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ASIA: Region Lags Behind in Reducing Maternal Mortality Rates

Marwaan Macan-Markar

BANGKOK, Sep 16 2009 (IPS) - In landlocked Laos, pregnancy brings with it the spectre of death. South-east Asia’s poorest country has recorded over 700 women dying every year due to complications during childbirth.

“We have one of the highest maternal mortality rates in South-east Asia,” admits Bounthavy Sisouphanthong, the country’s vice minister for planning and investment. “Most of the women who die are those who give birth at home. They are from rural communities, villages.

“Limited access to hospitals and clinics is part of the problem. Most of these rural communities are scattered in remote areas,” Bounthavy revealed during an interview in the Thai capital. “There is also a lack of information. We need more advocacy programmes.”

Change, however, is in the air in the country that has 11,000 villages spread over a vast terrain of mountains, plateaus and flat stretches. The Laotian government is working on a new national plan to be presented to the parliament that aims to drum up such messages as ‘women should go to hospitals to give birth’. The plan aims to improve the number of “skilled birth attendants” and to improve health facilities for safer childbirth.

Laos, though, is not an exception in the struggle to slash the number of maternal mortality rates, which currently hover at 400 deaths for every 100,000 live births in a country of nearly six million people. In 1995, it recorded 650 women dying due to childbirth. The government’s target, according to Bounthavy, “is to reduce the maternal mortality rate to 266 by 2015.”

Other Asian countries that have similar disturbing maternal mortality rates are Nepal, India, Pakistan, East Timor and Cambodia. The death toll of mothers from these countries and others in Asia and the Pacific has meant this region accounts for close to half the number of the estimated 500,000 maternal deaths recorded annually across the world.


It is a figure that reveals the region’s inability to improve the conditions for pregnant women during childbirth, experts said at the start of a regional meeting in Bangkok to assess progress to meet key population and development targets set during a groundbreaking United Nations (U.N.) conference in Cairo in 1994.

“Maternal health and child mortality are areas where progress has been extremely slow and where urgent action is required,” said Noeleen Heyzer, head of the Economic and Social Commission for Asia and the Pacific, a regional U.N. body based in Bangkok. “With more than 300 maternal deaths per 100,000 live births, the region accounts for half the global total.”

“The largest number of these deaths occurs in South Asia,” she added during the opening session of the Asia-Pacific High-level Forum on ICPD (International Conference on Population and Development) at 15. “These tragic and premature deaths are all the more unacceptable as they are largely preventable through the provision of quality reproductive health services and antenatal care.”

The ICPD Programme of Action, which was adopted by 179 governments during the Cairo gathering, was hailed for the spotlight it shed on a range of population issues. They included reproductive rights, birth control, family planning, women’s education, protection for women from unsafe abortions and infant mortality.

As regards maternal mortality, the governments pledged to reduce by half the 1990 levels of maternal deaths by 2000, and then slash by half the 2000 figure of maternal mortality by 2015.

These targets became part of another development pledge made by government leaders at the U.N. Millennium Summit in New York in 2000 – the Millennium Development Goals (MDGs). These eight goals set time-bound targets to be met by 2015. They include the first MDG: a pledge to eradicate extreme poverty and hunger by halving the number of people living on less than one U.S. dollar a day in 1990 by 2015.

The fifth MDG addressed the ICPD’s goals: to reduce by three-fourths the number of maternal mortality cases in 1990 by 2015.

Yet the Asia-Pacific region is far from meeting this goal. “MDG Five – maternal mortality – would not be met in most countries in the region,” Tomas Osias, executive director of the Commission on Population in the Philippines, told the Bangkok gathering. “This failure would impact other MDG targets, like MDG One.”

The Bangkok conference, which runs from Sep. 16-17, has drawn over 100 representatives from 30 governments, civil society organisations and international agencies. Failure to reduce the maternal mortality numbers has been flagged as a key area for discussion.

“Most of the maternal deaths occur in the poor rural areas. This is so even in countries that have shown progress – there are rural pockets where maternal mortality is high,” says Dr. Saramma Thomas Mathai, the maternal health advisor at the United Nations Population Fund’s Asia-Pacific office in Bangkok. “Mothers die due to bleeding during pregnancy and because of convulsions during pregnancy.”

The lack of skilled birth attendants and the lack of family planning are among the reasons for death during pregnancy, she said, adding that culture also plays a part. “Women’s needs are always considered the last,” she explained in an interview “Delays are also a factor, such as delays in getting care, delays in being transported to hospitals and delays in being treated at the hospital.”

The region’s slow progress in reducing maternal mortality also reveals the state of its healthcare systems, added Thomas Mathai. “Maternal mortality is an indicator of the functioning of a health system in a country.”

 
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