Development & Aid, Headlines, Health, Human Rights, Latin America & the Caribbean, Population, Poverty & SDGs

HEALTH-LATAM: Too Many Women and Children Dying

Daniela Estrada

SANTIAGO, Jan 15 2009 (IPS) - "Latin America is not in the tragic conditions of the least developed countries, but an average rate of 130 maternal deaths per 100,000 live births is very high," UNICEF representative Egidio Crotti told IPS.

Along with Chilean Planning Minister Paula Quintana and Public Health Minister Jeannette Vega, Crotti took part in the local presentation of UNICEF’s (United Nations Children’s Fund) "The State of the World’s Children 2009" report Thursday in Santiago. The report was launched in South Africa.

Every day, 1,500 women worldwide – more than 500,000 a year – die while giving birth. But the risk of dying of complications during pregnancy or delivery is 300 times greater for women in developing countries than in the industrialised world, the report says.

And for every woman who dies, another 20 suffer illnesses or injury.

Sub-Saharan Africa has the highest maternal mortality rates, averaging 920 deaths per 100,000 live births, compared to a rate of eight per 100,000 in industrialised countries.

In Latin America, Chile has the lowest rate, with 16 maternal deaths per 100,000 live births, followed by Uruguay (20), Costa Rica (30), Cuba (45), Venezuela (57), Mexico (60), Argentina (77), Brazil (110), Colombia and Panama (130), the Dominican Republic and Paraguay (150), El Salvador and Nicaragua (170), Ecuador (210), Peru (240), Honduras (280), Guatemala and Bolivia (290), and Haiti (670).

"This is even more serious because there are funds in Latin America. Everything depends on where countries put their priorities," said Crotti.

With respect to neonatal mortality (deaths within 28 days of birth), Latin America and the Caribbean have an average rate of 13 deaths per 1,000 live births, compared to 41 per 1,000 in South Asia, 45 per 1,000 in West and Central Africa – and just three per 1,000 in the industrialised world.

In Latin America, Cuba stands out, with a neonatal mortality rate of four per 1,000 live births, followed by Chile (five), Uruguay (seven), Costa Rica, (eight), and Argentina (10).

The worst rates are found in Guatemala (19), Bolivia (24) and Haiti (32).

Crotti stressed that 80 percent of neonatal deaths in the world are avoidable.

With regard to under-five mortality, the region’s average is 26 per 1,000 live births, while the global rate is 68.

The UNICEF representative said there is a scientific consensus on the factors needed to eradicate maternal and infant mortality.

For example, a favourable setting for the development of women and respect for their rights, timely and continuous health care for mothers and children, and the implementation of integral and coordinated public policies.

"Another issue that I think is a big challenge for Latin America and the Caribbean as a whole is the question of teen pregnancies, which have not gone down, and which science shows are very risky to women’s health and imply dropping out of school. Furthermore, this question is related to societies that are violent against women," said Crotti.

"If Latin America wants to meet the Millennium Development Goal (MDG) on maternal and infant mortality rates, it has to make faster progress, because at this pace, most of the countries will be far from meeting the targets in 2015," said Crotti, who urged governments "not to lose sight of the fact that we are talking about human lives."

From 1990 to 2005, the region’s maternal mortality rate dropped from 180 to 130 deaths per 100,000 live births.

The eight MDGs, which were adopted by the world’s governments at the 2000 U.N. General Assembly, set specific targets for reducing poverty by 2015, taking 1990 levels as the baseline.

The fourth MDG is to reduce mortality of children under five by two-thirds, and the fifth is to reduce maternal mortality by three-quarters and guarantee universal access to reproductive health.

The rest of the MDGs are a 50 percent reduction in poverty and hunger; universal primary education; the promotion of gender equality; ensuring environmental sustainability; the reversal of the spread of HIV/AIDS, malaria and other diseases; and a global partnership for development between the rich and the poor.

In his speech Thursday in Santiago, Crotti highlighted Chile’s child protection system, implemented by the government of Socialist President Michelle Bachelet, known as "Chile Grows with You".

The multisectoral programme, the first of its kind in Latin America, provides full support for all mothers and children from pregnancy until the child turns four, offering universal day care and preschool education, maternity care and health services.

The programme began to operate in 159 municipalities in 2007 and was extended to the entire country in 2008.

"We are talking about 198,000 pregnant women and 647,000 children from birth to age four who are covered by the public health system," said Planning Minister Quintana.

Two weeks ago, the government introduced a draft law creating an intersectoral social programme system and institutionalising the "Chile Grows with You" programme. The draft law is expected to be approved in the first quarter of this year.

The Bachelet administration has had contacts with other countries in the region, like Brazil, Mexico and Uruguay, to replicate the experience outside of Chile, said Quintana.