HEALTH-MALI: Women Clock Up Success With Maternal Mortality MDG

By Almahady Cissé Reprint | | Print |

Almahady Cisse

BAMAKO, Aug 13 2004 (IPS) - The small Malian town of Zegoua – population 22,000 – doesn’t have a great many “claims to fame”. In one respect, however, it has achieved something remarkable.

“Since January 2002, there’s not been one case of neonatal or maternal mortality in Zegoua or any other nearby village,” Yaya Coulibaly, director of the Zegoua Community Health Centre, told a group of local and international journalists recently.

The centre caters for nine villages, which are divided into 16 zones. Zegoua is located almost 500 kilometres south of the Malian capital, Bamako – near the country’s border with the Ivory Coast.

According to Coulibaly, the secret of the area’s success in reducing neonatal and maternal mortality lies in the determination of its women to tackle these problems. They have organized themselves into teams for taking charge of their health care.

“In spite of their meager financial resources, these women pay the fees for postnatal consultations, vaccinations and family planning,” Coulibaly said.

According to the United Nations Children’s Fund (UNICEF), an average of 1,530 women fall pregnant every day in Mali. Of these, 230 experience complications during pregnancy, while 20 die. About 100 of the children they deliver also die. In addition, several women develop serious postnatal conditions such as fistulas and descended uteruses.

Before the women of Zegoua and its surroundings started grouping together to address these problems, the approach that some had to healthcare was a little haphazard.

“We never thought about our health problems,” says Mariam Ouatara, from the village of Katele, adding that scarce funds were sometimes spent on entertainment. “After these big parties, some of us couldn’t even afford to pay the 100 CFA francs (about 18 cents) it costs for a simple vaccination card.”

The women have now formed groups that plant cotton, peanuts and rice. A share of the revenues generated by these crops is used to pay for consultations to check on the health of babies and new mothers, and to discuss family planning issues. The funds also extend to vaccinations, and buying drugs for treating malaria.

In the event that severe problems develop during a pregnancy, the coordinator of each village team must ensure that the woman concerned is transferred to a clinic that is equipped to deal with such emergencies.

According to the World Health Organization (WHO) and UNICEF, nearly 600,000 African women die each year as a result of complications resulting from pregnancy, or those experienced during childbirth.

In recognition of the extent of obstetric problems, Mali’s government joined UNICEF, the UN Population Fund, the WHO and other organisations to hold the “Vision 2010” conference in Bamako in 2001, on neonatal and maternal mortality.

The regional secretary of the Pan-African Organisation of Women, Ichata Sahi Alwata, told IPS that it was important for men to realise they also had a role to play in addressing pregnancy-related problems. “We want to help men get more involved in this struggle,” she said.

“Everyone knows that men are the decision-makers, both within the family and in society. Women have to get men to agree if they’re going to go to the health centre or pay for a prescription,” she added. “For all these reasons, it’s very important for us to involve men in this fight.”

The problem of maternal mortality is also addressed by the UN’s eight Millennium Development Goals (MDGs), a series of targets that were agreed on by global leaders at a millennium summit held in 2000.

One of the MDGs stipulates that maternal mortality should be reduced by three-quarters by 2015 – something that Zegoua has already achieved. (Other goals include reducing the mortality rate of children under five by two-thirds, ensuring universal primary education – and halving the number of people who live on less than a dollar a day.)

According to statistics compiled by the World Bank, women living in sub-Saharan African countries with high national fertility rates, have a one-in-16 chance of dying when they fall pregnant, give birth – or develop postnatal complications.

In European countries that have low fertility, this risk has been massively reduced. Only one-in-2000 women in these nations suffer from the same difficulties that plague their African counterparts. For North America, the figure is one-in-3,500.