health facilities until 2013/14. As part of efforts to address maternal mortality, the Maternal Mortality Surveillance and Response System began in 2013 in Ethiopia that helps improve the quality of healthcare provision.
Maternal health services are provided at all three levels of the health sector structure: Basic, secondary and tertiary levels in Ethiopia. At the community level, these are provided by Health Extension workers who focus on prevention services and promotion of skilled birth attendants. This is supported by a community and ownership network called the Health Development Army that enhances community ownership and further enables communities to produce and maintain their own health. At this level the main services provided are community mobilization, and awareness creation with some provision of services such as contraception.
Similar to the global situation, the cause of maternal deaths in Ethiopia ranges from delayed labor and postpartum haemorrhage where access to trained midwives and emergency obstetric care have an important role for women's survival during pregnancy, labor and the postnatal period.
Interesting factors related to maternal health in Ethiopia as shown in Table 1 1. There is a progressive increase in all indicators, except for MMR, from 2000 to 2014 2. Despite the increase in other indicators and skilled manpower, the MMR increased from 673 676 from 2005 to 2011 shows the existence of other factors that contribute significantly to MMR.
Maternal health trends in Ethiopia from 1950 to 2015 compared to the global situation
Evidence on maternal health conditions in Ethiopia is available starting from 1990. According to the target set to track the annual reduction in maternal mortality, Ethiopia is categorized under districts that are making progress towards achieving targets set for MDG5 by the National Nation. According to estimates of World Health Organization (WHO) mothers deaths declined from 523,000 in 1990 to 289,000 in 2013 globally, accounted for 45% reduction. It was reduced from 990,000 t0 510,000 to Sub-Saharan countries in the same year interval with a 49% reduction. In this report, maternal mortality in Ethiopia decreased from 43,300 to 13,000 from 1990 to 2013 showing a 38% decrease and with a contribution of 4% to overall global maternal deaths. These figures show that the reduction of maternal deaths in Ethiopia is below the surplus for Sub-Saharan countries or the world, despite the great advances and achievements of the country have been made. In addition, Ethiopia has not reached the MDG target set for MMR. Have objectives and initiation targets to further identify barriers to the quality of maternal health care and addresses at all levels of the health system or SDG achievement. To meet SDG targets, Ethiopia has developed a five-year plan from 2015/16 to 2019/20 to reduce the maternal mortality ratio from 420 per 100,000 live births to 199 per 100,000 live births. Similarly there are plans for improving maternal health services within the same duration of time.
Maps Maternal health in Ethiopia
References
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