Motherhood still not safe for many women
Oct 16, 2007
This week the world celebrates 20 years of the Safe Motherhood Initiative at the Women Deliver conference in London from October 18-20. Launched in Nairobi in 1987, the Safe Motherhood Initiative aimed at reducing the number of women who die in pregnancy and childbirth.
By Catherine Mwesigwa Kizza
This week the world celebrates 20 years of the Safe Motherhood Initiative at the Women Deliver conference in London from October 18-20. Launched in Nairobi in 1987, the Safe Motherhood Initiative aimed at reducing the number of women who die in pregnancy and childbirth.
Every year about 600,000 women in the world die due to pregnancy and childbirth related complications. Some 99% of these deaths occur in the developing countries of Africa and Asia. In Uganda, the maternal mortality ratio (the number of women who die during pregnancy, childbirth and six weeks after ending pregnancy) stands at 435 deaths per 100,000 live births per year, according to the 2006 Uganda Demographic Health Survey (UDHS). This translates into about 6,000 women dying every year due to preventable pregnancy and childbirth-related complications, that is, about one taxi full of pregnant mothers crashing and killing all on board every day.
Nasser Takuba, the Chairman of Kawempe Division, early this month was reported in the press to have said that about 200 mothers die every year in Kawempe division in Kampala. If this is happening in Kampala, it is not difficult to imagine what could be happening in Pader, Amuria, Rukungiri or Kibaale, hundreds of miles away from the capital.
Women die due to bleeding, infection, abortion, pregnancy-related blood pressure, obstructed labour and other causes like HIV/AIDs, malaria, anaemia, and poor nutrition, which aggravate poor health during motherhood. Most of the complications are preventable where women have functional health systems and support at home and in their communities to be healthy and get healthy babies.
But in many of our communities, a woman is no woman if she goes to hospital to deliver a baby, yet out of every 100 pregnancies, 15 will result into a complication which needs to be managed by a trained health worker with midwifery skills.
Even if a woman attended all the antenatal care visits, it may still not be possible to rule out some of the complications that a woman who is seemingly healthy may face during delivery and after.
That is why it is crucial that all childbearing women have access to functional health care 24 hours a day, seven days a week, all year round. It is almost useless for a woman to be near a health centre that closes at night, that has one midwife attending to 14 mothers at the same time without gloves, cotton wool, water or light; where simple drugs to manage bleeding and high blood pressure and prevent infecting babies with HIV are restocked once in three months. Many of these health centres still have no connection to at least an ambulance to transfer mothers with complications to main hospitals for attention. In some instances, there are no roads to the main hospitals. At times it is easier to transfer a bleeding woman from an upcountry town to Kampala than to the nearest regional hospital. Even at hospital level only 14% of hospitals in Uganda have the equipment and personnel to manage pregnancy and childbirth complications. Some 86% have an unmet need for signal functions, according to a 2005 Ministry of Health needs assessment survey.
It is no wonder that the few women with the means fly out of the country to have their babies or fork out millions for private health care. About 700,000 women (58%) who get pregnant in Uganda every year deliver at home. For 23% of the women, a traditional birth attendant’s hut where they can pay in installments, in form of chicken, bunches of matooke or goats is all they can afford. There is even a category that cannot afford this. The 2006 UDHS found that 10% of women deliver alone. In environments that are not hygienic, many bleed or get infections and die an untimely death. They leave behind grieving husbands and young children who might never live beyond the fifth birthday.
Yet access to safe motherhood for women can be achieved through ordinary down-to-earth interventions. Women need to space their births to be healthy and reduce the risk of complications but in Uganda, only 24% of married women use contraception. Girls need to delay childbirth but in Uganda, 50% of girls have had a baby by the age of 19. Women need to be in secure relationships with their partners participating in their reproductive health but 70% of women have experienced physical or sexual violence and 16% have experienced violence during pregnancy. Women need care from healthworkers with midwifery skills during labour, delivery and in the post natal period within the first six weeks after childbirth. In Uganda, only 42% get skilled attendance and 74% who had a live birth in the five years preceding the 2006 UDHS received no post-natal care at all yet 60% of women who die after childbirth die during this period.
The Women Deliver conference in London is therefore a very important event for especially countries with poor reproductive health indicators like Uganda. As the world reviews progress on Safe Motherhood in the past 20 years, the women of Uganda wait to see if our leaders at the community, national and global levels, will put the resources and commitment where the need is. The conference theme, “invest in women, it pays,†could not be more relevant.
Uganda has made strides in girl education, is moving towards women empowerment, in putting up health centre buildings but a lot needs to be done to make skilled care by midwives or doctors during pregnancy and childbirth accessible to all childbearing women and their newborns.
Health centres and hospitals should be able to offer all the services necessary to manage complications – an unmet need of 86% for these services at these levels is unacceptably low.
