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Summary
Conflict zones dramatically increase maternal mortality rates due to damaged healthcare infrastructure, limited access to care, and the psychological trauma of war. Women in these regions, like Sub-Saharan Africa and the Middle East, face life-threatening complications due to a lack of antenatal care, skilled birth attendants, and essential medicines.
As hurtful as conflict situations are to any individual and to society, particularly expectant mothers, some burdens are well beyond the visible injuries.
In regions racked by war and displacement, just managing to stay alive eclipses perhaps the most necessary health concerns concerning women. Without easy access to antenatal, normal birth attendants, and medicines, they suffer from life-threatening complications at alarming rates.
Maternal Mortality in Conflict Situations
While maternal mortality is a critical problem throughout the world, conflict zones create an amplified version of the crisis. According to the World Health Organization, over 60 per cent of preventable maternal deaths are found in conflict or disaster countries.
In areas of instability and conflict, the maternal mortality ratios remain outrageously high compared to countries that do not experience violence. Examples of such include Sub-Saharan Africa and the Middle East. For instance, South Sudan has one of the highest rates in the world, at 1,150 per 100,000 live births. Similarly, the MMR in conflict-shaken Yemen jumped to 183 per 100,000 live births from an already high global average of more than twice its value.
Meanwhile, women in northern Nigeria, which has been ravaged by the Boko Haram insurgency that disrupted health care services, are four times more likely to die while giving birth compared to women in southern parts of the country.
The State of Healthcare in Conflicted Areas
Northeastern Nigeria has remained the hotbed of conflict, displacing millions of persons. Acute challenges to maternal health persist in the northeastern states of Borno, Yobe, and Adamawa because of the very high level of insurgency by the Boko Haram sect. The WHO reports that over 60% of the health facilities in these regions have been damaged or non-functional, thus leaving millions of women bereft of basic maternal healthcare.
Equally, Uganda is currently hosting over 1.5 million refugees, mostly from South Sudan and the Democratic Republic of Congo, hence putting a strain on its health system. Refugee camps are overcrowded, with an abnormally very low ratio of health workers to patients.
Most of the pregnant women in these camps also lack prenatal care, which explains the high complication rates like preeclampsia and sepsis. According to a report by PubMed Central, it has been documented that only 59.9% of pregnant women receive the recommended four or more antenatal visits in refugee camps in Uganda.
In displaced persons’ camps, most mothers deliver without skilled birth attendants to manage complications from obstructed labour or haemorrhaging postoperatively. Another major contributing factor relates to malnutrition: conflict usually disrupts supplies of food in affected areas and depletes household nutritional levels in pregnant women who need nutritious intake for themselves and their fetuses.
Besides physical barriers, sociocultural factors further hinder access to care. For instance, in northern Nigeria, medical consultations between women and male doctors are often discouraged, further enhancing the delay in receiving care.
These further include sanitation ills and hygiene. Most camps are poorly equipped with clean water and proper sanitation facilities. This heightens the possibility of infections at birth and afterwards. These problems are compounded by limited access to emergency obstetric care because most camps happen far from referral hospitals.
Comparative Analysis of Maternal Health Outcomes in Conflict Zones
While Nigeria and Uganda epitomise the precarious situation in Sub-Saharan Africa, other regions paint similar tales. In Yemen, protracted conflict has ravaged more than 50% of health facilities, leaving pregnant women with little life-saving action. By contrast, Afghanistan, even prior to the recent escalation of conflict, shows an MMR of 638 per 100,000 live births, attributed to systemic barriers in place due to cultural stigma and the shortage of female healthcare providers.
In Syria, the United Nations Children’s Fund reported the MMR was estimated at 31 deaths per 100,000 live births. This has increased since the civil war began. The WHO has estimated that 57% of public hospitals are severely damaged, and 37% are out of service in Syria.
On the other hand, innovative interventions have shown signs of progress in some regions. For instance, in South Sudan, mobile clinics operated by the International Committee of the Red Cross have greatly reduced maternal deaths among displaced communities by offering emergency obstetric care and training community health workers, a clear example that targeted efforts can save lives.
Trauma and the Invisible Wounds of War
Beyond physical risks, conflict also has a significant, awful impact on maternal mental health. Displaced mothers are more likely than others to suffer from post-traumatic stress disorder, anxiety, and depression.
According to the WHO estimates, up to 1 in 5 people in conflict settings experience mental health conditions, with pregnant women being particularly vulnerable. WHO mentioned that worldwide, an estimated 10% of pregnant women and 13% of post-partum women are suffering from mental disorders due to mainly depression.
A chart representing mental health conditions in conflict settings and among pregnant and postpartum women worldwide. Source: World Health Organization (WHO)
Trauma ripples into an intergenerational pattern of continuing traumas that don’t simply burn away. Developmental delays and emotional disturbances affect children of mothers suffering from conflict-induced mental health problems. For that reason, addressing maternal mental health among such populations is essential to the well-being of mothers and future generations.
Successful Interventions: Signs of Hope
Several initiatives have demonstrated the potential to improve maternal health outcomes in conflict zones:
- Mobile Clinics and Field Hospitals: ICRC-operated mobile clinics in South Sudan are carrying out essential prenatal care and offering emergency services to reduce maternal mortality rates in hard-to-reach areas and places troubled by armed violence.
- Mental Health Integration: WHO’s Mental Health Gap Action Programme trains non-specialist health workers in countries like Uganda and Syria to psychologically treat displaced mothers in response to both traumatic experiences and challenges in maternal mental health.
- Safe Spaces for Women: In the Bangladeshi refugee camps that host the stateless Rohingya population, UNFPA-supported safe spaces provide mental and physical counselling services, and prenatal and post-rape care to displaced mothers, creating comprehensive maternal health facilities.
- Technology-Driven Solutions: In Yemen, telemedicine platforms connected far-flung community health workers with medical specialists to improve the quality of maternal health care even in conflict zones.
Solutions: What Can Be Done?
Improving maternal health in war zones calls for an integrated approach and collaboration. Below are key recommendations to address this crisis:
- Health System Reconstruction: Invest in rebuilding healthcare infrastructure and deploying mobile clinics to reach remote areas.
- Training and Distribution of Human Resources: Midwives and community health workers need training on the provision of basic and emergency maternal care.
- Integration of Mental Health: Use counselling and other mental health services to treat the psychological trauma of war.
- Addressing GBV: Offers a safe place and post-rape care kits for victims of sexual GBV.
- Global Advocacy: Increase financing toward maternal health in areas of conflict and bring the matter into focus.
Key Findings and Conclusion
Several key findings are underlined in this article, which include: maternal mortality rates due to conflict are disproportionately high because the health systems are broken and resources scarce, and skilled personnel not available; case studies from Nigeria and Uganda present an example of complex physical, cultural, and systemic barriers to maternal care; it also gives a comparative analysis that targeted interventions, including mobile clinics and mental health programs, can create a large difference in improving the outcomes.
It is the moral obligation of the international community to focus on maternal health in humanitarian responses. This requires all governments, NGOs, and international organisations to work together in ways that ensure no mother is left behind, no matter the circumstance. Advocacy must raise the voices of displaced mothers, calling for increased funding, policy changes, and systemic healthcare improvements.
Recognising maternal health as a priority worldwide will allow us to save not only lives but also to nurture resilience and hope among the most vulnerable. Every mother has the right to safe childbirth and dignified care, especially in the face of conflict.
Editor’s note: This story was written by Adeyemi Okediran and was first published onBoNews Service
