A woman dies from complications
in childbirth every minute about 529,000 each year
the vast majority of them in developing countries.
A woman in sub-Saharan Africa has a 1 in 16
chance of dying in pregnancy or childbirth, compared to a
1 in 4,000 risk in a developing country the largest
difference between poor and rich countries of any health indicator.
This glaring disparity is reflected in a number
of global declarations and resolutions. In September 2001,
147 heads of states collectively endorsed Millennium Development
Goals 4 and 5: To reduce child mortality rate by 2/3 and maternal
mortality ratio by 3/4 between 1990 and 2015. Strongly linked
to these is Goal 6: To halt or begin to reverse the spread
of HIV/AIDS, malaria and other diseases.
The direct causes of maternal deaths are haemorrhage,
infection, obstructed labour, hypertensive disorders in pregnancy,
and complications of unsafe abortion. There are birth-related
disabilities that affect many more women and go untreated
like injuries to pelvic muscles, organs or the spinal cord.
At least 20% of the burden of disease in children below the
age of 5 is related to poor maternal health and nutrition,
as well as quality of care at delivery and during the newborn
period. And yearly 8 million babies die before or during delivery
or in the first week of life. Further, many children are tragically
left motherless each year. These children are 10 times more
likely to die within two years of their mothers' death.
Another risk to expectant women is malaria.
It can lead to anaemia, which increases the risk for maternal
and infant mortality and developmental problems for babies.
Nutritional deficiencies contribute to low birth weight and
birth defects as well.
HIV infection is an increasing threat. Mother-to-child
transmission of HIV in low-resource settings, especially in
those countries where infection in adults is continuing to
grow or has stabilised at very high levels, continues to be
a major problem, with up to 45 per cent of HIV-infected mothers
transmitting infection to their children. Further, HIV is
becoming a major cause of maternal mortality in highly affected
countries in Southern Africa.
A majority of these deaths and disabilities
are preventable, being mainly due to insufficient care during
pregnancy and delivery. About 15 per cent of pregnancies and
childbirths need emergency obstetric care because of complications
that are difficult to predict.
Access to skilled care during pregnancy, childbirth
and the first month after delivery is key to saving these
women's lives and those of their children.
Source: The United Nations Children's Fund (UNICEF)
Sub-Saharan Africa has experienced an impressive
5 percent annual economic growth since the late 1990s, outpacing
the world average. But other aspects of the region's development
are lagging. The region is behind on many of the Millennium
Development Goals (MDGs), a set of goals agreed upon by world
leaders at a UN summit in 2000 to reduce poverty, improve health,
and foster economic development. Sub-Saharan Africa is especially
deficient in areas of reproductive health crucial for meeting
MDGs for child and maternal health. Improving access to family
planning, reducing maternal deaths, and preventing HIV infections
are important for achieving better reproductive health.
planning has steadily decreased as an international priority
in recent years, despite its documented impact on both maternal
and child health and overall development. In addition to reducing
fertility (births per woman), family planning use has a direct,
positive impact on reducing maternal deaths and preventing
mother-to-child transmission of HIV. However, to achieve these
health benefits, women and couples must have access to a wide
range of contraceptive methods at all stages of their reproductive
lives to allow them to have the number of children they want,
when they want them.
In sub-Saharan Africa, 23 percent of married
women are using family planning18 percent with a modern
method and 5 percent with a traditional method. However, an
even larger percentage of women25 percentreport
having an "unmet need," meaning that they would
prefer to stop having children or delay their next birth,
but are not using any method of family planning. Meeting this
unmet need is an important step toward improving reproductive
health in sub-Saharan Africa. But other factors affecting
women's health also need to be addressed, including the availability
of skilled care during childbirth and extreme povert.
Reference Bureau (PRB)