It is seven years to 2015, and progress on the Millennium Development Goal Number 5 is still slow. There are seven more years of hope to make motherhood and childhood safe for the women and the children of this nation. That achieved we can count on them to deliver for this country.
The writer is a journalist
This week the world celebrates 20 years of the Safe Motherhood Initiative at the Women Deliver conference in London from October 18-20. Launched in Nairobi in 1987, the Safe Motherhood Initiative aimed at reducing the number of women who die in pregnancy and childbirth.
Every year about 600,000 women in the world die due to pregnancy and childbirth related complications. Some 99% of these deaths occur in the developing countries of Africa and Asia. In Uganda, the maternal mortality ratio (the number of women who die during pregnancy, childbirth and six weeks after ending pregnancy) stands at 435 deaths per 100,000 live births per year, according to the 2006 Uganda Demographic Health Survey (UDHS). This translates into about 6,000 women dying every year due to preventable pregnancy and childbirth-related complications, that is, about one taxi full of pregnant mothers crashing and killing all on board every day.
Nasser Takuba, the Chairman of Kawempe Division, early this month was reported in the press to have said that about 200 mothers die every year in Kawempe division in Kampala. If this is happening in Kampala, it is not difficult to imagine what could be happening in Pader, Amuria, Rukungiri or Kibaale, hundreds of miles away from the capital.
Women die due to bleeding, infection, abortion, pregnancy-related blood pressure, obstructed labour and other causes like HIV/AIDs, malaria, anaemia, and poor nutrition, which aggravate poor health during motherhood. Most of the complications are preventable where women have functional health systems and support at home and in their communities to be healthy and get healthy babies.
But in many of our communities, a woman is no woman if she goes to hospital to deliver a baby, yet out of every 100 pregnancies, 15 will result into a complication which needs to be managed by a trained health worker with midwifery skills.
Even if a woman attended all the antenatal care visits, it may still not be possible to rule out some of the complications that a woman who is seemingly healthy may face during delivery and after.
That is why it is crucial that all childbearing women have access to functional health care 24 hours a day, seven days a week, all year round. It is almost useless for a woman to be near a health centre that closes at night, that has one midwife attending to 14 mothers at the same time without gloves, cotton wool, water or light; where simple drugs to manage bleeding and high blood pressure and prevent infecting babies with HIV are restocked once in three months. Many of these health centres still have no connection to at least an ambulance to transfer mothers with complications to main hospitals for attention. In some instances, there are no roads to the main hospitals. At times it is easier to transfer a bleeding woman from an upcountry town to Kampala than to the nearest regional hospital. Even at hospital level only 14% of hospitals in Uganda have the equipment and personnel to manage pregnancy and childbirth complications. Some 86% have an unmet need for signal functions, according to a 2005 Ministry of Health needs assessment survey.
It is no wonder that the few women with the means fly out of the country to have their babies or fork out millions for private health care. About 700,000 women (58%) who get pregnant in Uganda every year deliver at home. For 23% of the women, a traditional birth attendant’s hut where they can pay in installments, in form of chicken, bunches of matooke or goats is all they can afford. There is even a category that cannot afford this. The 2006 UDHS found that 10% of women deliver alone. In environments that are not hygienic, many bleed or get infections and die an untimely death. They leave behind grieving husbands and young children who might never live beyond the fifth birthday.
Yet access to safe motherhood for women can be achieved through ordinary down-to-earth interventions. Women need to space their births to be healthy and reduce the risk of complications but in Uganda, only 24% of married women use contraception. Girls need to delay childbirth but in Uganda, 50% of girls have had a baby by the age of 19. Women need to be in secure relationships with their partners participating in their reproductive health but 70% of women have experienced physical or sexual violence and 16% have experienced violence during pregnancy. Women need care from healthworkers with midwifery skills during labour, delivery and in the post natal period within the first six weeks after childbirth. In Uganda, only 42% get skilled attendance and 74% who had a live birth in the five years preceding the 2006 UDHS received no post-natal care at all yet 60% of women who die after childbirth die during this period.
The Women Deliver conference in London is therefore a very important event for especially countries with poor reproductive health indicators like Uganda. As the world reviews progress on Safe Motherhood in the past 20 years, the women of Uganda wait to see if our leaders at the community, national and global levels, will put the resources and commitment where the need is. The conference theme, “invest in women, it pays,†could not be more relevant.
Uganda has made strides in girl education, is moving towards women empowerment, in putting up health centre buildings but a lot needs to be done to make skilled care by midwives or doctors during pregnancy and childbirth accessible to all childbearing women and their newborns.
Health centres and hospitals should be able to offer all the services necessary to manage complications – an unmet need of 86% for these services at these levels is unacceptably low.
It is seven years to 2015, and progress on the Millennium Development Goal Number 5 is still slow. There are seven more years of hope to make motherhood and childhood safe for the women and the children of this nation. That achieved we can count on them to deliver for this country.
The writer is a journalist