HEALTH: US Help Sought to Curb Maternal Mortality Worldwide

By Marwaan Macan-Markar Reprint | | Print |

Marwaan Macan-Markar

MEXICO CITY, Jan 26 2001 (IPS) - Public health activists in the United States are determined to secure more funding this year for health programmes aimed at reducing maternal mortality worldwide.

And among those to be approached by a coalition of US-based non- governmental organisations (NGOs) to get such financial backing, are US policymakers.

On Friday, this coalition, the White Ribbon Alliance for Safe Motherhood, will gather in Washington D.C. to map out a strategy aimed at gaining endorsements from the US Congress “for increased funding for maternal health programmes specifically”.

“We want to make pregnancy and childbirth safe for women around the world,” says Manjiri Sonawane, programme associate at the Washington D.C.- based NGO Networks for Health, the secretariat for the Alliance.

And for that, she points out, more funding is needed from the United States to support “the implementation of cost-effective interventions in the developing world”.

Currently, according to Sonawane, the US government devotes about 1.1 billion dollars a year towards “critical global issues”, which is “less than one-tenth of one percent of the over one trillion dollars spent on health care domestically”.

The Alliance, she says, wants US policymakers to recognise global maternal health as “a priority” issue.

And statistics on global maternal health demonstrate just how serious a concern it is.

Studies done by the Safe Motherhood Initiative (SMI), an international health body supported by United Nations agencies, the World Bank and public health groups, estimate that close to 600,000 women die every year due to complications of pregnancy and childbirth. This means “more than one woman dying every minute from such causes,” notes the SMI.

The death toll, it adds, is significantly higher in the developing world, where one woman in every 48 giving birth die, as opposed to what prevails in the developed world, where it is one death for every 1,800 women giving birth.

And within the developing world, maternal mortality in Africa is the highest, where one woman in every 16 die from pregnancy-related complications, as against one in every 65 women in Asia and one in every 130 in Latin America and the Caribbean.

In countries like Sierra Leone and Somalia, for instance, the toll is even higher, with one in every seven women dying due to childbirth, while in Ethiopia, it is one out of every nine women. By contrast, in a developed country like Switzerland, the toll is one death for every 8,700 women.

“The causes of women’s deaths during pregnancy and childbirth have been pretty consistent since records ever existed,” says Marilen Danguilan, senior advisor in the Women’s Health section of the UN’s Children’s Fund (UNICEF).

Such causes include: haemorrhaging, sepsis or massive infection, hypertensive disorders of pregnancy, complications of unsafe abortions and obstructed labour.

And as long as women lack access to adequate health care and life- saving services, “a woman’s chance of surviving complications of pregnancy and childbirth is diminished”, she adds.

The SMI agrees, given the evidence it has unearthed about the quality of health care available to pregnant women, particularly in the Third World.

While close to 97 percent of pregnant women are guaranteed prenatal care in the developed world, in the developing world, the percentage of women who seek it at least once is 63 percent in Africa, 65 percent in Asia and 73 percent in Latin America and the Caribbean.

And when it comes to childbirth the lack of skilled health workers to assist women is stark. “Each year, 60 million women give birth with the help of an untrained, traditional birth attendant or a family member, or with no help at all.”

After delivery, the SMI says, the majority of women in developing countries receive no postpartum care. “In very poor countries and regions, as few as five percent of women receive such care.”

According to the SMI, “most maternal complications and deaths occur either during or shortly after delivery.”

Such mortality rates are also rooted in women’s powerlessness and lack of equal access to employment, finances, education, basic health care and other resources, says the Family Care International (FCI), a New York- based NGO.

“Women must be empowered, and their human rights including rights to good quality services and information during and after pregnancy and childbirth must be guaranteed,” declares FCI.

These rights, in fact, have been recognised by the international community since the International Conference on Human Rights held in Tehran, the Iranian capital, in 1968. On that occasion, a woman’s right to health, including reproductive health, was identified as an essential feature of human rights.

That guarantee was followed by other commitments to strengthen a woman’s right to reproductive health-care services. They include the 1979 Convention on the Elimination of All Forms of Discrimination against Women, the 1993 Vienna Declaration adopted during the World Conference on Human Rights and the 1995 Platform for Action that stemmed out of the Fourth World Conference on Women, held in Beijing.

Yet, remarks Danguilan, governments have still to measure up to such guarantees. “For safe motherhood to take hold in any country, governments must exert that critical but elusive thing called political will, the commitment to invest part of its financial resources in ensuring that women who choose to have babies do not have to die.”

On the other hand, though, she admits that a number of successes have been achieved to reduce maternal mortality in the developing world. In countries ranging from Indonesia, Bangladesh and Peru, programmes managed by UNICEF and local health authorities have enabled women to deliver babies without the fear of dying.

“The Peruvian measures, which have incorporated traditional practices in its health system, have been so successful that the number of deliveries in these facilities have quadrupled,” says Danguilan.

For Sonawane, more needs to be done to enable women to have safe deliveries. And for that, the support of US policymakers is imperative.