Maternal mortality hits a record high in Kazakhstan

The country’s health ministry believes these are consequences of COVID-19 and systemic troubles in the national health system

During the COVID-19 pandemic, the maternal mortality rate rose threefold in Kazakhstan. However, mortality factors associated with obstetric services account for just 18% of lethal cases, according to the Ministry of Health. The vast majority of these deaths were caused by diseases unrelated to pregnancy.

According to data from the Bureau of National Statistics, the number of women who died while giving birth reached 200 in absolute terms last year. This is the highest rate in a decade. For comparison, the same rate was 55 cases in 2019.

When comparing countries and regions with different population rates, international statistics use a relative indicator. This is a coefficient of maternal mortality per 100,000 newborn children. Last year this rate rose to 44.7 in Kazakhstan while in 2019 it was about 13.7 per 100,000 newborn babies. For comparison, the same rate in developed countries such as the Netherlands, Japan, Germany and Finland is about just 1-4 cases per 100,000 newborn babies, Our World in Data says.

Kazakhstan’s health officials blame the COVID-19 pandemic for that increase in maternal mortality. The health ministry data shows that in 163 cases the cause of women in labor death were different diseases unrelated to pregnancy or giving birth. For instance, in 140 cases the death was caused by pneumonia or complications from coronavirus infection.

However, when the pandemic first started in 2020, the country’s maternal mortality rate was half as much.

In Kazakhstan, every single incident with the death of a pregnant woman or woman in labor is reviewed by a special commission. Experts from six medical universities from all over the country and two national medical centers take part in such investigations. The 2021 findings of the commission, for example, were presented by Marat Shoranov, vice minister of health in response to a deputy of the Mazhilis of the country’s parliament.

«The commission’s expertise has shown a range of systemic problems in the national health system when it comes to pregnant women and women in labor. For example, in several regions, authorities have failed to monitor the situation. The reason is the lack or total absence of trained planners in local governments. Thus, in the East Kazakhstan, North Kazakhstan and Kostanay regions and the city of Almaty there are no specialists for maternity issues in the local health departments. Often, pregnant women with mild and severe forms of COVID were sent to regular maternity clinics unsuitable for such patients (they had no trained staff, diagnostic tools or equipment),» the health official said.

The lack of obstetric personnel in the maternity clinics is another reason for the problem, according to Mr. Shoranov. Many obstetrician-gynecologists and emergency physicians tend to leave public hospitals in favor of private clinics. In 2021, 245 obstetrician-gynecologists (40% of them are experienced specialists) left public hospitals. As the official noted, there are several reasons for that trend, including low salaries and lack of social support, loads of inspections, punishments, judicial attacks, legal insecurity and huge psychoemotional pressure.

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