Stillbirths: Time bomb in Ghana

IT has been established that until every Ghanaian gets access to potable water and the use of firewood and charcoal is stopped, stillbirths, in the country, will remain with us for a long time.

A new research has revealed that the use of charcoal and firewood as well as the consumption of contaminated drinking water are responsible for 25% of all stillbirths in Ghana.

Firewood and charcoal are also the predominant cooking fuel in rural Ghana owing to poverty and limited access to clean fuels.

In Ghana, institutional stillbirth figures went up nationally to 11,976 in 2013, according to the Ghana Health Service.

According to the research, women with no formal education or did not progress beyond basic education, are at 60% risk of experiencing stillbirth and other adverse pregnancy outcomes.

It said addressing educational inequalities in Ghana is essential for ensuring household choices that curtail environmental exposures and help improve pregnancy outcomes.

Dr Kofi Amegah of the University of Cape Coast was the lead researcher with two others - Simo Näyhä and Jouni J. K Jaakkola from Finland.

The findings have just been published in the renowned British Health Journal - BMJ Journal.

The researchers relied on data from the 2007 Ghana Maternal Health Survey (GMHS), a nationally representative population-based survey that collected comprehensive information at the household and individual woman's level on maternal health issues including pregnancies, stillbirths, abortions and miscarriages and maternal deaths in the country.

Dr Kofi Amegah told The Finder that government must strive to make clean cooking fuel such as Liquefied Petroleum Gas (LPG) and improved cook stoves that generate less smoke accessible to Ghanaians especially in rural communities.

In addition, he wants government to provide potable water to all communities across the country.

“Our results show that biomass fuel use and unsafe water consumption could be important pathways through which low maternal educational attainment leads to stillbirths in Ghana”.

The research recommended that women with no formal or low education should therefore receive extra care and support, and be alerted to household environmental risks to their pregnancies during prenatal visits.

It added that this recommendation could help curb the high stillbirth occurrence in developing countries.

Water sources

Many households in Ghana rely on ground and surface water resources due to limited access to pipe-borne water, erratic supply, and high connection and utility charges.

Mining/agric polluting waters

The research noted that these water resources are often polluted by mining and agricultural activities, as well as nearby pit latrines which are widely used in rural Ghana.

According to experts, mining activities, especially in unregulated mines, lead to deposition/leaching of substantial amounts of chemicals such as cyanide and sulfuric acid, and heavy metals into nearby water bodies.

Agricultural run-offs also introduce sediments, pesticides, fertilizers and pathogens into water bodies.

Pit latrines

It added that pit latrines have also been widely documented to leach microbial and chemical contaminants, including coliforms, Escherichia coli, faecal streptococci, ammonia, nitrates and nitrites into groundwater resources.

Poverty fuels stillbirth

Poverty further hampers many households from treating these unwholesome water resources before usage.

Statistics

Notably charcoal and firewood were the dominant cooking fuels of respondent's households with 91% of households using these fuels. LPG was used by 8% of the respondent's households.

Whereas among highly educated mothers, LPG was the dominant fuel used - 69% among uneducated and 77% among primary educated – for 64% of mothers, firewood was the fuel mostly used.

According to the findings, the dominant drinking water sources of the respondents are piped water - 40% and well/borehole water - 41%.

It came to light that about 5% and 11% of the respondents used bottled/sachet and surface water, respectively.

The research also revealed that - 59% secondary school and 64% of highly educated mothers patronised piped water mostly. A quarter of highly educated mothers used bottled/sachet water.

It said 53% of uneducated mothers used well/borehole water resources with 26% using piped water.

Middle school/JSS-educated women

Among primary and some middle school/JSS-educated women, the proportion using piped and well/borehole water resources were about the same.

About 6% of the respondents reported experiencing stillbirth in their lifetime with a small proportion of 13% of them experiencing this occurrence more than once.

Uneducated mothers and mothers who completed middle/JSS recorded the highest proportion of lifetime stillbirths; 32% and 26%, respectively.