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‘Every birth counts’: The critical need to improve emergency maternal care in Ghana

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• Author

 Imagine a young woman in labour, her heart racing, her unborn child in distress. She arrives at a district hospital — tired, scared, and in need of immediate care. What happens next determines whether she lives, whether her baby survives — and whether another Ghanaian family is shattered by a preventable loss.

A recent study in the Lower Manya Krobo Municipality of the Eastern Region is shedding new light on the realities of emergency obstetric and newborn care (EmONC) in Ghana. The findings are sobering — but they also reveal a clear path forward.

Why this matters now

Despite progress in maternal health, far too many Ghanaian women are still dying from child­birth-related complications. Ghana’s maternal mortality ratio is estimated at 308 per 100,000 live births — near­ly 20 times higher than the average in high-income countries.

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“We know what the problems are, and we know how to solve them,” says Dr Reuben Esena, one of the study authors. “The question is: are we willing to invest where it matters most — in women’s lives?”

What the study found

The research, published in the International Journal of Science Aca­demic Research, evaluated three key hospitals — St. Martins Catholic Hospi­tal, Atua Government Hospital, and Akuse Government Hospital — which serve a population of over 108,000 in Lower Manya Krobo.

The study reviewed 271 cases of obstetric complica­tions and found that the most common were:

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– Foetal distress (18 per cent)

– Com­plications from previ­ous C-sec­tions (13 per cent)

– Pre-ec­lampsia and ec­lampsia (8 per cent)

– Cephalopelvic dis­proportion and breech deliveries (7 per cent)

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These complications are not rare, nor are they unpredictable. Most are entirely preventable or manageable — with timely intervention and well-equipped facilities.

A mixed picture: Progress and gaps

The good news? All three hospi­tals provide round-the-clock EmONC services, staffed by midwives, medical officers, and anaesthetists. Life-saving drugs like oxytocin and magnesium sulfate are widely avail­able. Caesarean sections and manual placenta removal are routinely per­formed when needed.

The bad news? None of the facil­ities had an infant laryngoscope — essential for newborn resuscitation. Only one had ergometrine to control bleeding after childbirth. And not a single case utilised assisted vaginal delivery — even where it might have been appro­priate.

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In some cases, multiple complica­tions overlapped, such as foetal distress plus severe pre-eclampsia. For a woman in that situation, every minute counts. Every delay risks two lives — or more.

Who’s Most at Risk?

Women aged 25–29 years had the highest number of complications — a reminder that even “prime age” pregnancies can be dangerous without the right support. But adolescents and women over 40 faced some of the most se­vere risks, including eclampsia, foetal death, and difficult labour.

“Our younger girls, especial­ly those between 15–19 years, are particularly vulnerable,” the study noted. “They come late to the hospi­tal, sometimes after trying traditional remedies at home. By the time they arrive, it’s often too late.”

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A national crisis demands national response

The maternal health challenges in Lower Manya Krobo reflect a broader national reality. Many districts across Ghana lack the full complement of staff, drugs, and equipment required for quality EmONC services.

But the solutions are not out of reach.

So what must we do?

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1. Invest in life¬-saving supplies and training: Every hospital handling deliveries should be equipped with the full range of emergency tools — including items as simple, but critical, as an infant laryngoscope or ergometrine injection.

2. Improve documentation and digital health systems: Accurate re­cords allow clinicians to track compli­cations and adjust care accordingly. Ghana’s shift to digital health must prioritise maternal health systems.

3. Decentralise comprehensive EmONC: More health centres and CHPS compounds need capacity to offer basic EmONC. Complications don’t wait for referrals — care must be accessible at the first point of contact.

4. Promote community education: Women and families must be educat­ed on the importance of antenatal care, early referrals, and hospital deliveries, especially in rural areas where myths and delays still cost lives.

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Every woman deserves a safe birth

This study is more than data — it’s a call to action. Behind every statistic is a mother, a child, a family. Ghana has the knowledge, the workforce, and the policy framework to make maternal death a thing of the past.

What remains is commitment — not just in funding, but in leadership, in community involvement, and in valuing every single life.

As the researchers conclude: “Emergency Obstetric and Newborn Care is not a privilege. It is a right — and one that Ghana must deliver.”

