Maternal mortality remains one of the most pressing health challenges facing developing countries, including Papua New Guinea (PNG). Despite global progress in reducing deaths related to pregnancy and childbirth, many women in resource-limited settings continue to face life-threatening complications. The tragedy of maternal deaths is not just a health issue—it reverberates through families, communities, and nations, undermining social and economic development.
Understanding the causes of maternal mortality, the critical importance of antenatal care and skilled birth attendance, the role of emergency obstetric care, nutrition during pregnancy, and the impact of community-based programs is essential to accelerating progress toward safe motherhood.
Causes of Maternal Mortality in Developing Countries
Maternal mortality in developing countries is largely preventable yet remains unacceptably high due to a combination of medical, systemic, and social factors. The leading direct causes include severe bleeding (postpartum haemorrhage), infections (sepsis), hypertensive disorders such as eclampsia and pre-eclampsia, obstructed labour, and complications from unsafe abortion.
Underlying these medical causes are broader determinants: limited access to quality healthcare services, shortages of skilled healthcare providers, inadequate infrastructure, and delays in seeking or reaching care. Social factors such as poverty, low education levels, gender inequality, and cultural practices further exacerbate risks.
In PNG, geographical barriers—such as rugged terrain and remote villages—pose major challenges for timely access to maternal health services. Additionally, traditional birth practices and home deliveries without skilled attendants contribute to maternal deaths.
Importance of Antenatal Care and Skilled Birth Attendance
Antenatal care (ANC) is the cornerstone of safe motherhood. Regular check-ups during pregnancy provide critical opportunities to monitor maternal and fetal health, identify and manage complications early, and deliver preventive interventions such as tetanus vaccination and iron supplementation.
The World Health Organization recommends at least eight ANC visits during pregnancy to optimize outcomes, yet in many developing countries, including PNG, coverage remains suboptimal. Barriers include limited health facility availability, cultural beliefs, transport difficulties, and lack of awareness.
Skilled birth attendance—delivery overseen by trained health professionals such as midwives, nurses, or doctors—is essential to reduce maternal and newborn mortality. Skilled attendants can manage normal deliveries, recognize danger signs, and facilitate referrals for complications.
Encouragingly, PNG has made strides in increasing facility births and skilled attendance, but progress is uneven. In rural areas, traditional birth attendants often assist births, highlighting the need to integrate them into formal health systems through training and collaboration.
Emergency Obstetric Care and Complications Management
Even with good antenatal care and skilled attendance, pregnancy and childbirth can pose unexpected emergencies requiring prompt, high-quality interventions. Emergency obstetric care (EmOC) encompasses a range of lifesaving services, including management of haemorrhage, hypertensive crises, sepsis, and obstructed labour, as well as the capacity for safe cesarean sections and blood transfusions.
In PNG, the availability and accessibility of EmOC remain constrained by limited infrastructure, lack of surgical capacity in rural hospitals, and shortages of trained personnel. Delays in recognizing complications, transporting patients, and providing adequate care contribute to preventable deaths.
Strengthening EmOC involves improving health facility readiness, training healthcare workers, establishing referral and transport systems, and ensuring essential supplies and equipment are available.
Role of Nutrition and Health During Pregnancy
Maternal nutrition profoundly impacts pregnancy outcomes. Undernourished women face higher risks of anemia, infections, preterm birth, low birth weight infants, and maternal mortality.
Iron and folic acid supplementation during pregnancy are cost-effective interventions to reduce anemia and neural tube defects. Adequate caloric intake, balanced diets rich in micronutrients, and attention to maternal weight gain are critical.
In many parts of PNG, food insecurity and poverty limit access to nutritious foods. Cultural dietary restrictions during pregnancy may also contribute to inadequate nutrition.
Integrating nutrition counselling and supplementation into antenatal care, alongside community education programs, can improve maternal and newborn health.
Community Programs Reducing Maternal Deaths
Community-based interventions play a pivotal role in reducing maternal mortality by addressing barriers beyond the health facility walls. Programs that engage local leaders, women’s groups, and traditional birth attendants help promote awareness, encourage early care seeking, and support healthy practices.
In PNG, successful community programs include maternal waiting homes near health facilities to bridge distance gaps, training for traditional birth attendants in safe delivery practices and referral, and health education campaigns targeting men and families to support women’s health.
Mobile clinics and outreach services also increase ANC and postnatal care coverage in remote communities.
Collaboration between government, NGOs, and communities fosters culturally appropriate solutions and sustainable impact.
Conclusion
Maternal mortality in developing countries like Papua New Guinea is a multifaceted problem requiring integrated solutions. Addressing direct medical causes with quality antenatal, delivery, and emergency obstetric care saves lives. Equally important are tackling social determinants such as poverty, nutrition, education, and cultural norms.
Community engagement and strengthening health systems—including infrastructure, skilled workforce, and supply chains—are fundamental.
With sustained investment, political will, and partnership across sectors, PNG can accelerate progress toward safe motherhood and ensure that pregnancy and childbirth are moments of joy and hope rather than tragedy.