While government statistics point to declining maternal deaths in The Gambia since 2018, the number of women dying due to childbirth is too high to be taken for granted.

A total of 210 women per 100,000 live births died either due to pregnancy, childbirth or complications linked to pregnancy and childbirth, according to the 2021 Annual Service Statistics Report of the Ministry of Health.

Based on official statistics, it is a reduction from 283 deaths in 2018; 221 deaths for 2020.

Although the statistical improvement is credited by the government on improvement in healthcare services in The Gambia, the number is still disturbingly high resulting in women rights activists staging protests, demanding better and improved access to antenatal and postnatal care.

Mamading Suwareh lost her only daughter during her first childbirth at the Kanifing General Hospital.

The 27-year-old died at the hospital after developing complications following operation.

“She arrived at Edward Francis Small Teaching Hospital dead after referral from the Kanifing General Hospital. And that’s what the health officials at EFSTH told us. 

“I blame the Kanifing General Hospital for her death because she got complications after an operation from the Kanifing General Hospital,” she said.

Salifu Bah lost her 36-year-old sister at her fourth childbirth. He accused the health officials for being responsible for her death and demands explanation from the hospital. 

“They could have taken my sister to the theatre for an operation, but they refused and said she can deliver naturally on her own. 

“She later died in their hands. Her death was protracted and painful, and was solely the fault of the hospital,” he said.

Kaddy Dampha also lost her 45-year-old close relative during childbirth at the Kanifing General Hospital while undergoing operation. 

Dampha explained: “she died during operation at the Kanifing General Hospital. They told us that she died due to high blood pressure while conducting an operation on her which they said was too late for them to do anything to control her situation.”

The Gambia Bureau of Statistics health and demographic survey stated that the rate of mortality in The Gambia is 0.43 maternal deaths per 1,000 women, and that the rate is highest among women age 40-44 with lowest among women age 45-49.

The report added that maternal deaths represent 17% among women age 15-49 and that for every 1,000 births in The Gambia about three women die during pregnancy while in labour, or within 42 days of the end of a pregnancy from causes other than accidents or violence.

But health officials insisted that maternal deaths are drastically declining and cast blames on some cultural beliefs and negligence of pregnant mothers against health advices leading to some ‘minimal deaths of women during birth.’

Majula T Kinteh, head of maternity unit at the Bundung Maternal and Child Hospital said: “we have been seeing women deliver in their houses and they would report after giving birth. These are all cultural beliefs.”

She said maternal deaths at Bundung Maternal and Child Hospital has declined to 0.2% after six out of 8,000 women died during childbirth in two years. 

“We only registered three maternal deaths and two of those maternal deaths were due to PBB profuse bleeding after birth. 

“We also have three other maternal deaths but they didn’t die in the hospital. The women passed away in the community and their corpses were brought to the hospital so that we can certify them as deaths. 

“Though we registered five, only two were institutional deaths and the other three occurred in the community,” she said.

“So, you need to prove by all reasonable doubts that it is not your fault. The management will always investigate and the health staff are also on their toes to make sure that they do whatever is possible to save women from dying,” she said.

Majula Kinteh added: “Among the problems facing pregnant women in the country especially in rural Gambia is ‘economic burden and affordable transportation for pregnant women to major health facilities’.”

Sira Conteh, who is the officer in charge of Essau District Hospital said: “we know we are a poor country, food for some people is hard especially a poor farmer from far away from the health facility whereby getting transportation is difficult. So, this can also lead to deaths at childbirth.”

As all major hospitals referred their ill patients to Edward Francis Small Teaching Hospital in Banjul, which requires river transportation relying on the commercial ferries, is also a major factor to some of the deaths at the Essau District Hospital. 

Sira Conteh explained: “One of the deaths was due to a transportation delay to get to Edward Francis Small Teaching Hospital.

“We were managing and referred her to Banjul, but before the arrival of the ferry she sadly passed away.”

However, she doubled down on cultural beliefs as another factor to maternal deaths, saying “some cultures will tell you to take this medication and you don’t need to go to the hospital.”

Despite this, she said that they are doing their best to help their patients. She pointed out that “this year we registered only one maternal death.”

However, Ebrima Drammeh, spokesman for Women Lives Matter Gambia, described maternal deaths in the country as sad and blamed the rise in women deaths at childbirth to negligence of the health officials.

He added that despite his movement engaging the government to find a solution to the problem, the health minister, Dr Ahmadou Samateh, publicly debunked them and shunned their demands.

“Within our data now, the deaths are approaching 500 deaths which is very bad in The Gambia as a small country with a population of less than 2 million people. 

“And within two years, you see 500 people dying while giving birth is very, very sad,” he said.

Reporting by Adama Makasuba