NEW PUBLICATION: MATERNAL HEALTH
UP TO ONE MILLION MOTHERS DYING NEEDLESSLY EACH YEAR IN DEVELOPING COUNTRIES
Up to one million pregnant women a year worldwide die from largely avoidable causes, according to a report released on Mothers’ Day by the House of Commons International Development Committee. A lack of political will to improve maternal health in developing countries has contributed to a stark contrast in the experiences of childbirth around the world: for every woman who dies in childbirth in the UK, up to 1,000 die in the poorest countries. One in seven women in Niger, for example, can expect to die in childbirth, compared to one in 8,200 in the UK. The report highlights that there has been little progress in reducing maternal deaths over the last 20 years.
There is considerable uncertainty about the real scale of maternal mortality, particularly in sub-Saharan Africa and Asia. This is due to a lack of data from countries with some of the worst death tolls, a tendency to under-report maternal deaths and the use of national averages. Rt Hon Malcolm Bruce MP, Chairman of the Committee, said:
“Whilst the number of maternal deaths for 2005 is cited as 536,000, the figure could be as high as 872,000. We fear that the higher figure could indeed be nearer the truth. It has also been estimated that for each woman who dies, 30 further women will become disabled, injured or ill owing to pregnancy, so it is reasonable to assume that millions of women suffer in some way due to childbirth. DFID should support countries to strengthen data collection and birth and death registration so that progress can be measured accurately and successful policies implemented.”
Only two in five women in sub-Saharan Africa deliver their babies with the assistance of a skilled attendant-an official indicator for measuring progress on maternal health -and this is largely unchanged since the early 1990s.
The Report credits the UK’s Department for International Development (DFID) for its leadership on global efforts to improve maternal health. However, the situation remains grave and on current trends Millennium Development Goal (MDG) 5, which seeks to reduce by three-quarters the level of maternal mortality, is seeing the slowest progress of all the MDGs and will not be met by the 2015 deadline.
The Committee recommends that addressing the huge shortage of midwives worldwide and increasing the availability of emergency obstetric care to all women must remain at the centre of DFID’s approach. Increasing access to basic drugs and equipment -including family planning supplies - is also vital, as is tackling gender inequalities that prevent women gaining access to health care, a basic human right.
In its report, the Committee applauds DFID for its work on sensitive issues such as unsafe abortion, the third biggest cause of maternal death. It is estimated that meeting the existing demand for family planning services would in itself reduce maternal death and disability by at least 20%. Malcolm Bruce said,
“Those who deny women access to contraception and safe abortion services, whether through negligence or active policy, are effectively condemning millions of women a year to death or disability. We believe that DFID should challenge governments and other donors to address restricted access to contraception and safe abortion services.”
Poverty is a key factor driving high maternal death rates. User fees for maternal health care almost always hit poor women the hardest and there is a strong case for their removal in favour of universal free care. Malcolm Bruce said:
“DFID should continue to support the abolition of charges for health care and should help governments to identify and address the major barriers to care, especially for the poorest women. This is particularly necessary in conflict settings where demand for maternal care is higher and access more difficult.”
The Committee’s report highlights that DFID needs to step back and prioritise carefully in order to take full advantage of a series of crucial opportunities offered in 2008, including Japan’s forthcoming Presidency of the G8 which aims to focus on global health. This is all the more important given that, due to civil service efficiency targets, DFID has restrictions on the number of health advisers it can employ. This is despite a rising aid budget for maternal health. According to the Report, DFID must play to its strengths and support other actors, especially the UN, in playing their part in improving maternal health. New global initiatives such as the International Health Partnership, launched by Gordon Brown in September 2007, potentially provide an excellent framework for ensuring this.
Committee Membership is as follows: Malcolm Bruce MP (Chairman, Lib Dem), John Battle MP (Lab), Hugh Bayley MP (Lab), John Bercow MP (Con), Richard Burden MP (Lab), Stephen Crabb MP (Con), James Duddridge MP (Con), Ann McKechin MP (Lab), Jim Sheridan MP (Lab), Mr Marsha Singh MP (Lab), Sir Robert Smith MP (Lib Dem).
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