Patience Makwele
Namibia’s sharp decline in maternal deaths nationally is being undermined by persistent regional disparities, with the Omaheke and Zambezi regions recording maternal mortality ratios significantly above the national average.
Deputy minister of health and social services Suzan Ndjaleka made the disclosure on Monday during the launch of a national training programme aimed at strengthening health workers’ response to postpartum haemorrhage and other obstetric emergencies.
Ndjaleka said Namibia’s maternal mortality ratio had fallen from more than 450 deaths per 100 000 live births in 2000 to 139, representing substantial progress over two decades.
However, she warned that the national figure masks significant differences between regions.
“Despite this progress, internal regional disparities persist, with mortality ratios in regions like Omaheke and Zambezi significantly exceeding national averages,” Ndjaleka said.
The disclosure comes against the backdrop of a maternal-death review that found that more than half of the deaths assessed could potentially have been prevented through better clinical care.
According to Ndjaleka, a confidential inquiry covering maternal, stillbirth and neonatal deaths between April 2021 and March 2024 found that 54% of maternal deaths reviewed were preventable through improved clinical care.
Critical gaps were identified in nearly 80% of the maternal-death records examined, including delays in recognising clinical deterioration and inadequate referral practices.
The findings point to problems not only in access to maternal healthcare, but also in how quickly complications are identified and managed once women reach health facilities.
Direct obstetric complications accounted for 60.7% of maternal deaths, while obstetric haemorrhage alone accounted for 16%, making it one of the leading causes of maternal mortality.
Ndjaleka said postpartum haemorrhage remains a particularly urgent concern because severe bleeding can become fatal within a short period if not detected and treated promptly.
“Childbirth should be a moment of hope, joy and celebration,” she said, stressing the need for health workers to recognise danger signs and act without delay.
The ministry is now scaling up the WHO-recommended E-MOTIVE care bundle, which combines early detection of blood loss with immediate interventions to prevent women from dying from postpartum haemorrhage.
The three-day national training, running from 7 to 9 September, is bringing together healthcare professionals and trainers who are expected to transfer the skills to districts, clinics and maternity wards across the country.
Ndjaleka said the programme is intended to create a ripple effect, with trained health professionals becoming mentors and trainers for other frontline workers.
UNFPA Namibia representative Erika Goldson said reducing maternal deaths would require stronger clinical responses, particularly in regions where mortality remains high.
Goldson said evidence from a major clinical trial showed that the E-MOTIVE approach could reduce severe postpartum haemorrhage by about 60%.
She also stressed that improving survival must go hand in hand with improving women’s experiences in maternity wards.
“A key objective of this initiative is to ensure a provision of respectful, woman-centred maternity care,” Goldson said, emphasising that women should be treated with dignity, respect and cultural sensitivity even during obstetric emergencies.
According to the ministry of health, the initiative forms part of broader efforts under Namibia’s Sixth National Development Plan (NDP6) and its 2025–2029 Strategic Plan to reduce maternal and newborn deaths and improve the quality of maternal healthcare.
Despite Namibia’s progress, the national MMR of 139 deaths per 100 000 live births remains almost twice the Sustainable Development Goal target of fewer than 70 deaths per 100 000 live births.
However, for Omaheke and Zambezi, the challenge is even more pronounced.
The ministry’s latest warning suggests that achieving further national reductions will depend increasingly on closing regional gaps and ensuring that women, regardless of where they live, receive timely and effective emergency obstetric care.
Ndjaleka challenged the health workers undergoing training to take the knowledge back to their respective facilities and strengthen the response to obstetric emergencies.
The ministry’s ultimate goal is to eliminate preventable maternal deaths from postpartum haemorrhage in Namibia.
