News overview

There is more to maternal health than mortality only

Film and photo exhibition tell the stories behind the first research into pregnancy complications in rural Morocco
Worldwide, all eyes are on the latest UN figures showing slow, recent progress on maternal deaths. Yet, little is known about the widespread suffering pregnancy complications, also referred to as maternal morbidity, cause. “Maternal mortality is just the tip of the iceberg,” according to Bouchra Assarag, who dedicated her PhD research at the Institute of Tropical Medicine in Antwerp (ITM) to pregnancy complications in the isolated Moroccan Al Haouz region. A photo exhibition and documentary presented at the annual ITM Colloquium in Rabat tell the untold stories of pregnancy complications in rural Morocco.

Millions of women worldwide miss out on medical follow-up during and after their pregnancy. They often live in remote areas with limited access to emergency obstetric care facilities. Cultural and communication issues are also complicating factors. As a result, women may suffer physical or psychological conditions, which affect their wellbeing, including infertility, anaemia or depression and other ailments. This is called maternal morbidity.

While plenty of statistics are available on maternal mortality, women dying during or within 42 days after pregnancy, little is known about maternal morbidity in Morocco. The Institute of Tropical Medicine in Antwerp (ITM) and the Moroccan National School of Public Health (ENSP) have for the first time started mapping the social consequences of maternal morbidity in Morocco. This work is done in the context of an ITM capacity-strengthening programme, financed by the Belgian Development Cooperation, contributes to strengthening capacity of ENSP on training and research.

ENSP’s Dr. Bouchra Assarag interviewed plenty of women in Morocco’s remote mountainous region of Al Haouz for her PhD research at ITM. Her studies show that 60% of women have at least one health problem related to child birth at six weeks post-partum.

“Maternal mortality is only the tip of the iceberg. Below the surface women suffer from a range of complications that often go untreated and undiscussed. We need more attention for and evidence on maternal morbidity, in Morocco as well as in other low- and middle-income countries,” said Assarag.

In September 2015, a team of ENSP and ITM visited Al Haouz with photographer and documentary maker Paolo Patruno, who specialised in recent years in maternal health through his “Birth is a Dream” project. The resulting photo exhibition and video documentary, containing the personal stories of the women from Al Haouz, was presented at the 57th ITM annual Colloquium. Maternal morbidity is one of the three main themes of this international conference gathering international researchers and health experts in Rabat from 24-27 November. The conference is co-organised by ITM and ENSP.

Assarag’s will defend her PhD thesis at the Université libre de Bruxelles (ULB) on 4 December 2015. Her thesis suggests new research lines on how to measure the consequences of maternal complications and on how to reorganize health care to respond to the needs of mothers and babies.

The 2015 Colloquium on maternal and neonatal health

Participants at the 2015 ITM Colloquium in Rabat present new research, share experiences and debate lessons learned from the Millennium Development Goals (MDGs), which will be replaced with new sustainable development goals after 2015.

Since 1990, world-wide maternal mortality has been reduced by 44% and child mortality by 49%. However, more needs to be done to reach the MDGs aimed at reducing under-five mortality by two-thirds (MDG4) and decreasing maternal mortality by three-quarters, while achieving universal access to reproductive health (MDG5).

The ITM Colloquium will make recommendations on how maternal health can be improved in an integrated post-2015 development framework. It explores how we can work towards a vision of a healthy life for all, beyond reductions in mortality, in line with the UN Global Strategy for Women’s, Children’s and Adolescents’ Health. The conference focused on three areas: respectful childbirth; maternal morbidity and its consequences on newborn’s and women’s health; as well as maternal mortality surveillance.

The 57th ITM Colloquium is supported by the Belgian Development Cooperation, the Kingdom of Morocco, the Moroccan Ministry of Health, WHO, UNFPA, Unicef and the MNSIRSES project which is co-funded by the European Union.


Top picture © 2015 Paolo Patruno

Spread the word! Share this story on

Related stories