The health and wellbeing of mothers, children and adolescents are key indicators of national development and demonstrate a country’s commitment to promoting the right to health. Eritrea is committed to improve the health and wellbeing of women, children, and adolescents as well as end extreme poverty and promote development.
Maternal and child health are important public health issues because they provide the opportunity to end preventable deaths among women, children and adolescents and to greatly improve their health and well-being. Far too many women, infants and children worldwide still have little or no access to essential, quality health services and education, clean air and water, and adequate sanitation and nutrition.
Maternal complications and poor prenatal outcomes are associated with non-utilization of antenatal and delivery care services and poor socio-economic conditions of the patients. To be able to give birth to healthy children, it is essential for all pregnant women to have access to high quality obstetric care throughout their pregnancies.
The main components of maternal and child health care are family planning and reproductive health services; maternal, newborn and child health care services; health communications, health commodities and supplies and strengthened health systems. The maternal and child health services promote optimal health and development for children from birth until they reach school age through focus on the child, mother and family.
Three key components of a maternal health care delivery system are often emphasized in the literature on safe motherhood as being essential to saving lives and reducing maternal mortality. They are skilled birth attendants, an enabling environment and a functioning referral system. Safe motherhood decreases maternal and infant mortality and morbidity. Although most maternal and infant deaths can be prevented through safe motherhood practices, millions of women worldwide are affected by maternal mortality and morbidity from preventable causes.
Eritrea has been able to cut down mortality rates of mothers and children through its extensive public health work. In Eritrea, neonatal mortality rate was 27.2 deaths per 1000 live births in 1999 and gradually fell, reaching 18.4 deaths per 1000 live births in 2018. Similarly, child mortality rate declined from 90.1 deaths per 1000 live births in 1999 to 41.9 deaths per 1000 live births in 2018. Neonatal mortality rates in Eritrea account for half of the infant mortality rate and 27% of under 5 mortality. Many of these deaths (up to 50%) occur in the first 24 hours of life. The causes of neonatal mortality are routine infection, prematurity, low birth weight and poor maternal health, amongst others. Child mortality is skewed towards rural locations and poorer household.
Eritrea’s maternal mortality ratio declined from 498 deaths per 100,000 live births in 2016 to 480 deaths per 100,000 live births in 2017, a reduction of 3.61%. This shows that maternal mortality is still high in Eritrea and is said to be largely driven by complications associated during pregnancy, intrapartum and postpartum. Attendance by skilled birth attendants is low, at 58%, and poor rural and remote populations face difficulties in accessing more specialized health service.
The Government of Eritrea has been working to provide health services by building health centers throughout the country, including remote locations. One of the main purposes of the health centers is to give mothers in remote locations access for regular checkups before and after conception and serve as centers for immunization. The health centers also provide refuge for pregnant women that need special care until they are transferred to referral hospitals for delivery.
Many women who live in remote areas depend on traditional birth attendants, often associated with increased maternal and infant mortalities, due to transport problems. To mitigate this problem the Ministry of Health (MoH) has been empowering traditional birth attendants through training.
The MoH has been making efforts to immunize children below 5 years old with high coverage both in rural and urban areas. In addition to this, antenatal care and delivery at hospitals are promoted to identify risk factors earlier and prevent complications related to delivery. Health services are given in Eritrea free of charge and are available throughout the country. Therefore, on top of what has been achieved so far, we expect further reduction in maternal and infant mortality in the near future.