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POPULATION-RIGHTS: Combating Maternal Mortality

UNITED NATIONS, Oct 28 1999 (IPS) - The World Bank joined three UN agencies Thursday in pursuing priority activities designed to reduce maternal mortality worldwide.

The coalition called for increased efforts to reduce the estimated 600,000 deaths of pregnant or child-bearing women that currently were occurring each year – 98 percent in the developing world.

In a joint statement, the UN Children’s Fund (UNICEF), UN Population Fund (UNFPA), World Health Organisation (WHO) and the World Bank urged governments to treat maternal mortality as a human rights issue, to improve the availability and quality of maternal health services and to ensure access to family planning.

Gro Harlem Brundtland, WHO director-general, deemed their action important, both as a summary of what the organisations had learned about reducing health risks to mothers and as a sign of partnership among the agencies to reduce maternal mortality.

“We need societies to commit themselves firmly to making pregnancy and birth safe for all women,” Brundtland said.

The joint statement noted that some 80 percent of all maternal deaths resulted directly from complications during pregnancy, delivery or the first six weeks after birth.

Hemorrhaging was blamed for about one-quarter of all deaths but infections, high blood pressure, obstructed labour and unsafe abortions also were major direct causes of maternal mortality, according to the statement.

“There is no magic bullet that will ensure that women can go safely through pregnancy and childbirth,” Brundtland said. However, she added, there were many medical, social, cultural and economic changes that could help prevent the risks for pregnant women.

Many of those steps, added UNICEF Executive Director Carol Bellamy, were straightforward and cost-effective – such as focusing on nutrition before birth, and even before pregnancy, and providing women with education and training in skills.

“I think we’ve learned a lot over the past 10 years,” she said.

The agencies urged that health professionals – whether doctors and health centres or trained midwives – be made accessible to all mothers.

Currently, according to the joint statement, only 53 percent of deliveries in developing countries are attended by a health professional, and only 40 percent occur in hospitals or health centres.

Although training more health service providers was part of the solution other areas – like the improvement of transportation systems – needed to be pursued to ensure access, Bellamy said.

Just as important, argued Nafis Sadik, UNFPA executive director, was the prevention of unplanned pregnancies – which accounted for about half of all pregnancies.

Some of the changes therefore needed to be cultural, she said, including preventing girls from being married at too early an age, or from being pressured to produce boys. Another would be to reduce the dangers of unsafe abortions by ensuring that, in countries where abortion is legal, health providers are adequately trained.

World Bank Vice President Eduardo Doryan said that the steps needed to prevent the overwhelming majority of maternal deaths and half of all infant deaths could be funded at an annual cost of “only about three dollars per person.”

The agencies contended that the measures being proposed to reduce maternal mortality would also have a tremendous impact on lowering infent deaths.

According to the joint statement, nearly two-thirds of the eight million infant deaths occurring every year resulted from poor maternal health and hygiene, or because of the lack of essential medical care during and after birth.

“More than three million infants die in the first week after birth from factors relating to pregnancy and labour” and, each year, another three million pregnancies end in stillbirths, Bellamy said.

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