Tuesday, June 16, 2009

Africa Steps Up the Fight Against Maternal and Child Deaths

by Pilirani Semu-Banda

The very survival of women and children in Africa may depend on the newly-launched Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA). According to latest estimates by the African Union (AU), over the next ten years there will be 2.5 million maternal deaths, another 2.5 million child deaths and 49 million maternal disabilities in Africa alone if urgent actions are not taken.

Around the world, a woman dies every minute from pregnancy-related causes. Globally, there are more than 500,000 maternal deaths per year, the majority of which are in Africa where in many places the maternal mortality rate (MMR) is as high as 1,000 deaths per 100,000 live births. And these death threats are only increasing: one in every 16 African women faces the lifetime risk of dying from pregnancy and delivery-related complications, particularly those from marginalized communities and those living in poverty.

On May 7th, I attended the AU's launch of CARMMA in Addis Ababa, Ethiopia. Its theme, Africa cares: no woman should die while giving life, reflects a campaign designed to accelerate the availability and use of universally accessible quality health services, including those related to reproductive and sexual health.
The AU Commissioner for Social Affairs, Bience Gawanas, describes the maternal mortality rate in Africa as “unacceptably high.” She says CARMMA aims to enhance political leadership and commitment at national levels to reducing maternal and child deaths. By identifying and working with national champions, the campaign will leverage local resources to mobilize action.

Gawanas says the campaign will help raise and maintain awareness and appropriate response at global, continental, regional and national levels to ensure that the best practices of countries which have significantly reduced maternal mortality rates are replicated elsewhere through exchanges and visits by health professionals.

“It is my hope, through this campaign, that we will ensure that our renewed efforts save the lives of women who should not die while giving life,” she says. “We should ensure accountability; every single loss of a mother’s life should be reported. In this regard, it is essential to establish and institutionalize maternal, infant and child mortality audits.”

Gawanas says that if every maternal and child is reported, experts will be able follow up on the specific causes and work on prevention.

For Agnes Mapapa, 67, from southern Malawi, the campaign is welcome news – her first-born daughter died while giving birth in 2007 because the nearest health center is some 35 kilometers away. “She bled to death soon after giving birth. There was no skilled attendant to help her and we could not get to the health center as it is too far away from our village,” says Mapapa. Her newborn granddaughter died just seven days later.

“I also lost a niece in child-birth last year,” she continues. “I have three other daughters of child-bearing age who are already married and I fear that they might face death or disability if they [get] pregnant. We need help and this new campaign might bring salvation to my community.” Mapapa hopes that with the campaign, a clinic will be built within her area so that pregnant women can easily access maternity services.

Malawi’s MRR is 807 deaths per 100,000 live births, making it one of Africa’s highest. It is second only to war-torn Sierra Leone. The good news is that Malawi is among the first batch of countries that will conduct government-led national launches and get technical support from the AU and UN agencies in the next three months. Other countries leading in the launch effort include Mozambique, Rwanda and South Africa.

Malawi already has initiatives promoted by the United Nations Population Fund (UNFPA) and the country’s Ministry of Health where traditional leaders and their communities are empowered to create their own community-based campaigns to improve maternal and child health. UNFPA reproductive health officer, Juliana Lunguzi says CARMMA will strengthen these programs.

“Traditional chiefs, who command a lot of respect in Malawi’s villages, are used as champions for promoting the maternal and child health initiatives. The chiefs facilitate the formation of local village committees on safe motherhood and family planning. The committees encourage pregnant women to seek antenatal care, monitor the health and growth of new-born babies and are also in charge hygiene and sanitation in the villages,” says Lunguzi.

Reports from UNFPA Malawi indicate that these initiatives are working. As just one example, Pitala Village in the country’s central district of Mchinji has seen no maternal deaths in the past two years. Before the initiative, it was not strange to hear that a pregnant woman or a newborn child had died.

Speaking on behalf of African government at CARMMA’s launch, Prime Minister of Ethiopia Meles Zenawi says it is regrettable that women and children continued to die from preventable causes. He emphasizes the need for a universal and adequate health service system for all African countries saying it will not be possible for the continent to achieve the Millennium Development Goals without addressing the issue of maternal and child mortality.

“We should come up with solutions that work in the resource constrained environment we live in,” he says. “Most of the health problems in Africa can be tied to preventable diseases so emphasis should be given to preventive measures, which are relatively cheap.”

Meanwhile the United Nations (UN) - through the UNFPA, World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) - has thrown its weight behind CARMMA, vowing to support it fully.

UNFPA Africa Regional Director Bunmi Makinwa told journalists at the launch that the UN is convinced that the battle against maternal mortality could be won if there is effective coordination among all players.

He says the high incidence of maternal death in Africa must change. “Is this something that should continue happening? No,” he says. “It’s really sad that one of the worst things that could happen to a woman in Africa is being pregnant.”