Africa: Helping Mothers to Deliver Healthy Children Safely

Members of Tupange - an organization that promotes family planning and reproductive health - recruit people to a health clinic in Nairobi, Kenya.
11 November 2013
guest column

Holding the hand of Kumi as she went into labor at 3 am is a moment I'll never forget. Kumi lives in small hut in rural Ethiopia, hours away from the nearest health facility - and just hours away from my hometown of Addis Ababa.

As a mother myself, it is disturbing to know that there are still millions of mothers like Kumi who do not have access to the basic essentials for delivering a child, including light, clean equipment, and trained medical staff.

Fortunately, despite her challenging circumstances, Kumi had a safe delivery and a healthy newborn child. She named her daughter Adame - which means lucky day.

The reality is, however, that complications during pregnancy and childbirth are still among the leading causes of death among young women in the developing world.

Millions still lack access to the health care essential for safe motherhood, including family planning. As a global community, we must continue to challenge ourselves to ensure that women, no matter where they live, have every opportunity for healthy pregnancies and to have their children delivered safely.

In addition to ensuring women receive quality care from a skilled birth attendant during delivery, we should also be providing women with access to family planning so they can space and limit their pregnancies, so ultimately reducing the risks to their health.

In fact, the evidence shows that if couples keep pregnancies more than two years apart, more than 30 percent of maternal deaths and 10 percent of child deaths can be averted.

Closely-spaced pregnancies hold the greatest risk to the health of mothers and their newborns.

Yet many women lack knowledge or have misconceptions about their chances of becoming pregnant again soon after giving birth.

Postpartum women experience amenorrhea, or the absence of menses, for varying lengths of time and can return to fertility before menses resumes, even when breastfeeding.

The International Conference on Family Planning taking place this week in Addis Ababa provides an important opportunity to spotlight new perspectives and approaches for improving access to postpartum family planning to ensure healthy birth spacing.

Postpartum family planning - which responds to the desire of the overwhelming majority of women who want to delay pregnancy for at least two years after childbirth - is key to the well-being of mothers and their families. Yet we are missing many obvious opportunities for educating postpartum women about their family planning options.

In developing countries, women like Kumi are rarely informed of how they can delay or limit the number of births. In rural areas, the critical window following the birth of a child, when women are most likely to be in closest touch with health providers, may be the only opportunity to educate them about family planning options and related health concerns.

Fortunately, a core group of top global health organizations, including the World Health Organization, the U.S. Agency for International Development and its flagship Maternal and Child Health Integrated Program, led by Jhpiego, the non-profit group associated with Johns Hopkins University, and its partners, are tackling the issue.

They work closely with governments and health providers in developing countries to extend postpartum family planning coverage throughout the health system to the most remote places where women like Kumi live.

We have made great strides in reducing maternal and child deaths since the Millennium Development Goals were launched in 2000. But more must be done to equip women in every village across the globe with the tools and services they need for safe motherhood.

Liya Kebede is an Ethiopian-born model, clothing designer and actress who has founded the Liya Kebede Foundation to press for the reduction of maternal and newborn mortality.

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