A Safer World For Mothers

By Dr Rina Mukherji on Tuesday, June 29, 2010 - 16:20

The WHO estimates a shortage of over 3 lakh midwives in countries with high maternal mortality rates. With only five more years left for the deadline for Millennium Development Goals, the focus is on improving maternal health. UNFPA Executive Director Thoraya Ahmed Obaid spoke to Rina Mukherji in Washington on the organisation’s plans in this direction.

Every minute, a woman dies in pregnancy or childbirth. Of all the Millennium Development Goals (MDGs), MDG 5 -- improving maternal health -- has been the most difficult to achieve. UN Secretary General Ban Ki-Moon has noted that MDG 5 “stands as the slowest moving of allthe MDGs”.

Over the past decade, the global maternal death rate has remained stagnant, with a mere 1% annual decline in maternal mortality from 1990 to 2005. The problem is particularly acute in Africa and South Asia. Complications related to pregnancy and childbirth are the leading causes of death of women of childbearing age, with an estimated 35% not having access to trained health personnel. The consequences of losing half a million women annually mean a ripple effect on families, communities and nations.

With just five years to achieve MDG 5 (the deadline being 2015), the United Nations Population Fund for Women (formerly the United Nations Fund for Population Activities, UNFPA) has embarked on a slew of measures to ensure every pregnancy is wanted, and every birth is safe.

Maternal mortality is inextricably linked to lack of trained health personnel, malaria and violence all over the world. What is UNFPA doing to tackle the problem?

The lack of trained health personnel is the failure of existing health care systems. Since 2008, UNFPA has been working towards strengthening national healthcare systems through the Maternal Health Thematic Fund (MHTF) and helping governments overcome obstacles that prevent their own maternal health plans from being successful.

Skilled attendants at births backed by emergency obstetric care can reduce maternal deaths by 75%. Similarly, access to voluntary family planning can reduce maternal deaths by more than one-third, and child deaths by as much as 20%. The World Health Organisation (WHO), however, estimates a shortage of 3,34,000 midwives to fill in the gaps in high-mortality countries by 2015. We have hence joined forces with the International Confederation of Midwives (ICM) to strengthen midwifery services worldwide through education, training, and regulation. This will be a cost-effective investment to ensure better standards of maternal health at the community level everywhere.

Where violence is concerned, it is just not domestic violence, but all forms of violence against women that the UNFPA is out to tackle. This includes rape, violence inflicted on women during conflicts, and fistula. Hence, we have teamed up with UNICEF and have an ongoing collaboration with UNIFEM for the past five years to tackle the issue.

Have you any specific measures aimed at tackling domestic violence? What about the pilot programme you had initiated in India on the issue?

As you rightly said, we are working since 1997 in six states in India, providing medical counseling at hospitals to women who are victims of domestic violence. We plan to expand this highly successful programme to include men in our campaign to end all forms of violence against women .We shall not only work with hospitals, but also with judges, the police and the perpetrators of the violence to tackle the problem.

How do you propose to do that?

We already observe a fortnight devoted to ending violence against women. The Secretary General has now initiated a network of prominent men from all over the world who shall speak up against violence against women. It will make it clear to men that it is say, not very manly to indulge in violence against their wives or female relatives. There will be a network of 30 distinguished men from all over the world, such as Bishop Desmond Tutu and others who shall address men on the issue

What about malaria, and curbing maternal mortality due to the disease?

The WHO’s global fund for Tuberculosis, Malaria and HIV is already in existence since some time. This is a vertical fund meant to tackle these diseases. We have opened up this fund to link these issues together with maternal mortality. We have invited proposals from the various countries to integrate efforts by the various organizations within the UN system and make things more cost-effective.We did not receive enough proposals last year and have hence invited more proposals from the various countries to make it successful this year. WHO has an ongoing programme dealing with the distribution of pesticide- treated nets to prevent malaria. We are now trying to integrate this into our maternal mortality programme.

Rina Mukherji is a senior Kolkata-based journalist with nearly 25 years of experience in the print and online media Her long career in the media has seen her cover a wide variety of subjects ranging from gender issues, business, politics, the environment and the arts . She also hold a doctorate in African Studies, and has several academic articles to her credit.