26 February 2008
Maputo — Mozambican President Armando Guebuza on Monday declared that many maternal and child deaths could be avoided, if women had greater power to take decisions over the measures needed to protect their own health and that of their children.
Guebuza was speaking in Maputo at a national meeting on forming a partnership for maternal and child health, the culmination of a series of meetings on the subject - with health workers, with women's representatives, with religious leaders - that began last week.
Guebuza stressed that, on average, 11 Mozambican women die every day because of complications arising from pregnancy or childbirth. "The tragedy is that the great majority of these women do not die from disease, but in the normal process of reproduction", he said. "Death takes them by surprise as they are undertaking the most noble of missions, which is giving life to another human being".
Every day Mozambican children died too, he added, from malnutrition, from malaria, from AIDS, and from diarrhoeal or respiratory illnesses. Many of these deaths could be avoided.
He stressed the need to empower women, to ensure that more women attend ante-natal consultations, and give birth in health units rather than at home, and that children under the age of five attend regular consultations regardless of whether they are sick or not.
Appropriate care should be on hand, Guebuza added, to deal with obstetric emergencies, and save the lives of the women concerned.
The Mozambican government is committed to meeting the Millennium Development Goals, approved by virtually every country on the planet at the United Nations Millennium Summit in 2000. They include the targets of reducing the under-five mortality rate by two thirds and the maternal mortality rate by three quarters, between 1990 and 2015.
Rising to this challenge could not be a task left solely in the hands of health professionals, said Guebuza. "To improve the health of Mozambican women and children, we have to act, in a coordinated and synchronized manner, simultaneously at the levels of the family, the community and the government".
Thus civil society bodies and community leaders had a responsibility to work with the health service in building houses near health units, where mothers-to-be could wait for the moment of birth, and in mobilizing pregnant women to come to hospitals and health centres to give birth. Husbands and other relatives also had a key role in ensuring that births took place in institutions, where medical help is at hand, and not at home.
But Guebuza recognised that peripheral health units battle with severe problems, including shortage of money, materials, electricity and even water. Long distances to be traveled over poor roads also discourage rural women from giving birth in health units.
"The shortage of these resources should challenge us all to persist in the struggle against poverty and particularly for the education and training of women, as a strategy for their complete emancipation", declared the President.
The government, he stressed, "remains committed to Safe Motherhood, and to an ever speedier reduction in the number of avoidable deaths among our women and children".
The Presidential Initiative on Mother and Child Health will be followed up by a three day seminar on back-street abortions, starting on Tuesday, in the town of Namaacha on the border with Swaziland.
A sizeable proportion of maternal deaths result from complications arising from clandestine abortions, including severe bleeding, sepsis, puncturing of the uterus and peritonitis. Even when such conditions do not kill the woman, they can lead to chronic pelvic pain and infertility.
According to the World Health Organisation (WHO), unsafe abortion is the cause of 13 per cent of maternal deaths in Africa. The obvious solution is to provide abortion under clean and safe conditions in health units, but this runs into the wall of religious bigotry.
Abortion remains illegal under all circumstances under the Mozambican Penal code, inherited from Portuguese colonial-fascism. However, many years ago, the Health Ministry took the pragmatic decision to ignore this clause in the Penal Code and doctors have been quietly practicing abortion in some of the country's main hospitals. But this has never been formalized: as a result, most women do not know that they can apply for hospital abortions, and backstreet abortions continue to flourish.
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