Ebola could increase maternal mortality - Report

The loss of health workers due to the Ebola Viral disease in West Africa may result in an additional 4,022 deaths of women each year across Guinea, Liberia and Sierra Leone.

The fatalities are as a result of complications in pregnancy and childbirth.

According to the new World Bank report: “Healthcare Worker Mortality and the Legacy of the Ebola Epidemic,” published by Lancet Global Health and made available to Ghana News Agency, said the recent outbreak of Ebola in these countries could leave a legacy significantly beyond the deaths and disability caused directly by the disease itself.

Markus Goldstein, Lead Economist at the World Bank Group and a co-author of the report who heads the World Bank’s Africa Gender Innovation Lab said: “The loss of health workers to Ebola could increase maternal deaths up to rates last seen in these countries 15-20 years ago.”

The paper estimates how the loss of health workers to Ebola would likely affect non-Ebola mortality even after the countries are declared Ebola-free.

Maternal mortality could increase by 38 per cent in Guinea, 74 per cent in Sierra Leone, and 111 per cent in Liberia.

Since the Ebola epidemic hit Guinea, Liberia and Sierra Leone, health workers have died at a higher rate than any other population group, exacerbating skill shortages in countries that had very few trained health personnel. Once these countries reach zero Ebola cases, this would negatively affect the health of their populations.

As of May, 0.11 percent of Liberia’s entire general population had died due to Ebola, as compared with 8.07 percent of its health workers, defined in the study as doctors, nurses and midwives.

In Sierra Leone, the loss was 0.06 percent of the general population compared with 6.85 percent of the health workers, while 0.02 percent of Guinea’s overall population had died compared with 1.45 percent of all health workers.

According to the report, this translates into a 10 percent reduction in doctors in Liberia and an eight per cent reduction in nurses and midwives.

In Sierra Leone, it means a five per cent reduction in doctors and a seven per cent reduction in nurses and midwives.

In Guinea, the reduction is smaller, two percent for doctors and one per cent for nurses. At the outset of the epidemic, the World Health Organisation ranked Liberia, second; Sierra Leone, fifth; and Guinea as 28th from among 193 countries in terms of doctors per 1,000 people.

“Ebola has weakened already very fragile health systems in these countries,” says David Evans, Senior Economist at the World Bank Group and co-author of the report.

“Ebola’s devastating impact should be the catalyst to strengthen the health systems far beyond their pre-Ebola levels,” he said.

The report suggests that to save these lives, 240 doctors, nurses and midwives would need to be hired immediately across the three countries. This is a small fraction of the 43,565 doctors, nurses and midwives that would need to be deployed in Guinea, Liberia and Sierra Leone to achieve sufficient access to essential health services as implied by the Millennium Development Goals.

“These countries require urgent investment in health systems starting with a substantial increase in the number of trained health workers,” says Dr. Tim Evans, Senior Director of Health, Nutrition and Population at the World Bank Group.

“This is to ensure that Guinea, Liberia and Sierra Leone are not only equipped to deal with future deadly epidemics but that every day, mothers have access to the quality healthcare they need that will save their lives and prepare them for a more promising future.”

As of May 2015, the World Bank Group has mobilized US$1.62 billion in financing for Ebola response and recovery efforts to support the countries hardest hit by Ebola.