54% of maternal deaths preventable, says health ministry

More than half of Namibia's maternal deaths could have been prevented with better clinical care, with critical gaps, including delays in recognising danger signs and poor referral practices, found in nearly 80% of maternal death records reviewed.

Deputy health minister Hambelela Suzan Ndjaleka said maternal mortality remains one of Namibia's biggest public health challenges, despite significant progress over the past two decades.

“Childbirth should be a moment of hope, joy and celebration. Yet, for far too many women across the globe and within our own borders, severe bleeding after childbirth, postpartum haemorrhage, remains the leading, most tragic cause of maternal mortality,” she said.

Ndjaleka was speaking on Monday at the launch of the national training-of-trainers programme to scale up postpartum haemorrhage (PPH) care in Windhoek.

She said a confidential enquiry into maternal, stillbirth and neonatal deaths, covering April 2021 to March 2024, found that 54% of maternal deaths were preventable through improved clinical care.

Critical gaps were identified in nearly 80% of the maternal death records reviewed, with delays in recognising clinical deterioration and substandard referral practices among the key shortcomings.

Namibia's maternal mortality ratio has fallen from over 450 to 139 deaths per 100 000 live births between 2000 and 2024, the deputy minister said, but remains almost double the Sustainable Development Goal target of fewer than 70.

The national improvement masks significant regional disparities, with maternal mortality ratios in the Omaheke and Zambezi regions remaining significantly above the national average, Ndjaleka said.

Reaching that target will require continued efforts to strengthen the quality and timeliness of maternal healthcare, she said, including the ability of frontline health workers to recognise and respond to obstetric emergencies.

Direct obstetric complications account for 60.7% of maternal deaths, the ministry said, while obstetric haemorrhage alone accounts for 16%, making it the second-leading cause of maternal death.

The findings have prompted renewed efforts to strengthen the ability of frontline healthcare workers to recognise and respond to obstetric emergencies before they become fatal.

The PPH training is based on a World Health Organisation-recommended care bundle designed to ensure that postpartum haemorrhage is detected early and treated immediately.

Ndjaleka said the healthcare professionals receiving the training would be expected to take the skills back to districts, clinics and maternity wards across the country.

“You are the backbone of our health system, and your dedication to saving lives is the very reason we are gathered here today,” Ndjaleka said. She challenged the trainers to become champions of maternal health by mentoring nurses, midwives and doctors to respond decisively when seconds count.

The ultimate objective, she added, is to achieve "zero preventable maternal deaths from postpartum haemorrhage in Namibia".

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