Poverty And Private Health Insurance Make Further Progress On Maternal Mortality Difficult
Guinea has made unsteady progress in the last ten years towards improved maternal health services. While the maternal mortality ratio has been cut in half since 1990, the number of deaths is still 610 per 100,000 live births, and this figure would have to be further slashed by 50% for the country to reach its stated Millennium Development Goal. Guinean women have a one in 30 chance of dying in pregnancy and childbirth, and only one-tenth of poor women receive skilled attendance at birth. Nearly 90% of all health expenditures in Guinea come from patient’s out-of-pocket expenses, showing how gravely access to health care is determined by socioeconomic status12
Obstetric fistula, a birth injury caused by obstructed and prolonged labor, is all too common in Guinea, a result of the poor health infrastructure provision, particularly in rural areas. Non-governmental organizations, including EngenderHealth, have worked to improve the status of mothers, including by setting up “Safe Motherhood Village Committees” at the rural level. These committees encourage women to seek care at facilities during pregnancy and birth.
However, if the government does not increase direct assistance to poor patients, women’s ability to access care will not just be determined by their level of awareness. If the patient cannot pay for services, she has little choice but to remain at home in the care of her family. These barriers to care encourage the continued incidents of maternal death and disability, as women are unable to receive the emergency services necessary to assist in incidents of birth complication.
Thanks to Julianne Parker Weis for her contribution of this report.