Laos: MSF to help reduce maternal and child mortality
December 26, 2012
Following two years of negotiations, Médecins Sans Frontières/Doctors Without Borders (MSF) has signed a four-year agreement with the Government of Laos to open a maternal child health project in the remote north-east of the country close to the Vietnamese border.
“There is no reason why having a child in Laos should be such a life-threatening experience for so many women,” said MSF Head of Mission for Laos, Sylvie Goossens.
Laos has one of the highest maternal mortality rates in Asia, with 405 deaths per 100,000 births – almost three times that of its neighbour Vietnam (WHO 2009).
Mortality rates for children under five are the highest in Southeast Asia (70 per 1,000 births) and second highest in all of Asia, behind only Afghanistan.
“MSF’s experience in other resource-limited countries with similar shocking figures is that expanding access to emergency obstetric care through low-cost strategies can dramatically reduce the risk of women dying from pregnancy-related complications,” added Sylvie.
The signing of the agreement will see MSF launch activities in five districts of Huaphan province, which has one of the worst maternal and infant mortality rates in Laos.
Numerous other socio-economic problems affect the province, which is the second-poorest in the country, and access to safe water and medical facilities are far worse than the national average.
MSF is the only medical NGO operating in the area and will support obstetrics, neo-natal and pediatric care (up to five-years-old) in five district hospitals and 10 health posts covering a population of 140,000 people.
Mobile clinics and disaster response
The activities in the hospitals and health posts will be complemented by mobile medical clinics, which will target some of the most remote and disadvantaged communities in the region.
MSF staff will also improve laboratory and pharmacy facilities in the area, as well as water, electricity and sanitation infrastructure – all critical determining factors in reducing the number of unnecessary deaths among newborns and their mothers.
As part of the project, MSF will also strengthen its ability to respond to natural disasters and disease outbreaks in the country. Logistics and other infrastructure preparations have already begun and medical activities are expected to begin in the first quarter of 2013.
Lack of access
Around 30 per cent of the population of Laos are considered to be living under the poverty line, many of whom are from remote rural areas like Huaphan province.
With a national health care system based on cost recovery and user fees, many women cannot afford access to the Laos medical system.
These financial barriers, combined with the low level of awareness among the population about the importance of ante, post natal and delivery care, has resulted in Laos having the lowest rates of ante-natal care and assisted deliveries in all of Asia, with almost 85 per cent of deliveries being conducted at home.
Poor quality equipment, lack of water and electricity infrastructure and the extremely remote and rugged terrain of the province pose further challenges.
“Half of the health posts in areas we are targeting are currently not accessible in the rainy season, one is only accessible by foot and many are not yet connected to water and/or electricity, which means the quality of services is currently very low,” said Sylvie.
“This is part of the reason why the local population tends to overwhelmingly give birth at home and rely on traditional birth attendants so much.”
Lack of qualified staff is another limiting factor and the project will include the direct training of skilled birth attendants as well as improvements to the rural referral system to enable it to better manage urgent medical complications relating to pregnancies, particularly among the most vulnerable groups of patients.
Sylvie added: "MSF looks forward to working with our partners in the Ministry of Health to implement resource-efficient, sustainable solutions to this preventable tragedy affecting generations of Lao mothers and children.”
MSF is Laos
MSF worked in the Lao refugee camps in Thailand until1989. Between 1989 and 2001, MSF worked in Saravan, Bokeo and Champassak in Laos to assist refugees returning from Thailand.
MSF was the first organisation to introduce ARVs to Lao between 2001 and 2008 in Savannakhet and Setthathirath hospitals and provided an emergency response to Ketsana typhoon in Kaleum, Sekong province from October 2009 to March 2010.