Pregnancy is not the harbinger of joy in Sierra Leone. Instead, it brings distress, sufferings and death. When Hawa Kamara of Thompson Bay went into labour, her husband, Joseph Dumbuya, had to rush her to a hospital because of the complications that she had developed. Hawa had reposed faith in a traditional birth attendant for supervision during pregnancy. The attendant did not have the expertise to handle the complications. At the hospital, Joseph was heart-broken when doctors told him that he had lost both his wife and child. “The baby was in the wrong position and Kamara had lost a lot of blood,” the 34-year-old, who would have been a proud father the second time, was informed.

Sierra Leone, which has the highest maternal mortality ratio (MMR) in the world, recognises bleeding as the leading cause of maternal deaths. Pregnancy-induced hypertension and sepsis follow closely, states the maiden report of the Maternal Death and Surveillance Response (MDSR). The health ministry had introduced MDSR in 2016, when the sector was at its lowest ebb. The civil war in Sierra Leone between 1991 and 2002 had left most of its infrastructure in ruins. Millions of US dollars poured in as foreign aid, but the outbreak of Ebola brought the health sector to its knees one more time.

When MDSR was introduced, the government made it mandatory to report the death of every woman of child-bearing age. The MDSR report noted that regular supervision of trained healthcare providers was crucial to prevent complications.

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