In many parts of the world, a Caesarean section is a straightforward procedure. In Africa, however, this surgery remains perilous, with maternal mortality rates up to 50 times higher than in high-income countries. These alarming statistics underscore a stark reality: African women undergoing Caesarean sections face tremendous risks due to systemic inadequacies in healthcare. Professor Salome Maswime, Head of Global Surgery, recently delivered a powerful presentation titled “Enhancing Caesarean Section and Obstetric Outcomes through Care,” emphasizing that these gaps demand urgent, transformative change. Her insights serve as a call to action, urging all stakeholders to rethink and strengthen obstetric care systems for African women.
Systemic Gaps in Care
A major issue highlighted by Professor Maswime is the gap between what patients need and the support provided by healthcare systems. Accessing a Caesarean section in Africa often means overcoming substantial hurdles: seeking help, reaching a facility, and receiving timely care. Tragically, these delays frequently lead to preventable maternal deaths. These are not simply medical issues but reflections of weak infrastructure, fragmented referral networks, and resource constraints that hinder healthcare providers from delivering the life-saving interventions they are trained for.
Community-Based Interventions and Health Education
Professor Maswime’s presentation highlighted community-based health promotion and education as crucial interventions for maternal health. A recent Delphi study identified 28 effective interventions for improving maternal outcomes in African countries, including health education initiatives that empower women to seek medical care and promote early antenatal visits. Evidence shows that women who engage early with healthcare systems experience significantly better outcomes. By leveraging community health workers, these initiatives bridge knowledge gaps and encourage expectant mothers to make timely health decisions.
Investing in Capacity and Infrastructure
Improving obstetric outcomes requires investments in facility infrastructure and healthcare providers. Many African healthcare workers face life-threatening complications with limited resources and few emergency transport options. Simulation-based training and advanced skills development for handling severe cases, like haemorrhages during C-sections, are highly recommended. However, without substantial investment from governments and partners, healthcare facilities will continue to struggle with inadequate preparation for high-risk situations.
A Call for System Thinking and Collaborative Leadership
Addressing these challenges necessitates a holistic approach, integrating human resources, referral pathways, transport networks, and community partnerships. Collaborative leadership—bringing together policymakers, healthcare professionals, and community leaders—can foster the necessary political and social commitment for lasting improvements. Advocacy for stronger referral systems, improved access to blood products, and better-equipped facilities is also critical to reducing maternal risks.
Technology and Innovation as a Lifeline
Technology holds promise as a solution in resource-limited settings. Patient monitoring systems, telemedicine platforms, and biomedical devices can enable safer surgeries and quicker responses. While these tools require an initial investment, they are often cost-effective in the long run and can be transformative, especially in rural and underserved areas. By integrating technology into healthcare practices, African health systems have the potential to bring equity and improved safety to maternal care.
The Imperative for Policy Action
Professor Maswime’s insights emphasize that policy reform is a foundational element for maternal health improvement. Policymakers play a critical role in building systems that do not merely react to crises but prevent them. Strengthening healthcare systems by prioritizing emergency care funding, expanding referral networks, and ensuring that hospitals are equipped for obstetric emergencies is essential to creating safer maternal healthcare environments across the continent.
Potential Solutions from DIMA Health
To address the multifaceted challenges raised by Professor Maswime, DIMA Health offers a range of solutions designed to improve maternal healthcare in Africa. While each solution holds promise, effective implementation depends on stakeholder commitment and alignment with local needs. DIMA Health’s potential contributions to obstetric care improvement include:
- Systemic Gaps in Care
- Integrated Referral System: DIMA’s referral mechanisms can facilitate smoother communication between primary health centres, transport services, and hospitals, potentially reducing delays in accessing emergency care. This system could improve response times and help ensure that patients receive timely treatment.
- Healthcare Worker Support: Through partnerships with local health facilities, DIMA can provide essential resources and real-time support, empowering healthcare workers to deliver life-saving interventions.
- Community-Based Interventions and Health Education
- Community Health Ambassadors: By training community health ambassadors, DIMA could help educate women on the importance of antenatal care and warning signs, promoting early healthcare engagement.
- Maternal Health Education Programs: DIMA’s structured health education initiatives have the potential to empower community health workers to share critical information with expectant mothers, fostering greater awareness and better outcomes.
- Investing in Capacity and Infrastructure
- DIMA Academy: DIMA’s training programs could provide healthcare providers with simulation-based experiences for complex obstetric scenarios, enhancing their preparedness for high-risk situations like haemorrhages during C-sections.
- Extensive Health Facility Profiles: DIMA Health currently maintains detailed profiles of over 7,200 healthcare facilities. These profiles provide crucial insights into each facility’s infrastructure, resources, and service capabilities, laying a strong foundation for targeted interventions and partnerships. This extensive database enables DIMA Health to conduct asset audits efficiently, identify critical resource gaps, and support strategic resource-sharing or optimization efforts across the healthcare network.
- Facility Upgrades and Resource Allocation: DIMA could partner with healthcare facilities to assess needs and direct resources towards essential infrastructure improvements, such as emergency care rooms and diagnostic tools.
- Systems Thinking and Collaborative Leadership
- Partnerships with Policymakers and Health Leaders: By fostering partnerships among policymakers, healthcare professionals, and local leaders, DIMA could support an integrated healthcare approach. Promoting systems thinking and cross-sector collaboration could create sustainable improvements in healthcare delivery.
- Policy Advocacy : DIMA can advocate for policies that improve referral systems, blood bank access, and facility readiness, ensuring that critical resources are available when needed. With technology as its core strength, DIMA Health can partner to co-create appropriate technology to drive and catalyse the implementation of effective policies.
- Technology and Innovation as a Lifeline
- Booking and Appointment System for Improved Access and Facility Optimization: The DIMA Health booking and appointment system offers a streamlined solution to manage patient appointments across healthcare facilities, helping patients secure timely care at the most suitable location. By allowing facilities to monitor and manage bookings in real-time, the system can identify and redirect patients from overbooked facilities to nearby locations with available capacity, effectively reducing congestion and optimizing resource allocation. This approach not only improves patient experience by reducing wait times and overcrowding but also ensures that facility resources are better utilized, supporting more balanced and efficient healthcare delivery across the network.
- Health Facility Locator and Monitoring Tools: Through digital technology, DIMA could offer tools that help patients locate facilities equipped for obstetric care. Patient monitoring systems could also improve tracking and response times.
- Telemedicine for Remote Consultations: DIMA’s telemedicine platform could enable healthcare workers in remote areas to consult specialists, gaining valuable guidance on complex cases.
- The Imperative for Policy Action
- Advocating for Maternal Health Policies: DIMA can support government bodies in prioritizing maternal health through policies that strengthen emergency obstetric care, secure funding for facilities, and support transportation initiatives.
- Legislative Support for Referral Pathways and Resources: DIMA’s advocacy efforts could extend to promoting legislation for better-equipped referral pathways and resource allocation, contributing to a proactive rather than reactive healthcare system.
Through these potential solutions, DIMA Health aligns itself with the specific needs Professor Maswime identified, offering a structured approach that can help reduce maternal mortality and enhance obstetric outcomes across the continent.
Concluding Thoughts
For African women, a Caesarean section should not be a life-threatening experience. Professor Maswime’s presentation is a poignant reminder that improving maternal healthcare requires a shared commitment from governments, healthcare professionals, and international organizations. With targeted interventions, political will, and robust community engagement, we can make significant strides in reducing maternal mortality associated with obstetric surgery. Women’s lives depend on it, and it is up to us to ensure that their survival is a top priority.