Source: All Africa
Poor maternal health systems in developing countries usually results in the growth of maternal death. Maternal death refers to the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy.

Though the 2010/11 Demographic and Health Survey indicated that Ethiopia made limited progress to reduce maternal deaths over the previous decades, it has been showing considerable progress on improving maternal health in recent years. In supporting this fact, State Minister Dr. Amir Aman said that the Ministry has been working together with midwives and has achieved the Millennium Development Goals ahead of time in reducing maternal and child mortality rate, while speaking at the 24th General Assembly of Ethiopian Midwives Association.

According to him, the Ethiopian Government has met the MDGs, reducing maternal mortality rate, by encouraging pregnant women facilitating things to give birth at health institutions and providing them the necessary medical treatment.

In 2013, UN also estimated that Ethiopia has been making significant progress in reducing maternal mortality, and achieving its MDG 5 (to reduce maternal mortality).

Nevertheless, Dr. Amir has stated, "But much remains to be done in order to control the prevalence of the situation. Over 12,000 mothers die annually while giving birth with about 23 infants dying in an hour."

Moreover, the World Health Organization (WHO) estimated that over 500,000 women had died from pregnancy and birth related causes in 2005. It also states that a woman in a developing country is several times more likely to die as a result of pregnancy than a woman in a developed country. The majority of these deaths occur during and immediately following birth: 25 per cent are caused by severe bleeding, 15 per cent by infection, 12 per cent by a seizure disorder, and 8 per cent by obstructed labour. The remaining deaths are due to unsafe abortion (13 per cent), other direct causes (8 per cent), and indirect causes such as HIV and malaria which may be aggravated by pregnancy, according to WHO.

In order to reduce maternal mortality rate, a wide-ranging of activities can be carried out. Among these: training traditional birth attendants to provide skilled care at birth. In developing countries, many births are assisted by "traditional birth attendants" (TBAs), who acquire their skills through experience and apprenticeship, rather than through the formal training that characterizes "skilled birth attendants" (which include doctors, midwives, and nurses). Programs to provide short training courses to TBAs, to teach them how to respond to minor complications, were recommended by WHO in the 1970s through 1990s.

Researches in the field recommend that maternal health-care systems must be strengthened, and communities have to be mobilized and educated to improve deliveries in birth clinics; skilled community-based birth attendants should be trained and posted to increase maternal coverage in remote areas.

Establishing proper relations with private organizations to deliver maternal health-care services is called for. This will ensure rural areas are covered and will reduce supply shortages-but attention must also be paid to the quality of service provided.

Educating and empowering women and girls about maternal health issues is crucial since educated and empowered women can lead healthy lives and can lift their families out of disease. Women and girls are a driving force in our economies, and when women are healthy, they play a crucial role in the development of countries. Young women especially, have lifetimes of potential economic returns to give to their communities. They usually marry later, and have fewer and healthier children who are more likely to attend school.

Evaluating and monitor maternal and child health policies. Make sure that the appropriate government ministries are accountable to the public about the performance of investments in maternal health.

Creating strategic alliances between groups representing maternal health is crucial, as that will open doors to political and financial support. Currently, maternal health communities have many leaders but no leadership. Making child and maternal survival a core national and global health concern is decisive. Implementing the above strategies is not only the right thing to do, it is the economically smart thing to do.

To realize this vision, it is essential to produce model midwives and give them recognition, State Minister added.

Association President Aster Teshome on her part said that the government gives special consideration to providing quality and equitable health service for the public. Thus, investing in midwives helps to achieve the target set in GTP II. Midwives should be committed to providing quality service for pregnant mothers and creating a brighter future for babies, mothers and families. The association has been working to raise professional competence and skills of midwives by providing institutional care. The association is also working to give recognition to the best performers, she said.

In order to achieve the intended goal the ministry has now prepared Health Sector Transformation Plan that is accompanied with strong commitment and support of midwifery and health extension workers.

• Ethiopia