A mother’s health is crucial to a child’s survival, growth and development. A woman’s health and nutritional status also determines whether she survives pregnancy and childbirth. But most of our region is far from achieving the fifth MDG target of cutting maternal mortality ratios by three-quarters between 1990 and 2015; in fact, progress has stagnated. Linked closely to neonatal deaths, maternal deaths are unacceptably high in the region, and in some countries the rates are alarming.
- Maternal deaths mirror our region’s health disparities. In China, the maternal mortality rate is estimated at 45 deaths per 100,000 live births whereas Lao PDR’s rate is 660. National aggregates also hide vast disparities within borders: China’s maternal mortality ranges from a low of 10 to a high of 401 in Tibet.
- Women are dying because they lack access to even basic emergency obstetric care. Many women in our region give birth without the assistance of a skilled attendant. A skilled professional can assist with unexpected labour complications and help women access a higher level of obstetric care if and when needed. Antenatal care not only ensures healthy pregnancies but also identifies high-risk pregnancies. However, too many women do not make the recommended four antenatal visits, which amounts to missed opportunities to ensure their and their baby’s survival.
- Undernutrition heightens the risk of dying during pregnancy. Staggering numbers of women in our region suffer anaemia, up to 66 per cent in Cambodia and Timor-Leste, for example, which puts them at risk of heart failure, shock and infection during pregnancy. Underweight and short-statured mothers are more prone to obstructed labour. Malnourished mothers produce smaller babies who might subsequently suffer both developmentally and physically, perpetuating a vicious cycle of poor nutrition and ill health.
- Gender discrimination is large part of the problem. In addition to the medical challenges (access to a skilled attendant, basic drugs, proper equipment and referral facilities) and systemic challenges (a health facility is not available, too far away, not accessible or not affordable), there are societal challenges linked to gender – abuse, inequality and lack of empowerment – that inhibit women’s access to health care. In many parts of our region, women and girls do not have power over their lives because they lack equal status and access to education, employment, nutrition, safety and health care.
UNICEF in Action
UNICEF pursues the following strategies to reduce maternal deaths in our region:
- Improving access to and use of existing emergency obstetric care services.
- Improving access to preventive and primary health care that includes early diagnosis and treatment of diseases such as malaria, TB, HIV and AIDS, urinary tract infections, worm infestations, supplementation for prevention of anaemia and measures to improve women’s nutrition.
- Addressing strategies to improve reproductive health care and education, including encouraging women to wait two to three years between children and to have fewer children overall.
- Strategies to prevent adolescent pregnancies, which affect the health and survival of both the adolescent girl and her baby.
- Targeting young women (and men) with health and nutrition programmes to better educate and prepare them for pregnancy and parenthood and break the inter-generational effects of malnutrition.
- Working to improve the rights and status of women and girls so they are empowered to make decisions for themselves.