The incidence of maternal mortality and morbidity is likely to increase in Ghana within the next two to four years, as a bulk of midwives from the various health institutions retire from public service. About 90 per cent of the present 2,800 midwives are expected to retire within the two to four years, creating a gap of 3,500 midwives. "This has serious service implications and likely to thwart the efforts of the Ministry of Health in achieving the Millennium Development Goals on maternal mortality and infant mortality. We need our mothers and babies to be healthy to sustain the development of the nation", said Mr Abraham Odoom, Deputy Minister of Health on Monday. Speaking at the opening of the first ever meeting of the African Region of the International Confederation of Midwives, the Ghana Registered Midwives Association (GRMA), and the Ministry of Health, in Accra on Monday, Mr Odoom said there was the need for the Ministry of Health to restructure midwifery schools and train more midwives. The four-day meeting on the theme; " Africa Midwives Uniting for the Reduction of Maternal/ Infant Mortality and Morbidity, has far attracted practitioners from 15 African countries out of an expected 20. The meeting is to commit practicing midwives to improving women's lives in the context of reproductive health and to have influence on the high mortality rates in Africa. There is a grim picture of the situation of maternal mortality, as figures from the World Health Organisation indicate that 500,00 women die from pregnancy related complications. For women in low and middle-income countries, the leading causes of the mortality are haemorrhage, hypertension, sepsis abortion, and obstructed labour. Worldwide, 60 per cent of pregnant women and 43 per cent of children under five years of age are anaemic with the highest prevalence in Africa and Asia. In addition, obstructed labour is often the cause of obstetric fistula that lead to untold suffering in a large number of women in countries of Asia and Africa, and it affects more than two million women worldwide. The situation in children is not much better as child mortality stands over 111 per 1000 births and one in nine children die before they reach the age of five years. Mr Odoom said midwifery training was a priority area for the Ministry of Health and training had been scaled up over the last four years to train more people for reproductive health care. He said the Ministry had also instituted policies to enhance career progression and conditions of service for midwives and all other health professionals. These include continuing professional development, and opportunities to establish private maternity homes. "The Ministry has also introduced the exemptions policy in the National Health Insurance Scheme to increase access to maternal deliveries and reproductive health for pregnant women," Mr Odoom said. Dr Joaquin Saweka, WHO Resident Representative, in a speech on his behalf, said many first referral level health facilities in developing countries had little or no surgical teams; and the few medical, nursing and paramedical staff available often had to perform a wide range of clinical procedures, often with inadequate training. In many situations, the quality of care is frequently constrained by inadequate basic equipment to perform simple but vital interventions as resuscitation, the provision of oxygen, and assessment of anaemia. Also, basic supplies like gloves, soap, water intravenous fluids are also too frequently lacking. Dr Saweka said training in health care and providing equipment required for managing patients with major health challenges to overcome, especially at referral level facilities in developing countries. This lack is compounded by the fact that midwives trained to care for pregnant women and women in labour move to other disciplines. He urged the midwives to team up to find a common solution toward the attainment of the Millennium Development Goals 4, 5 and 6, to a go a long way to improve the unacceptable conditions found on the Continent of Africa. The goals form part of eight goals adopted by member countries of the United Nations in September 2000, seeks to achieve a wide range of objectives by 2015. The fourth goal seeks to reduce by two-third the mortality rate among children under, the fifth to reduce by three quarters the maternal mortality ration and the sixth to halt and begin to reverse the spread of HIV /AIDS, as well as the incidence of malaria and other major diseases. Source: GNA