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By Henry Okorie Ugorji

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Health Essentials

Do you want to be happy?

• Talking to God has a way of calming nerves
• Talking to God has a way of calming nerves

Don’t we all dream of a life that is filled with laughter? That may be a reason for chasing big bucks, which like the Golden Fleece eludes the majority of us.

Financial Wellness is extreme­ly important but there are other factors that make us happy and healthy and eventually wealthy.

I will introduce a few everyday activities that are guaranteed to make you happy if you continue practising them.

You definitely do not need to live in Finland to experience happiness even though many people agree that is the “headquarters” of hap­piness.

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1. Wake-Up Ritual

a. Say to yourself that today will be a beautiful day or a great day!

b. Ask God what He has in store for you. Use me Lord (if not a Christian what you believe in will be useful as well.

c. Remind yourself of your purpose in life and get out of bed.

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d. Do Not grab your phone as the first thing for the day.

2. Pray

a. Talking to God has a way of calming our nerves. It brings about unexplained peace and when we add praise and worship then the floodgates open. That is how to win battles against unhappiness.

3. Smile

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a. Definitely floods your body with feel good hormones and insu­lates you from stress.

b. Smiling is infectious so the more you smile the better and you set off a smiling OR happiness domino effect.

4. Meditate

a. Extremely good for your brain and an easy way to start is to do deep-breathing and just focus on your “breath” excluding all others. That is what some will prefer to call mindfulness. Be­ing in the moment has immense benefits. Things you never knew existed suddenly spring up.

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5. Exercise

a. That wonder drug that trumps virtually all others. Like smiling it does pour out feel good hormones. Strength training even goes an extra mile causing our muscles to act as “pharmacies” that pour out life-changing signals every time they contract.

6. Be kind to yourself & to others

a. We are often too harsh on ourselves. Give yourself a break. Self-care is the real deal!!

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b. Being harsh to others has no benefits.

7. Spend some time doing nothing!

a. We need to re-set from time to time. Spend about 10 min­utes a day doing abso­lutely nothing. There is happi­ness and in­novation in “idling”. Do not abuse idling though.

8. Spend time with loved ones.

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a. This is another powerful happiness “hack”. You have to make time and be intentional about this; talk on phone, send messages, arrange to meet for a drink or meal. Social Wellness ranks very high on the happiness index and it’s fairly easy to plug into it.

b. While spending time to­gether remember that your choice of food and drinks also impacts on how happy or sad or anxious you may feel.

9. Indulge in a hobby.

a. Our bodies and brain love variety. Do you have a hobby? Get one

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10. Write in your gratitude diary.

a. That is all it takes – keep doing it regularly.

11. Get a pet.

This list is not ex­haus­tive but definitely a good start. Share your happiness hacks with me via email and together we can keep the world smiling and happy.

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At the end of each day ask yourself if you did better than the previous day. That is all it takes. Doing better than the previous day for 365 days, for 5 years, 10 years… How amazing that will be!!!

AS ALWAYS LAUGH OFTEN, EN­SURE HYGIENE, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pres­sure, blood cholesterol, BMI)

Dr. Kojo Cobba Essel

Health Essentials Ltd/ Medics Clinic

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(dressel@healthessentialsgh. com)

*Dr. Essel is a Medical Doctor with a keen interest in Lifestyle Medicine, He holds an MBA and is an ISSA Specialist in Exercise Therapy, Fitness Nutrition and Corrective Exercise. He is the author of the award-winning book, ‘Unravelling The Essentials of Health & Wealth.’

Thought for the week – “There is no magic formula to being hap­py but making a conscious effort to be happy goes a long way.” – Dr. Kojo Cobba Essel

By Dr. Kojo Cobba Essel

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Health Essentials

Measure your blood pressure accurately, control it, live longer

May 17 is World Hypertension Day and please do not panic. This is not a stress-filled day that aims at increasing your blood pressure but rather it’s a day set aside to increase awareness of a serial yet silent killer. That is exactly what Hypertension it; its killing the young and old at an alarming rate yet in most instances people with high blood pressure may feel absolutely well.

