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Maternal
deaths fall around the world
While
the latest statistics on global maternal mortality are encouraging,
the situation in sub-Saharan Africa
is still cause for serious concern.
Susan
Anyangu-Amu
THE
number of women dying from pregnancy-related causes around the world
is falling. Sub-Saharan Africa remains
one of the most dangerous places for pregnant women, despite recording
a 26% reduction in maternal mortality rates.
The
statistics in the 'Trends in Maternal Mortality' report released by
the World Health Organisation on 15 September cover the period from
1990 to 2008, revealing that maternal mortality fell from 540,000 deaths
worldwide in 1990 to 358,000 in 2008 - a 34% decline.
Several
reasons are cited for the reduction in number of maternal deaths, including
improvement in health systems to assist pregnant women and increased
education of women, raising awareness of the importance of delivering
with skilled help.
Around
the world, more midwives are also being trained. The proportion of deliveries
attended by skilled health personnel rose from 53% in 1990 to 63% in
2008. The proportion of women who attended a pre-natal clinic at least
once also rose from 64% to 80%.
The
use of contraceptives by women aged 15-49 also rose: East Asia, which experienced the greatest reduction in maternal
deaths, has a contraceptive prevalence rate of 86%. Sub-Saharan Africa, where contraceptives are used by just 22% of women,
recorded one of the lowest declines of maternal mortality.
Sub-Saharan
Africa and South Asia still account for 87% of global maternal deaths.
Nearly two-thirds of all maternal deaths take place in just 11 countries
- Afghanistan, Bangladesh, the Democratic Republic of Congo, Ethiopia, India,
Indonesia, Kenya, Nigeria,
Pakistan, Sudan and Tanzania.
South Asia recorded an overall maternal mortality rate of
280 deaths per 100,000 live births. Sub-Saharan Africa
had a rate of 640 per 100,000. Afghanistan,
Chad, Guinea-Bissau
and Somalia
all recorded maternal mortality rates of over 1,000 per 100,000 live
births.
The
rate of progress recorded in the UN figures is less than half of what
is needed to achieve the target under the Millennium Development Goals
(MDGs) for reducing maternal deaths, translating into an average annual
decline of 2.3% since 1990. To meet MDG target five, an annual decline
of 5.5% is required.
Lack
of funding
Reacting
to the release of the numbers by the UN, Kenyan reproductive health
expert Joachim Osur said the decline must be concentrated elsewhere
in the world, because the situation in sub-Saharan Africa
continues to be bad.
Osur
says a lack of funding for the health sector, and particularly reproductive
health, is at the heart of the problem. 'Most governments - almost all
of them in Africa - depend on international donors for funding for
maternal health. In the case of Kenya,
we cannot survive without external help. Budgets do not fund the health
sector fully. If you want good services, especially in reproductive
health, you must pay for this,' he says.
Osur
says community education is lacking in most rural areas and he argues
that in the case of Kenya,
the situation was actually better in the 1990s.
'In
the early 1990s, there was increased awareness on family planning but
this went down in the 2000s. The hype has gone down, supplies in hospitals
are lacking. The reality here is markedly different from the global
reduction in the rate of maternal deaths,' he says.
In
a statement released to the press, the executive director of the United
Nations Children's Fund, Anthony Lake, said that to achieve the goal on
improving maternal health and to save women's lives, government initiatives
must reach those most at risk. 'This means reaching women in rural areas
and poorer households, women from ethnic minorities and indigenous groups
and women living with HIV and in conflict zones,' he says.
The
UN report calls for donors to help governments implement plans to improve
access to reproductive health services. - IPS
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Kenya: The high price of
birth
EXPECTANT
mothers living in internally displaced people's (IDP) camps in
western Kenya
need qualified medical help to minimise the possible risks associated
with delivery, the residents said.
'It
is by God's grace that mothers and children survive,' Paul Thiongo,
chairman of Pipeline IDP camp along the Nakuru-Eldoret highway,
said. 'Safety during birth is a luxury here; even getting three
meals is like a dream. Though it may sound odd for us to be depending
on traditional birth attendants [TBAs] in the 21st century, there
is not much choice.'
Each
week, he said, about five children are born in the camp of 6,500
people. But the TBAs who deliver them lack even the basics, such
as gloves.
Margret
Wanjiku Njuguna, whose nine-month-old baby was born in the camp
after she fled Burnt Forest
near Eldoret during the 2007-08 post-election violence, said she
was helped by a neighbour.
'I
knew it was wiser to seek professional [help], but I could not
raise the KSh400 [$5] taxi fee and Sh2,650 [$33] delivery fee
at Rift Valley General Hospital,'
Wanjiku, 37, a mother of two other children, said.
Her
labour started when she was preparing dinner for her family. When
the contractions intensified, she called an elderly neighbour
who safely helped her to deliver a son.
Like
Wanjiku, 31-year-old Phyllis Wairimu had no money to travel to
hospital to deliver her fourth child. 'We depend on earnings of
KSh100 [$1.25] per day to cater for our family's needs; affording
medical fees is like a dream,' she said.
When
she went into labour at around 4am, Wairimu could not bear her
children watching her giving birth in their one-roomed tent. Hours
later, the pain intensified and, accompanied by a friend, she
decided to walk to Rift Valley
Hospital,
about 10km away.
After
1km, she delivered the baby with the help of a TBA. 'I was lucky,'
she added. 'A month later, my neighbour almost lost her life after
traditional birth attendants badly cut her umbilical cord.' The
IDPs eventually raised the money to take her to hospital.
Linnet
Anindo, a TBA in the camp, said: 'I have trained other women so
that they can offer help to their neighbours while I am not around.
I am aware of the risks that come with giving birth at home...
[but] most of the women in this camp cannot afford to access a
health facility.' - IRIN humanitarian news and analysis service
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*Third World Resurgence No. 240/241, August-September
2010, pp 62-63
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