||Asean Affairs 14 June 2013
Lao Mothers in Sekong Risk At-Home Births
Nearly three-quarters of pregnant mothers in one of Laos’s poorest provinces deliver their babies at home at great risk to their lives due to a scarcity of health centers and midwives in the area, according to local health officials.
Laos has placed a high priority on reducing its maternal and infant mortality rates, which are among the highest in Southeast Asia. But in rural Sekong province in the south, the difficulty of accessing medical centers is hindering progress on containing the problem, officials said.
More than 70 percent of mothers in Sekong—Laos’s second-most poverty-stricken province—give birth at home, unassisted by medical personnel, a provincial public health official focusing on mothers and children told RFA’s Lao Service.
“The rates of deaths for mothers and children during childbirth at home [in Sekong] are still high,” she said, speaking on condition of anonymity.
“It’s because over 70 percent of mothers give birth at home, mostly on their own or with help from other families, and there are still few midwives.”
She said the main reason the mothers-to-be don’t seek medical services for the births is because the centers are too far away, with would-be patients having to spend hours on bumpy roads in order to reach them.
Even some of the largest villages in Sekong, which is among the most remote areas of Laos, are virtually inaccessible by road for at least half of the year, reports say.
Another provincial health official said there were not enough health centers in the area, and that for patients living in remote areas, reaching them is difficult.
“Not all areas have a health center, especially not remote areas,” he said.
Patients have trouble accessing roads during the rainy season, and the cost of transportation adds further strain to their meager finances on top of medical costs, he said.
“There are 20 centers in the province, but there’s not enough medical staff for them,” he added.
According to provincial data, since 2005, 300 mothers or newborns have died during childbirth in Sekong province, 20 of them occurring over the past year.
But the maternal and infant health official said the actual number of deaths could be higher due to unreported cases.
Laos has said it plans to improve medical services at rural health dispensaries and ramp up the number of midwives it trains and sends to remote areas.
Last year, state media reported that there were 300 midwives across the country and that the government planned to create a total of 15,000 midwife positions by 2015.
According to the country’s U.N. Millenium Development Goals, Laos is supposed to reduce the national mortality rate to 260 deaths per 100,000 live births by 2015.
While the rate has improved since 2005, when 450 women out of every 100,000 live deliveries died in the process of giving birth, the latest figures show the ratio is 300 deaths per 100,000 live births, according to state media.
According to World Health Organization statistics, which vary from the figures given in state media, Laos has the highest maternal mortality rate in Southeast Asia.
According to WHO and U.N. estimates for 2011, it has the fourth-highest infant mortality rate in the region, after Timor-Leste, Myanmar, and Cambodia.
Reported by RFA’s Lao Service. Translated by Somnet Inthapannha and Viengsay Luangkhot. Written in English by Rachel Vandenbrink.