The theme for this year is “Mea­sure your blood pressure accurately, control it, live longer”

Do these when you take your blood pressure since the accuracy of the reading matters:

• If you have been walking or running rest for at least 5 to 10 min­utes

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• No caffeinated drinks or alco­hol two or three hours before check­ing blood pressure

• Sit (sometime you may need to stand or lay in bed) comfortably with your back rested/supported and your arm for the cuff resting on a table of firm surface

• Have your feet flat on the floor and not legs crossed

• Ensure the cuff is the right size for your arm

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• If using an electronic monitor ensure battery is working well

• If clothing covering arm is thick remove

• Loosen your neck-tie or belt if uncomfortable

• If you are not conversant with checking blood pressure, get the appropriate training

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Global statistics show that only 50 per cent of those with hypertension are actually aware and that aware­ness in some areas may be as low as 10 per cent while awareness may exceed 75 per cent in a few areas.

The bitter truth is some people do not have enough information about the condition, a significant number do not have easy access to measur­ing their blood pressure and a few stubborn ones think it is better not to know if something is going wrong.

What do we need to understand about our blood pressure numbers? There are ALWAYS two numbers in a blood pressure reading such as 120/80mmHg. The top figure rep­resents the force of the blood against the artery (blood vessel) walls as your heart beats and the lower value represents the force on the walls in between beats or while the heart rests. Both numbers are important.

Essentially when your blood pres­sure is higher than it should normally be all organs in the body are exposed to elevated pressures since arteries supply blood to every part of the body. These sustained high pressures will be causing harm gradually every minute of the day.

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Prevention of high blood pres­sure is based mainly on adopting the appropriate lifestyle, while having regular medical check-ups to pick up conditions that can may lead to hypertension if not tackled early. Management of hypertension on the other hand requires a three-pronged attack in most situations;

• Lifestyle modifications

• Regular medical checks to pick up other conditions that be worsen our hypertension or general wellbeing

• Use of appropriate physician prescribed medication

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Age and our genes may have a way of increasing our blood pressure or predisposing us to hypertension, but since we have no control over the choice of our family and years rolling by, it may be worth focusing on the above three that we can control to a large extent.

Lifestyle Modification

• Exercise adequately

• Do not smoke

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• Limit or avoid alcohol

• Aim at fat (weight) loss

• Manage stress appropriately

• If you have sleep apnoea (intermittent snoring during sleep and feeling tired and sleepy on waking up) seek medical intervention

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• Adopt the DASH (dietary ap­proaches to stop hypertension) diet; low sodium (salt), increased potassi­um from fruits and vegetables, low or no saturated fats and increased fibre.

• Control conditions such as diabetes, cholesterol challenges and kidney disease.

Exercise need not be rushing to the gym to sweat out only, but taking walks, gardening, cleaning your home, using the stairs and many others. Exercise increases heart func­tion and lowers blood pressure but there is a little hitch: the benefits of exercise on blood pressure do not last beyond 72 hours.

In short frequency is the watch word. Do not be a once a week or once a month exercise fan. The effect of exercise on the heart does not rely on past glory so if you were an athlete years ago but you have now become one with your sofa, I am sorry to disappoint you but you need to get moving NOW!

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All types of exercises will benefit you and lower your blood pressure but a word of caution here;

• When your blood pressure is not controlled DO NOT lift weights above your head

• Do not overdo exercises of the upper body but lower body ex­ercises such s squatting will enhance lowering of your blood pressure.

• Breathe properly especially while you train with weights; breathe out during the exertion phase as you lift a weight and breathe in while you relax.

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• Of course brisk walking, swimming, use of the treadmill and other exercises that target heart function are also a must

When all is said and done, you can never know our blood pressure with­out measuring or checking it. Take a few minutes to check your blood pressure and ensure at least one oth­er person checks their blood pressure before the end of the month.

Associations, companies and all identifiable groups should ensure they check their blood pressure and go an extra mile and as a corporate social responsibility help to check the blood pressure of hundreds or even thou­sands of people. You will be saving lives.

AS ALWAYS LAUGH OFTEN, ENSURE HYGIENE, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sug­ar, blood pressure, blood cholesterol, BMI)

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Dr. Kojo Cobba Essel

Health Essentials Ltd/ Mobissel

(dressel@healthessentialsgh.com)

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