The global maternal mortality rate is estimated at 197 maternal deaths per 100,000 live births according to the World Health Organisation (WHO,2023). Out of the global average, sub-Saharan Africa accounts for 70%. Maternal mortality is the death of a woman while pregnant or within 42 days of pregnancy termination, regardless of the cause of death, per 100,000 live births.
In Ghana, maternal mortality remains a public health challenge despite the significant improvements in healthcare access and infrastructure. According to the Ghana Maternal Health Survey (2022), the maternal mortality ratio (MMR) stood at 308 deaths per 100,000 live births, even though most of the cases are not reported, which underscores the urgency for effective interventions, especially in rural areas, which account for over 60%.
The rural-urban disparities in maternal care keep increasing. Poor women in hard-to-reach areas are least likely to receive healthcare and thus carry the burden of maternal and perinatal mortality from complications of childbirth. According to the Ghana Demographic and Health Survey (2022), 48% of rural births occur in health facilities, while over 90% of births in urban areas occur in health facilities.
The higher maternal mortality rate in rural areas is worse due to endemic poverty and inadequate healthcare facilities, posing substantial challenges to accessing maternal healthcare services. The situation is often due to the scattered nature of settlements, long distances of travel times and an inadequate transportation system. This geographic space significantly impacts the quality of care, making pregnant women vulnerable during and after childbirth.
According to the Ghana Health Sector Medium-Term Plan (2022–2025), many maternal deaths recorded in the country are preventable. To address this critical issue, scaling up pregnancy schools in rural health facilities will have a promising intervention aimed at equipping pregnant women with essential knowledge and support to go through the pregnancy period safely.
Pregnancy schools are organised sessions often conducted at health facilities or community centres designed to educate expectant mothers and their partners on pregnancy, childbirth, and postpartum care. These interventions include pre- and postnatal education, such as nutrition and personal hygiene during pregnancy, awareness of pregnancy complications, birth preparedness and skilful delivery, care of the newborn, and family planning, among others.
There has been a success story of pregnancy schools in some parts of the Ashanti Region, according to mordenghana.com (2024). For instance, the Adansi-Asokwa district health directorate recorded 0% maternal mortality and stillbirths in the year 2023.
This positive trend is attributed to the increased presence and skilled assistance of midwives during antenatal care, childbirth, and postpartum periods. Aside from this achievement, challenges like inequitable distribution of midwives and resource limitations persist, especially in rural and low-resource areas.
A lot has to be done throughout the country to improve maternal health outcomes.
For maximum impact, the program must be expanded and integrated into the broader primary healthcare system with the Government’s commitment, community involvement in monitoring and evaluation and training more community facilitators.
Increasing the use of mobile ambulances equipped with essential medical equipment and motorbikes in Ghana’s health delivery services must be encouraged, particularly in rural and remote areas, to improve access and quality of healthcare, especially for emergency situations.
Pregnancy schools are not just a health initiative; they are a lifeline. When women are informed, supported, and guided through pregnancy and childbirth, their chances of survival and those of their babies increase significantly.
These programs would help Ghana move closer to achieving the Sustainable Development Goal target of fewer than 70 maternal deaths per 100,000 live births by 2030. With continued investment and community support, pregnancy schools can become a cornerstone of maternal health and a beacon of hope for countless women across the nation.
By: Mercy Adomaa Beseah -Ashanti Regional Population Director
