United Nations Millennium Development Goal #5: Improve Maternal Health by 2015
Reduce by three quarters the maternal mortality ratio
Achieve universal access to reproductive health
- Estimates for 2005 show that, every minute, a woman dies of complications related to pregnancy and childbirth. This adds up to more than 500,000 women annually and 10 million over a generation. Almost all of these women – 99 per cent – live and die in developing countries.
- Maternal mortality shows the greatest disparity among countries: in sub-Saharan Africa, a woman’s risk of dying from treatable or preventable complications of pregnancy and childbirth over the course of her lifetime is 1 in 22, compared to 1 in 7,300 in developed regions. The risk of a woman dying from pregnancy-related causes during her lifetime is about 1 in 7 in Niger compared to 1 in 17,400 in Sweden.
- Every year, more than 1 million children are left motherless and vulnerable because of maternal death. Children who have lost their mothers are up to 10 times more likely to die prematurely than those who have not.
WHAT HAS WORKED
1. In countries such as Jamaica, Malaysia, Sri Lanka, Thailand and Tunisia, significant declines in maternal mortality have occurred as more women have gained access to family planning and skilled birth attendance with backup emergency obstetric care. Many of these countries have halved their maternal deaths in the space of a decade. Severe shortages of trained health personnel and lack of access to reproductive health are holding back progress in many countries.
2. Finding trained health workers to deliver emergency obstetric care is often a challenge in the developing world’s rural areas. UNFPA, in partnership with the Tigray regional health bureau (Ethiopia) and Médecins du Monde, an international NGO, has piloted an innovative project to train mid-level health officers so that they can provide life-saving emergency surgery at rural hospitals, where doctors are scarce. A positive evaluation of the project has opened the way for national scale-up to train health officers in integrated obstetric and emergency surgery. By doing so, access to critical life-saving obstetric services will be substantially improved to rural women.
3. In response to the 2005 Pakistan earthquake, UNFPA-supported mobile service units came to the rescue, and women received more comprehensive care than before the emergency. Health workers in these mobile clinics had seen 843,467 patients as of March 2008 for antenatal care consultations, deliveries, post-miscarriage complications and referrals for Caesarean section. Results show that 43 per cent of pregnant women in the affected area benefited from skilled birth attendance during the post-earthquake period as compared to the 31 per cent national average in Pakistan.
4. Galvanizing support for maternal health is the goal of the UNFPA-led Campaign to End Fistula, which in 2006 worked in 40 countries in sub-Saharan Africa, South Asia and the Arab States. The aim is to prevent and treat a terrible childbirth injury called fistula – a rupture in the birth canal that occurs during prolonged, obstructed labour and leaves women incontinent, isolated and ashamed. Nine out of 10 fistulas can be successfully repaired. More than 25 countries have moved from assessment and planning to implementation. Eleven governments, as well as private-sector supporters such as Johnson & Johnson and Virgin Unite, have donated to the campaign.
WHAT NEEDS TO BE DONE?
- Provide sufficient financing to strengthen health systems, particularly for maternal, childcare and other reproductive health services, and ensure that procurement and distribution of contraception, drugs and equipment are functioning.
- Establish dedicated national programmes to reduce maternal mortality and ensure universal access to reproductive health care, including family planning services.
- Provide trained health workers during and after pregnancy and childbirth for delivery of quality antenatal care, timely emergency obstetric services and contraception.
- Ensure access to timely emergency obstetric services and provide adequate communication, skilled personnel, facilities and transportation systems, especially in areas where poverty, conflict, great distances and overloaded health systems obstruct such efforts.
- Adopt and implement policies that protect poor families from the catastrophic consequences of unaffordable maternity care, including through access to health insurance or free services.
- Protect pregnant women from domestic violence; and involve men in maternal health and wider reproductive health.
- Increase access to contraception and sexual and reproductive health counseling for both men, women and adolescents.
- Increase efforts to prevent child marriage and ensure that young women postpone their first pregnancy.
Source: Committing to action: Achieving the MDGs, Background note by the Secretary-General for the High-level Event on the Millennium Development Goals, United Nations, New York, 25 September 2008; The Millennium Development Goals Report 2008, United Nations; UNFPA Webpage No Woman Should Die Giving Life: Facts and Figures, http://www.unfpa.org/safemotherhood