Source: World Health Organization
Mrs Souad is 30 years old, married with 2 children, and heavily pregnant with her third. She lives in a rural village 10 km from the health facility where she is to deliver her baby, and the journey to get there takes about 45 minutes.
On 21 October 2013, she started getting contractions. A community health volunteer informed the midwife who sent an ambulance to bring Mrs Souad to the health facility for delivery.
A few hours later, Mrs Souad delivered a healthy baby girl weighing 3.3 kg. But within minutes of the birth, she began bleeding heavily and the midwife diagnosed postpartum haemorrhage. She referred Mrs Souad to the regional maternity hospital for specialist care.
On arrival, Mrs Souad was in shock and admitted immediately for emergency care. They found that her cervix was torn and performed a life-saving hysterectomy. Mrs Souad has since recovered and returned home to her family.
Morrocco’s national plan on maternal and child health
Morocco is one of the 9 countries in WHO Eastern Mediterranean Region to have adopted a national plan to accelerate progress on maternal and child health over the past year. The Moroccan plan, which runs up to the 2015 Millennium Development Goals (MDG) deadline, was launched by the Moroccan Minister of Health, His Excellency Dr El Houssaine Louardi, and Dr Ala Alwan, WHO Regional Director for the Eastern Mediterranean Region, on 13 November 2013 in Rabat.
Morocco has already made substantial progress in reducing deaths among mothers and children. The country’s maternal mortality ratio fell by 67% between 1990 and 2010 and the under-five mortality rate dropped by 60% between 1990 and 2011.
The new plan aims to bring about even faster progress. It sets the country on course to achieve reductions in under-five and maternal mortality of 70% and 82%, respectively, from the 1990 levels by 2015.
The Moroccan plan was developed as part of a regional initiative on Saving the Lives of Mothers and Children launched by WHO, UNICEF, UNFPA and countries in the Eastern Mediterranean. Health Ministers from 22 countries committed to accelerate progress towards MDGs 4 and 5 (for child survival and maternal health) under the Dubai Declaration, adopted on 30 January 2013 at a high-level meeting in the United Arab Emirates.
Key actions for maternal and child services
The Moroccan plan targets 9 regions—home to 66% of the population—that currently have lower coverage for maternal and child health services due to difficulties accessing health services in remote areas, a shortage of trained health workers, and low quality of services. It identifies key actions that will enhance the capacity of these regions to plan, implement, follow up and evaluate services for women and children. It helps them to make the most of their resources and increase mothers’ and children’s access to high-quality services at clinics and hospitals.
Dr Yves Souteyrand, WHO Representative in Morocco, said “This plan is going to make a real difference for women and children living in areas of the country where health services are most in need of strengthening. It clearly sets out the actions that need to be taken to make new, life-saving services available and extend and improve existing ones.”
Roadmap to achieve MDG 4 and 5
Under the plan, services will be available for free, equipment and infrastructure will be upgraded, health workers will get more training on best practices, communities will be involved as an interface between the population and health services, and accountability mechanisms will be put in place at regional and local levels. Transportation systems will be improved so that pregnant women can travel safely from home to hospital, and those with complications will be able to get caesarean sections.
“This plan is critical for Morocco to accelerate reductions in maternal and child deaths,” said Dr Abdelali Belghiti Alaoui, Secretary General of the Moroccan Ministry of Health. “With WHO’s support, the Ministry of Health now has a roadmap to achieve MDGs 4 and 5.”
Other countries in the Eastern Mediterranean Region to have launched national maternal and child acceleration plans in the year since the adoption of the Dubai Declaration include Afghanistan, Iraq and Sudan. Djibouti, Egypt, Somalia, South Sudan and Yemen have also finalized plans which will be launched shortly.