Maternal health still a global challenge

Roselyne Sachiti Features Editor
It is just over 500 days remaining before the 2015 Millennium Development Goals deadline. While improvements have been made in the other seven goals, progress towards MDG 5 (improve maternal health) has been lagging furthest behind on the global scale.
Year-in-year-out, solutions on how to reduce maternal deaths have been suggested.

Sadly, these have just remained mere talk shows in some parts of the world and also in Zimbabwe.

Zimbabwe has its own maternal health challenges including user fees, long distances to health facilities and poor infrastructure.

While Government and its partners like UNFPA, Unicef and the Japanese Embassy have funded the construction and resuscitation of mothers waiting shelters at hospitals and clinics in remote areas, provision of free blood coupons, ambulances etc, some women still do not access them.

User fees remain a challenge despite Government’s commitment to reduce the rate of maternal mortality through the setting up of the Campaign on Accelerated Reduction of Maternal Mortality in Africa (Carma) in 2010.

The board that was appointed back then expected to raise $716 million between 2010 and 2013.

Only $1 million raised by the then Goodwill Ambassador former Deputy Prime Minister Thokozani Khupe was made known to the public.

Apart from Carma, other interventions included the support of some rural health centres through the Health Transition Fund (HTF) and the Results Based Financing for Health (RBF).

Despite the interventions, most women still have to pay.

The overall maternal mortality rates for Zimbabwe, according to the National Census Report 2012, was 525 per 100 000 live births.

Harare had the lowest (371) and Matebeleland South had the highest (677).

Child mortality rates were pegged at 24 per 1000 live births. Under five mortality rate was at 84 per 1000 live births.

Mashonaland Central had the highest infant mortality rate of 77 births per 1000 live births while Bulawayo had the lowest of 46 deaths per 1000 live births.

With fewer than 500 days left before the 2015 deadline, governments and stakeholders across the globe are worried.

Between June 30 and July 1 , 2014, chair of The Partnership for Maternal, Newborn & Child Health (PMNCH), Ms Graça Machel, will convene global leaders in Johannesburg, South Africa, to urge governments and partners to accelerate progress to help women, newborns, children and adolescents survive and thrive.

The landmark meeting marks Ms Machel’s first public appearance since her mourning period following the death of her husband Nelson Mandela in December 2013.

The 2014 Partners’ Forum <http://www.pmnchforum2014.com> will analyse progress made, identify success factors and outline the remaining challenges the world must collectively overcome to improve the health, education, equality and empowerment of every woman and child.

The forum will also feature the launch of a number of new reports, including the Every Newborn Action Plan, which was endorsed by the World Health Assembly and provides a concrete roadmap to reducing preventable newborn deaths and stillbirths.

Partners at the forum will also launch the Countdown to 2015 Report for 2014, which assesses progress toward the maternal and child health MDGs, and the Success Factors for Women’s and Children’s Health Report, which spotlights 10 countries that have made considerable progress in achieving the MDGs.

In addition, the forum will feature the Africa-focused launch of State of the World’s Midwifery 2014, which highlights progress and challenges delivering live-saving midwifery services in 41 sub-Saharan countries.

Since 1990, global poverty has been cut in half, and more mothers and children are surviving childbirth than ever before. Countries including Nepal, China, Bangladesh, Ethiopia and Rwanda have made significant progress and have provided a blueprint for the rest of the world. But this progress has been uneven: each year nearly 300,000 mothers still die in childbirth and 6.6 million children do not live to see their fifth birthdays, including nearly 3 million newborns.

High-level speakers include Prime Minister Erna Solberg of Norway, HRH Princess Sarah Zeid of Jordan, World Health Organization Director-General Margaret Chan, Nigerian Minister of Health Professor Onyebuchi Chukwu, Philippe Douste-Blazy, Special Advisor to the United Nations Secretary-General on Innovative Finance for Development, and Christopher Elias, President for Global Development, Bill & Melinda Gates Foundation.

Jill Sheffield, president of Women Deliver, a global advocacy organisation bringing together voices from around the world to call for action against maternal death, has in the past said they are at a critical juncture in global efforts to improve maternal and reproductive health.

“We have seen time and time again that prioritising girls and women is a good investment and a smart one. Now, more than ever, we need the political will and resources required to achieve the goals we have set and deliver on the promises we have made,” she said.

She adds that in recent years, sub-Saharan Africa has made progress toward improving maternal, sexual and reproductive health, however, significant challenges still remain.

Since 1990, maternal mortality has decreased by 26 percent across the region, but 39 percent of pregnancies are still unintended, and only 17 percent of married women of reproductive age use modern contraception.

On average, a woman in sub-Saharan Africa has a one in 31 chances of dying during pregnancy or childbirth, and 570 women die each day from pregnancy-related causes.

About 70 percent of people living in urban areas use contraceptives while only half of the population living in rural areas uses the same method to prevent pregnancy, a study has revealed.

The Zimbabwe Demographic Health Survey 2005-2006 showed that only 55 percent of the rural population in Manicaland Province recorded a 52,4 percent contraceptive use while Mashonaland Central Province had 61,4 percent and Mashonaland East Province recorded 64 percent. In Mashonaland West Province 62 percent of the population used contraception, Matabeleland North Province had 45,7 percent, Matabeleland South Province 47,2 percent, Midlands Province 63,4 percent, Masvingo Province 54,1 percent, Harare Province 71,9 percent and Bulawayo Province 67 percent.

Rural people have recorded lower contraceptive use due to the failure by health service providers to promote discussions on family planning methods.

Inaccessibility and unavailability of family planning services in remote areas of the country were also mentioned in the study as contributing to the low uptake of contraceptives by rural people.