Christopher Tufton | Committed to safe motherhood

The death of a mother and/or her baby is as saddening as it is sobering, reminding us – as a Government, health ministry, community, and family – to remain vigilant in our efforts to ensure safe motherhood.

It takes a village to preserve the health of mothers while also ensuring that their babies are born at a healthy weight and with access to breastfeeding and vaccination, which all contribute to improving survival and development.

It is within this context that the Ministry of Health & Wellness is continuing to advance a coordinated and strategic response to reducing preventable maternal and neonatal deaths in Jamaica through strengthened governance and targeted investments that have seen the Maternal and Neonatal Health Programme improving outcomes for both mothers and newborns.

With the Sustainable Development Goal target of 70 maternal deaths per 100,000 live births a priority, an upward trend in the maternal mortality ratio for Jamaica over the past two decades has been a major concern.

While there still is an overall upward trend looking at the past 10 years, there has been a lowering of the incline, brought about by a steady reduction in the rates over the last four years.

In 2024, Jamaica recorded a preliminary maternal mortality ratio of 133 per 100,000 live births, reflecting a downward trend post the COVID-19 pandemic from 211.3 per 100,000 live births at the peak of the pandemic in 2021. For the last three consecutive years, there has been a consistent decrease in the rate, and with the numbers so far for this year, we are expecting a continued downward trend.

IMPROVED ENGAGEMENT

With improved engagement of mothers early in pregnancy, better governance, upgraded facilities, updated guidelines, and the implementation of standards across the country, the ministry is continuously working to keep the trajectory of the maternal mortality rates at a downward trend.

More than 320 health centres, many of which have undergone recent renovation, offer maternal and child-health services. There has been a marked improvement in the proportion of women who sought antenatal care in the first trimester, reflecting early engagement and equitable access.

In 2023, 45 per cent of women received antenatal care in the first trimester compared with 22 per cent in 2018. Also, approximately 99 per cent of pregnant women were attended to by skilled birth personnel.

At the same time, recognising the vulnerability of adolescents, Jamaica launched a dedicated teenage clinic at the Victoria Jubilee Hospital, the largest maternity hospital in the country and the English-speaking Caribbean.

The ministry has also made deliberate efforts to enhance public education and awareness in this area, including radio advertisements aired on eight national stations from November 2024 to March 2025, and the distribution of flash drives with key antenatal information to be shared on televisions in waiting rooms at health facilities.

During the last year, there was also a series of maternal and child health planning meetings in addition to four regional maternal health fora. These meetings reflect continuous engagement with the service-delivery sites and a concentrated national effort to improve standards for responsive, comprehensive care in the perinatal period.

Eight emergency obstetric guidelines for the clinical management of high-priority conditions in pregnancy were printed and disseminated. Revision of the patient-held Maternal Record Book for continuity of care and the neonatal and maternal health sections of the Family Health Manual was completed.

CAPACITY BUILDING

In 2024-2025, capacity building was a priority. Three online training sessions were based on updated clinical obstetrics guidelines addressing the major causes of maternal mortality in Jamaica (hypertension, obesity, cardiac disease, sickle cell disease, sepsis, and thromboembolism in pregnancy).

Four maternal and two neonatal workshops were conducted, and point-of-care ultrasound training was continued in partnership with the Jamaicans Abroad Helping Jamaicans at Home Foundation. Additional simulation-based sessions for postpartum haemorrhage, reinforcing the CODE RED team approach, were conducted.

The 4th National Perinatal Review was conducted in November 2024. Additionally, monitoring and evaluation tools were developed, including templates for neonatal quarterly reporting to the national level and a postpartum home visits guidance tool. Quality assurance was also prioritised through data validation and the development of a Neonatal Quality-of-Care Audit Tool.

Still, there remains work to be done, including ensuring that we get more pregnant mothers into care early and throughout their pregnancies. This is especially important given what we know from the available data of recent years, which have seen a significant number of women suffer severe obstetric emergencies.

In 2019, for example, 1,125, or 3.3 per cent, of the 33,462 deliveries experienced pre-eclampsia while 1,219, or 3.6 per cent, experienced postpartum haemorrhaging. Pre-eclampsia and postpartum haemorrhaging are the leading cause of illness and death among pregnant women in Jamaica. In 2020, one thousand one hundred and twenty-two, or 3.54 per cent, of the 31,710 deliveries experienced pre-eclampsia while 1,714, or 5.4 per cent, experienced postpartum haemorrhaging.

We also need to see a continued increase in the number of women who access antenatal care from early in their pregnancies through to delivery and post-delivery. In 2018, ten thousand one hundred and eighty-six, or 45.9 per cent, of women accessing antenatal services in the public-health system were doing so for the first time in the second trimester of pregnancy and 175, or eight per cent, in their third trimester.

However, to truly advance our mission of safeguarding maternal health – a cornerstone not only for enhancing family and child well-being, but also for fostering economic resilience and achieving national development goals – we must adopt a collective, inclusive approach.

At the community level, we require the continued engagement and support of our local health teams, including community health aides who often serve as the first vital link between expectant mothers and the health system. We also recognise the essential contributions of breastfeeding support groups in promoting maternal and child health.

Moreover, we encourage families, and especially our fathers, to play an active role by supporting expectant mothers in attending all antenatal care appointments, and, whenever possible, accompanying them to these visits.

Safe motherhood requires all of us.

Dr Christopher Tufton is Jamaica’s minister of health and wellness and member of parliament for St Catherine West Central. Send feedback to cctufton@gmail.com or columns@gleanerjm.com.