The collective failure by governments worldwide to tackle maternal health problems has meant that the United Nations’ fifth millennium development goal, to reduce by three quarters maternal mortality by 2015, has seen the least progress of all the goals, a report from the UK parliament’s international development committee says.
Its report on the UK government’s effort to deal with the issues, published this week, claims that political will in the United Kingdom and worldwide has been insufficient “to drive actions to improve the health of women, both at the international and national levels.”
It acknowledges that the Department for International Development has done some important work. The department has been a leading donor to worldwide programmes on maternal health and “deserves credit for its creation of international partnerships, its willingness to address sensitive issues such as abortion, its support for research and its consistent focus on strengthening health systems,” the report says. “But “major challenges remain.”
Liberal Democrat MP Malcolm Bruce, the committee’s chairman, said at the report’s launch, “Whilst the number of maternal deaths for 2005 is cited as 536 000, it 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.”
Only two in five women in sub-Saharan Africa who give birth have the help of a skilled attendant, a situation that is “largely unchanged” since the early1990s, Mr Bruce said. “Addressing the huge shortage of midwives worldwide and increasing the availability of emergency obstetric care to all women has been and must remain at the centre of DFID’s [the Department for International Development’s] approach. Increasing access to basic drugs and equipment—including family planning supplies—is also vital.”
He said that it is also “crucial to address the gender inequalities that prevent women fulfilling their right to health,” as well as gender based violence and unsafe abortions, the third largest cause of all maternal deaths.
“Those who deny women access to contraception and safe abortion, whether through negligence or active policy, are effectively condemning millions of women a year to death or disability,” Mr Bruce said.
The report says that improvements to health information systems in developing countries need the continuing support of the department so that policies and programmes can be evidence based and progress can be tracked reliably.
“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 create uncertainty about the real scale of maternal mortality, particularly in sub-Saharan Africa and Asia,” it says.
The committee concludes that “inequalities in access to maternal care are driven primarily by poverty.” It says that the UK should continue to support the abolition of charges for health care and help governments to identify and remove the major barriers to care, “especially for the poorest women and in conflict settings where demand for maternal care is higher and access more difficult.”
Jeffrey Mecaskey, head of health at Save the Children, said, “This report is a clarion call for governments to redouble their efforts to get progress on the millennium development goals back on track.
“The global burden of maternal mortality is largely borne by poor women in poor countries. It is outrageous that a woman in Niger is a thousand times more likely to die in childbirth than a woman in the UK. This massive injustice is an outcome of political and policy choices by governments and is something that must be tackled by urgent and decisive action.”
Maternal Health is available from www.parliament.uk/indcom.