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Africa has the highest maternal mortality rate
in the world |
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Experts on
reproductive health have painted a grim picture
of maternal and child health on the continent
and warned that the situation could worsen in
the next decade if governments and development
partners do not take immediate remedial actions |
An exodus of medical personnel to overseas
destinations has hit many African countries in
recent years. "Only 42% of births in the African
region are attended by skilled personnel," said
an expert attending the regional conference in
Zimbabwe in MONTH YEAR on improving maternal and
newborn health. Unsafe abortions are also high
among adolescents, according to him.
At the conference experts from various
international organisations are examining the
extent of the problem on the continent and will
suggest ways of reducing the death rates of
mothers and infants. The conference indicated
that health budgets in African countries are not
adequate to deal with childbirth and maternal
health. "The percentage of GDP [gross domestic
product] devoted to health in sub-Saharan Africa
remains at between 1% and 3,7% compared to the
large percentage spent on arms," a statement
said. "If nothing is done to arrest the trend of
high and growing maternal and child deaths, it
is estimated that there will be 2.5 million
maternal deaths, 2.5 million child deaths and 49
million maternal disabilities in the region over
the next 10 years.” Prof Joseph Kasonde, one of
the delegates noted. He stated that more than
half of the 600 000 women who die each year from
pregnancy related causes worldwide are in the
African region, which accounts for only 12% of
the world's population and 17% of annual births.
The maternal mortality rate in Africa remains
the highest in the world and has actually
increased from 870 deaths per 100 000 live
births in 1990 to 1 000 per 100 000 live births
in 2001. In addition, according to a WHO
sponsored study made available at the
conference, neonatal morbidity and mortality
rates are currently estimated at 45 deaths per 1
000 live births and contribute about 50% of the
infant mortality rate in the region. The
findings of the study, presented by Dr Office
Chidede, a neonatal consultant at the University
of Zimbabwe, also show that stillbirths and
deaths within the first seven days of life in
the region were estimated at 76 per 1 000 live
births. The study had to take into account that
70% of deliveries take place in the community
where maternal and newborn births are usually
not recorded. It covered eight countries and was
conducted between February 2001 and August 2002.
Its goal was to provide a basis for developing
or recommending evidence based strategic
interventions, and establishing sustainable
institutions and implementation mechanisms for
identified remedial measures.
The study documents some of the causes of death
recorded by health care providers and at health
facilities. These include: birth asphyxia
(suffocation during birth), 40%; premature birth
and low birth weight, 25%; infections, 20%;
congenital defects, 10%, and acute surgical
conditions, 3%. Other findings point to a lack
of basic supplies and equipment, staff shortages
and low morale, bad roads and long distances
between referral points, continued use of
traditional birth attendants (who are still
popular and highly regarded) and mothers’
preference for delivery in health facilities,
although these are still largely perceived as
not user-friendly. "Pregnancy in adolescence
presents a unique and frightening picture,"
Chidede highlighted, adding that 13% of all
maternal deaths occurred in adolescents, who
account for 14 million births annually
worldwide.
Prof. Kasonde said that in spite of the sombre
picture, two major initiatives launched in the
past two decades had helped to stem the tide of
maternal and child deaths in Africa. One of
these, the Safe Motherhood Initiative launched
in 1987, drew attention to the multifaceted
nature of the problem. It identified five
critical areas needing investments:
human rights
empowerment of women
education
socio-economic development and
the improvement of health systems.
The other, the Making Pregnancy Safer Initiative
launched in 2000, focused on the health sector
and its crucial role in accelerating reductions
in maternal mortality. The aim of the initiative
was to ensure that women and their newborns have
access to the care they need through
strengthening health systems and appropriate
community-level actions. He stated that in spite
of the harsh economic environment in Africa,
governments can secure improvements in the
outcome of pregnancies by implementing
appropriate policies irrespective of the
economic status of their countries. According to
him, it is now time for African governments to
focus on the availability of, and accessibility
to, emergency obstetric care because emergencies
constituted a major risk for maternal mortality
in Africa.
Other essential interventions were the
reorganization of health systems, the
strengthening of midwifery skills, and
increasing the number of skilled birth
attendants. Kasonde concluded his presentation
with a four-pronged call for action to:
place maternal and newborn health high on the
agenda of governments and partners
review policies, guidelines and programmes
allocate and release resources and
harness resources from communities and
partners.
In her presentation Zimbabwean Secretary for
Health and Child Welfare, NAME NAME, called for
greater involvement by men in caring for their
spouses during pregnancy, basic education,
improved health systems and the use of skilled
birth attendants, which are key to reducing
maternal and newborn mortality in Africa. The
Millennium Development Goals call for a 75%
reduction in maternal mortality in the African
Region within the next decade. She noted that
other factors crucial to attaining the goal
included greater empowerment of women,
allocation of adequate human and financial
resources to the health sector, and greater
availability of user-friendly information to
improve individual, family and community
knowledge of danger signs during pregnancy and
labour. NAME emphasised that maternal deaths due
to pregnancy-related complications were
preventable.
In another presentation the UNFPA Maternal
Health Adviser, NAME NAME, outlined some of the
reasons why African countries have failed to
reduce maternal mortality. These include:
lack of national commitment, financial
support, coordination and partnership
increasing poverty and the low status of women
the adverse effects of HIV/AIDS, tuberculosis
and malaria, and
the use of inappropriate strategies to stem
the growing tide of maternal mortality.
He stated that UNFPA's vision and strategy for
maternal mortality reduction was based on three
pillars:
family planning
skilled attendance at all births and
the availability and accessibility of,
emergency obstetric care. |
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Prematurity and low birth weight causes 25% of
infant deaths. Worldbank. |
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