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HEALTH: Empowering Women to Slash Mother and Child Deaths

Armin Rosen

UNITED NATIONS, Apr 13 2010 (IPS) - In developed countries, child and maternal mortality is a health problem that has largely been solved.

According to the U.N. anti-poverty Millennium Development Goals’ (MDGs) website, only 11 out of every 100,000 mothers die in childbirth in the United States, although this figure is on the rise. In Somalia, the number is 1,400.

Unlike with HIV/AIDS, there is a cure for maternal and child mortality. The question that the Partnership for Maternal, Newborn and Child Health, a coalition of over 300 NGOs and international institutions, is attempting to answer is how governments and the international community can bring child and maternal care to the countries that need it most.

The MDGs specifically deal with mother and child health. Goal Four aims to reduce child mortality by two-thirds between the years 1990 and 2015, while Goal Five is to reduce the maternal mortality ratio (basically, the number of maternal deaths per 1,000 births) by three-fourths during the same period.

Mother and early child health represent one of the pressing public health problems on earth. According to a Lancet study released this week, there were 342,900 maternal deaths worldwide in 2008, while the Partnership states that 3.6 million infants die within their first month, and an additional 5.2 million children die before the age of five.

Counting mothers who die of childbirth-related causes some weeks or months after giving birth, around 11 million mothers and infants die each year.

Bringing these numbers down is a daunting but not impossible task, according to Partnership director Dr. Flavia Bustreo. She says that even some of the poorest countries on earth are capable of making seemingly-small yet effective efforts towards reducing maternal and infant mortality.

An emblematic example for Bustreo is Nepal, which is on target to meet MDGs Four and Five, and which has “had a lot of success” in facing child and maternal health challenges.

“[Nepal] has done so because they have enabled a programme that has empowered women at the community level,” she said, before describing a Nepalese programme that gave basic medical supplies and training to people in remote or impoverished parts of the country.

A Partnership press release lauds several developing countries for their work towards the MDGs, work which Bustreo says proves that the developing world can solve pressing public health problems without a major influx of aid from the developed world.

“We’re not only calling for donations” says Bustreo, “we’re looking at whether governments can increase their commitments to health.”

She pointed out that the Abuja targets from April 2000 call on African governments to increase health spending to 15 percent of their GDP, and that adhering to those targets could go a long way towards meeting MDGs Four and Five.

Sub-Saharan Africa and South Asia account for the vast majority of maternal and infant deaths, and Bustreo talked a bit about what governments in both regions have been doing to tackle the issue.

In India, women in the eastern state of Orissa are given a monetary incentive by the government to deliver their children as safely as possible. Pregnant women can receive about 60 percent of the state’s average monthly wage for delivering their child in a hospital rather than in their village, where doctors or a clean area for giving birth might not be available.

And in Nigeria, Bustreo says that the government will now send doctors or ambulances into villages where local tradition prohibits women from leaving their husband’s houses until after they give birth.

“We’re calling for these countries to become champions of this issue,” says Bustreo in reference to states that are making strides towards combating infant and maternal death. “They have political will and they can share their experience with others.”

This “political will” could determine whether these two MDGs are achieved: Bustreo’s coalition has identified a 20-billion-dollar annual gap in worldwide funding for maternal and child health, which means that these MDGs will depend on a new wave of investment from both donor nations and the countries that have the highest mortality rates.

According to the MDG website, several countries in sub-Saharan Africa still have maternal mortality rates of over 1,000 per every 100,000 births, as of 2005.

Meanwhile, the under-five mortality rate remains alarmingly high in conflict zones like Afghanistan and the Democratic Republic of Congo, where 257 and 205 out of every 1,000 children, respectively, do not make it to the age of five, as of 2006. But it remains high in countries that are at relative peace as well – in Burkina Faso, for instance, more than one in five children do not make it to age five.

Bustreo remains optimistic that the examples of Nepal, India and Nigeria can help other countries fight a health problem that continues to kill on a massive scale, even though medical technology has already solved it.

“These kinds of examples are very important for us because we don’t want to convey the message that only countries form the North can resolve this,” she says, before talking about the “global South’s” efforts at fighting child and maternal mortality. “No, no, no. Countries have done it. They know how to do it.”