31 January 2013

Uganda: No Woman Should Die Giving Life

Africa has many accomplishments in which to take pride and confidence. Progress on many fronts is dramatic with a new sense of optimism found right across the continent.

Economic growth is strong, feeding through into increased incomes and better living standards. Foreign investment is pouring in, encouraged by the energy and talent of Africa's people, rising consumer demand and improved standards of governance. But if the continent is to make the most of its rich potential, there are many challenges still to overcome. And none is bigger than improving Africa's record on maternal health.

Here, too, there have been remarkable success stories. Equatorial Guinea, for example, has already beaten the 75% reduction target in maternal deaths set in the Millennium Development Goals. Eritrea is also on course to meet the target, while Ethiopia and Rwanda are among the countries that have already seen a reduction of over 60%.

But despite these outstanding achievements and successes in many countries, Africa has not kept up with the pace of improvements on other continents. Indeed, a recent study published in The Lancet, an authoritative medical journal, showed that in 2008, eight of the ten countries with the worst maternal mortality records were found in Africa. Countries that have been particularly badly hit by the HIV and Aids epidemic have seen figures rise, rather than fall, in recent years.

The result is that while Africa has only 14% of the world's population, it accounts for well over half of all maternal deaths worldwide - deaths that are overwhelmingly avoidable. For it is not untreatable diseases but the lack of access to family planning, basic care around childbirth, skilled attendance, health checks and advice in pregnancy that are the main reasons for this loss of human life.

The impact of these individual tragedies goes far beyond the family involved. They are a major brake on wider economic and social development. It is a mark of the new determination across Africa to remove obstacles to progress, that we are seeing a major drive to end this unnecessary death toll. The Campaign on Accelerated Reduction of Maternal Mortality in Africa - CARMMA - was launched three years ago by the African Union, with the support of the United Nations Population Fund (UNFPA), which I am privileged to head.

Since Mozambique first launched its national campaign in 2009, another 36 African countries have signed up to the initiative. The aim, through CARMMA, is to galvanize political action and forge new partnerships across societies to identify the reasons for maternal deaths and put in place the policies and resources to tackle them.

The campaign has enjoyed tremendous support at the highest levels. In Zambia, for example, the initiative was launched personally by the president. Many countries have put CARMMA into practice, not just nationally but also at district and state levels. The high number of unattended births - caused in part by the lack of skilled practitioners - helps explain the high levels of maternal mortality.

To help tackle the shortfall, Cameroon is now opening eight midwifery schools. In a country where the last midwife graduated in 1987, a second wave of over 200 students is now completing training. We see similar success stories right across the continent, with strengthened health systems, increased funding and new partnerships between the public, private and voluntary sectors. Sierra Leone has brought in free medical services for pregnant women and their babies.

However, despite some remarkable results, over 450 women and girls continue to die in Africa everyday from complications in pregnancy or childbirth. That is why the CARMMA summit taking place this week in Addis Ababa, Ethiopia, under the auspices of the African Union and UNFPA, is so important. This is a chance for countries to recommit to the campaign, and share ideas and good practices.

The decisions taken in Ethiopia this week will help drive forward Africa's positive transformation. If the continent is to continue the remarkable economic and social progress achieved over the last decade, then reducing child and maternal deaths must be a top priority. It is within our reach that no woman should die giving life. The realization of this commitment is also in our hands.

The author is Executive Director of the United Nations Population Fund (UNFPA).

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