Africa has made significant progress in reducing the number of women who die while giving birth. On average, maternal mortality in Africa has reduced by 41 per cent between 1990 and 2010, but the current numbers are still unacceptably high.
In Africa, a woman still faces a one in 39 lifetime risk of dying due to pregnancy-related or child birth complications.
Exchanging views with media professionals in Johannesburg after his recent mission to South Africa, UNFPA Executive Director, Dr. Babatunde Osotimehin said Africa has made substantial progress in addressing the challenge of maternal mortality on the continent.
But we cannot hide under the canopy of culture and not address the fact that an unacceptably high number of women in Africa are still dying during child birth.
"There is no culture in this world that endorses the death of women while giving birth. We need more significant action to overcome this challenge, and going forward, this should be our focus," he said.
CARMMA – an advocacy platform to address maternal death
In recognition of the challenge of high maternal mortality in Africa, the AU in 2006 came up with the Maputo Plan of Action which urged for a more continental action to address the issue of women dying from pregnancy- and childbirth-related causes. This was expected to be done within broader sexual and reproductive health and reproductive right programmes.
In 2010, the 15th Ordinary Session of AU Summit in Kampala agreed on actions to prioritize maternal health and child health as part of Africa's development. The resolution called for appropriate national action to overcoming the barriers that contribute to high maternal death in Africa.
An important initiative to galvanize continental action is the Campaign for Accelerated Reduction of Maternal Mortality in Africa, (CARMMA).
Established in 2009, the campaign uses policy dialogue, advocacy and community mobilization to enlist political commitment and increase resource allocation to maternal health services.
So far, 37 countries have launched the campaign. Many countries, such as Malawi, Chad, Rwanda, Zambia, Sierra Leon and Nigeria, have also committed to various actions including community mobilization. Other countries like Swaziland, Congo Brazzaville, CAR, Botswana and Chad have instituted CARMMA champions to lead the campaign on community mobilization.
Partnership for maternal mortality agenda
Achieving a substantial maternal mortality reduction requires the support of critical influential institutions and networks. For example, the Pan-African Parliament has endorsed the need for more governmental action.
Africa's Women Parliamentarians have also initiated the process of social mobilization to mobilize national and community action. The recently formed Forum of African Parliamentary Forum on Population and Development has agreed to prioritizing and positioning CARMMA as a critical agenda of African parliaments.
The various actions are expected to help keep maternal health as a major development agenda at the national and regional level. In addition, they are to assist with practical actions of dealing with the bottlenecks that affect maternal, newborn and child health in Africa.
Such barriers include inadequate human services and high turnover of health workers, weak health systems, poor health infrastructure and inadequate and sustainable health financing.
But cultural issues such as low male involvement, religious barriers and traditional practices that affect access to adequate services for women also need to be addressed.
Going forward – no woman should die giving life
There is significant agreement among public health programmers that achieving progress in maternal health for the continental is possible.
Obviously, CARMMA is an important vehicle in this respect.
But beyond the launch of the campaign, it is critical for countries to do what is needed to prevent pregnant women from dying while giving life.
Dr. Osotimehin notes that UNFPA is collaborating with AU to ensure that political leaders revisit their commitment and take new actions that will accelerate expected actions on the ground. "During the next AU summit in January 2013, we will be working with AU to advocate for more actions to take CARMMA to the next level and translate the ideas into reality for women in the communities." An important way forward is intensification of action at national and community levels. It is widely believed that the road from policy development to policy implementation is long. While there is substantial political commitment to ensuring the reduction of maternal mortality, this needs to be matched with necessary programmatic actions, such as the elimination of user fees in some countries or the provision of skilled birth attendants in others.
The intersection of political rhetoric in various conference rooms and the reality of implementation through actions on the ground level is of utmost importance in ensuring that African women leave the tunnel of maternal death into a new path of meaningful and empowered lives. And this, of course, is compatible with African culture, values and development agendas.
Adebayo Fayoyin UNFPA, Regional Communication Adviser, Johannesburg.