From Riet Groenen, Gender Advisor, Pacific Sub-Regional Office, UNFPA
Every year, more than half a million women and girls die from the complications of pregnancy or childbirth. More than 80 per cent of maternal deaths worldwide are due to five causes: haemorrhage, sepsis, unsafe abortion, obstructed labour and hypertensive disease during pregnancy. While these are the direct causes of maternal death, unavailable, inaccessible, unacceptable, or poor quality health care is fundamentally responsible. Research has shown that about four out of five maternal deaths could be averted if women had access to essential maternity and basic health-care services. Of all health indicators, maternal mortality ratios show one of the greatest gaps between rich and poor countries. The lifetime risk of a woman dying as a result of pregnancy or childbirth in Niger is about 1 in 7, compared to 1 in 48,000 in Ireland. In Millennium Development Goal 5, the international community committed to reducing the maternal mortality ratio by three quarters between 1990 and 2015. Yet figures released in a recent UN report show only limited progress in making motherhood safer, especially in the poorest countries.
With trained health-care staff, properly equipped primary health-care and emergency facilities, and adequate medicines and supplies, most maternal mortality and morbidity could be prevented. But deeper, underlying causes keep the goal of safe motherhood out of reach for many developing countries. Most of these causes stem from the subordinate position of women. Many are unable to negotiate contraceptive use with their husbands or partners; nor do they demand the right to share in decision-making that affects their lives. This lack of power may be magnified in the face of domestic violence. Furthermore, the meager budgets allotted for sexual and reproductive health care are rarely challenged. Poverty, gender discrimination, social exclusion and political insecurity all serve to deepen and solidify the direct and underlying causes of maternal mortality and morbidity. They are further exacerbated by a lack of global commitment to respond to women’s needs and to improve their status.
Ultimately, reducing the toll of maternal mortality and morbidity on women, girls and their families requires a human rights-based approach, with gender equality and cultural sensitivity at its core. An enabling environment for women’s and children’s rights is free from violence. This requires not just protection from abuse, exploitation, discrimination and violence, but also implies a decent standard of living, quality education, equal participation in the home, community and political life, and greater involvement of men in the care of women and children. Women who are empowered, in both their productive and reproductive roles, tend to have a positive impact on their families, including their children. This empowerment can have a ripple effect across generations. In the context of maternal mortality, empowered women are more likely to claim their right to quality health care and education, and to understand the warning signs during pregnancy. In early 2008 the UNFPA launched the Maternal Health Thematic Fund (MHTF). This effort — UNFPA’s contribution to boost maternal and newborn health — aims to provide support to countries with a high maternal mortality burden to scale up proven interventions needed to save mothers and infants.
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