Maternal health remains a thorn by our side

MATERNAL Health

Internationally, the number of maternal deaths has decreased from more than 540,000 deaths in 1990 to less than 290,000 in 2010 with a decline rate of 47 percent. However, Pakistan, along with India and Bagladesh still accounts for 46 percent of the world’s total maternal deaths.
According to World Health Organization’s (WHO), World Health Statistics 2012 report, the world has made significant progress by reducing the number of child deaths from almost 10 million children aged less than five years in 2000 to 7.6 million annual deaths in 2010.
The report said decline in numbers of deaths from diarrhoeal disease and measles have been particularly striking.
The report contains data from 194 countries on a range of mortality, disease and health system indicators including life expectancy, illnesses and deaths from a range of diseases, health services and treatments, financial investment in health, as well as risk factors and behaviours that affect health.
In all parts of the world, women are more likely to be obese than men, and thus at greater risk of diabetes, cardiovascular disease and some cancers.
Half a million women die each year due to pregnancy related complications and 95 percent of them come from developing world. The lifetime risk of a woman dying of pregnancy related causes in developing countries is 1:40 as compared to 1:3600 in developed world. Various studies have shown four major causes of maternal mortality in Pakistan: haemorrhage, hypertensive diseases, sepsis and abortion. Even in this time and age, 89 percent of deliveries are conducted by traditional birth attendants at home, who are unable to manage the complications that may arise.
An estimated 30,000 women die each year due to pregnancy related causes. It is estimated that about 500 maternal deaths occur per 100,000 live births each year in Pakistan. Recent estimates (WHO & UNICEF) place the figures around 270/100,000 live births but in reality it may be higher because of under registration of deaths in country and absence of cause of death information.
Out of the eight Millennium Development Goals, set by the United Nations, MDG No 3, 4 and 5 relate to women and children. Under MDG No 3, the member states are committed to promoting gender equality, empowering women and eliminating gender disparity, while MDG No 5 binds all countries to improve maternal healthcare and reduce, by three quarters, the maternal mortality rate – a target Pakistan is highly unlikely to achieve by 2015.
Inflation has pushed more people below the poverty line (based on $2-a-day criterion). Food inflation has gone up, with the worst affected by the cut in per capita calory intake being mostly women, which has left them vulnerable to diseases due to low body resistance.
Women, being the main victims of rising household poverty in the country, particularly in the face of absence of equitable and institutionalised social safety nets, have had to bear the brunt. Gross neglect of the agriculture sector – the main poverty alleviator and food provider – coupled with large-scale grain exports and hoarding – has created shortages, which the middlemen exploit to maximise their profits.
Eighty-five governments have reaffirmed commitment to addressing maternal mortality as a human rights issue and that the magnitude of the problem calls for the renewal of political will to address it. However, Pakistan was not one of the signatories to this document, because the government refuses to recognize the death of Pakistani mothers, as a result of medical negligence and lack of awareness, a basic human rights issue. This alarming attitude of the government has moved the civil society and various national and international NGOs to urge the Pakistan Government to sign the upcoming resolution on maternal mortality in the coming UN Human Rights Council session scheduled for June 2-18, 2009 in Geneva. More initiatives to prevent maternal mortality would be an obligation of countries which are signatories of this resolution. The condition in Pakistan requires some serious efforts.



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