Protecting Lives of Mothers, Newborns in Ghana: Japanese Cross-Sector Efforts to Tackle Mortality Rates in West African Nation

By Miho Kibiki / Yomiuri Shimbun Staff Writer

11:05 JST, April 25, 2024

Developing countries are in need of cross-border assistance to improve maternal and child health care and reduce mortality rates. In Ghana, Japanese organizations, including private companies, are working to improve the health of mothers and babies by using their expertise and technologies.

I visited the West African nation about 13,000 kilometers from Japan from late January to early February to learn about the efforts being made to achieve this goal.

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“I gave birth to my child [on a boat] on the lake on my way [to a health center]. My bleeding did not stop easily after I gave birth,” recalls Regina Narteh Teye, a mother of five in the Upper Manya Krobo District of the Eastern Region of Ghana, looking back on her childbirth five years ago.

The district is about a three-hour drive from Accra, the capital of Ghana. To get to the Akateng Health Center, the closest medical facility from her home, she must cross the large Lake Volta. Reaching the center takes about four hours by foot and boat.

She gave birth to three of her five children on a boat bound for the health center. Each time, instead of going to the center, she returned home and stopped her bleeding using herbs and other measures available, she says.

The World Bank classifies Ghana as a middle-income country. However, according to UNICEF’s 2023 “State of the World’s Children” report, the newborn mortality rate in the nation was 23 per 1,000 live births and the maternal mortality rate was 263 per 100,000 live births. While the United Nations’ Sustainable Development Goals aim to reduce the maternal mortality rate to less than 70 per 100,000 live births by 2030, achieving this goal has been a steep challenge.

One reason is a lack of access to medical facilities. In some villages of the district that includes parts of Lake Volta, it takes nearly two hours by boat to reach the health center. Last year, a pregnant woman who was heading to the center alone gave birth in the bushes on the way. She was found alive the next morning, but her baby was dead.

To improve this situation, a maternity waiting home for expectant mothers near their due dates was opened near the Akateng Health Center in February, in cooperation with the major pharmaceutical company Shionogi & Co. and the Japanese Organization for International Cooperation in Family Planning (JOICFP). Shionogi has been supporting maternal and child health in Africa since 2015 through employee donations.

JOICFP previously established a similar facility in Zambia in southern Africa, but the one in Ghana is the first of its kind for the country. The waiting home has five rooms that can accommodate two pregnant women each, for a total of 10 at once. The rooms are available from four to two weeks before a due date until 72 hours after delivery. Cooking is possible if propane gas and other equipment are brought in.

Stanley Nkaku, the director of the health center, said that they expect about 20 people a month to use the facility, including pregnant women from distant villages.

Shionogi and JOICFP also plan to build a delivery ward in the future. They have already trained volunteers so that the facility can operate independently in the community, and they plan to conduct another training session this year.

“It is important to make this system sustainable,” said Etsuko Yamaguchi, deputy executive director of JOICFP who has been stationed in Ghana in the past.

Nutrition assistance from Japanese companies

In early February, at the Ejisu Government Hospital in Ghana’s Ashanti Region, a prenatal checkup was being conducted.

A midwife was interviewing a pregnant woman while writing her replies on a tablet. At another table, a midwife was giving advice to an expectant mother while displaying a graph showing her weight and health considerations on a screen.

They were using an app developed by NEC Corp. that quickly analyzes and evaluates the results of medical interviews and tests. The midwife said the app was very useful, as they could use it to instruct expectant mothers on what to watch out for.

In recent years, economic growth in Ghana has been accompanied by a widening economic gap between urban and rural areas. The same is true for health issues. Poor nutrition has been a pronounced trend especially in rural areas.

According to the country’s 2022 demographic health survey, 17% of children under 5 are stunted, or their height-for-age is far below the median. The trend has been at a standstill, not improving much over the past decade.

Gloria Folson, a researcher at University of Ghana’s Noguchi Memorial Institute for Medical Research, said the Ghanaian diet tends to lack protein, iron and vitamins.

She said that it is important to ensure that mothers, who have limited knowledge about nutrition, have opportunities to learn and to raise their awareness.

Against this backdrop, three Japanese firms from different industries — NEC, medical equipment giant Sysmex Corp. and the Ajinomoto Foundation (TAF) — launched a joint project in 2022 to improve the health and nutrition of mothers and children.

In the project, midwives and public health nurses use NEC’s medical interview app. Based on the results, pregnant women are given a referral for TAF supplements that can be mixed with baby food in an effort to supplement protein and iron deficiencies. They can also give recommendations for blood tests at hospitals equipped with Sysmex equipment that can quickly detect malaria infection and anemia. The goal of the project is to smoothly guide them from health checkups to nutritional guidance and medical care.

“Giving proper nutrition in the first 1,000 days of life, which means from pregnancy to age 2 — will protect the life and growth of a child,” TAF official Yusuke Takahashi said. “Through the project, we hope to deepen mothers’ knowledge of nutritional issues.”

Drones deliver medical aid in remote areas

In a sky dusted with sand from the Sahara, an airplane-like drone, about 2 meters long with a wingspan of about 3 meters, appeared in the distance and came ever closer. The moment it passed overhead, the fuselage opened and a bright red box was dropped with a parachute into the grounds of Nsutem Health Center in southern Ghana.

When the box was opened, it was filled with medicine wrapped in cushioning material. Janet Boateng, the center’s director, said that if they run out of medicine, delivery by drone takes about five minutes where a car would take much longer. She added that this is very helpful in time-sensitive situations, such as when oxytocic is needed during childbirth.

The drone was dispatched by Zipline International Inc., a U.S. startup which Toyota Tsusho Corp. has invested in.

Ghana has many unpaved roads, and transportation of medicine and vaccines has long been a challenge. In 2019, the startup began emergency delivery of medicines by automated drones. Flying at 100 kph, the drones can deliver to areas within an 80-kilometer radius of its base. In deliveries that would take as much as four hours by car, a drone can arrive in under an hour.

Currently, there are eight drone bases in Ghana. One of them, the Omenako in the town of Suhum, southern Ghana, has medicine, vaccines and blood products on warehouse shelves and in refrigerated storage.

When orders come in from medical institutions, drugs are packed in boxes and loaded onto drones made of carbon fiber and expanded polystyrene. The drones are placed on a 10-meter-long launch ramp that extends diagonally toward the sky and shoot off with the push of a button.

According to staff member Eva Hackman, over 100 drone launches can be done in a day. They are launched during emergencies, such as when someone is giving birth. When a pregnant woman started hemorrhaging after her water broke while farming, multiple drones flew one after the other to deliver blood products, saving the lives of the mother and her child.

Hackman said that if requested, they dispatch relief at night as well, adding that they want to help communities that are far from medical facilities.