Lack of Obstetric Care in Poor Countries Amounts to Neglect
|
|
|
Cuban teacher shows how to use a condom. Young people need access to reproductive health information and services. |
Of the half a million women who die each year from complications of pregnancy and childbirth, 99 percent, are in the world’s developing countries, according to a new report by the United Nations Population Fund, UNFPA, which says the shortage of appropriate reproductive health care services in poor countries amounts to deadly neglect.
Each year 38 million women in Africa, Asia and Latin America receive no care whatsoever during pregnancy, and over 52 million women deliver their babies without a nurse, midwife or doctor present, according to The State of World Population 2000 report. This is in stark contrast to rich countries such as the United States, where nearly 100 per cent of births are professionally attended and maternal mortality is a thing of the past.
The lack of obstetric care causes injuries and illness in millions of women and also affects their infants, contributing to an estimated 8 million stillbirths and newborn deaths each year, the report says.
While care during pregnancy is important, the report says the primary means of preventing maternal deaths is to provide access to emergency obstetric care. Such care, including treatment of haemorrhage, infection, hypertension and obstructed labour, is often severely limited in poorer countries, especially in rural areas. "A community-based system for ensuring rapid transport to a medical facility is crucial to save mothers’ lives," states the report.
One country that has made considerable progress is Honduras, where maternal deaths dropped dramatically between 1990 and 1997, according to a study prepared for the World Bank. After declaring the reduction of maternal mortality a public health priority, the government increased emergency obstetric care in urban, rural and district facilities, and established birthing centres in remote areas. Midwives were also trained and integrated into the health system, resulting in greater community acceptance and more emergency referrals to hospitals. As a result, the maternal mortality rate dropped by half.
Communities in different parts of the world are increasingly organizing to prevent mothers from dying in childbirth. For example, in Juaben, Ghana, midwives were trained in life-saving skills and a blood bank and operating room were established at a community health centre for emergencies. After services were improved, the number of women coming in for care almost tripled.
According to the report, effective post-abortion care would reduce maternal mortality rates by as much as one fifth in many low-income countries. Each year, women undergo an estimated 50 million abortions, 20 million of which are unsafe, resulting in 78,000 deaths and millions of injuries. At least one fourth of all unsafe abortions are to girls between ages 15 and 19, the report says.
A number of countries, particularly in Africa and Latin America, are providing post-abortion care to reduce the health impact of unsafe abortion and training midwives in emergency treatment.
Noting that "about a third of all pregnancies–80 million a year–are believed to be unwanted or mistimed," the report says better reproductive health services are urgently needed, not only to reduce unwanted pregnancies, abortions and sexually transmitted diseases, but also to enable men and women to lead healthy, productive lives of their own making. Another crucial, and seemingly simple, recommendation is increased communication and cooperation between partners. "Couples and families who discuss family planning are more likely to use the services," the report states.
Increasingly, reproductive health programmes are addressing critical issues such as sexuality, gender roles and power imbalances between women and men. This is in response to the growing recognition that inequality and rigid gender stereotypes are harmful to health, especially in the era of AIDS.
In 1994, at the International Conference on Population and Development, governments agreed that everyone should have access to reproductive health services by the year 2015. They also agreed that women’s empowerment and gender equality were crucial to reproductive health and family planning efforts. But of the estimated $5.7 billion in international assistance needed for reproductive health and population programmes in the year 2000, only about $2.1 billion per year is currently being provided.
(END)
Word count: 676
return to top
|
