UNICEF Calls for Continued Efforts to Reduce Maternal Mortality
KINGSTON, 15 January 2009 – The United Nations Children’s Fund (UNICEF) today said that the Jamaican government must continue stepping up its effort to lower the country’s rate of maternal mortality, as the agency released the findings of a global report on maternal and newborn health.
The 2009 edition of UNICEF’s flagship publication, The State of the World’s Children, reveals that women in the world’s least developed countries are 300 times more likely to die in childbirth or from pregnancy-related complications than women in developed countries.
Ninety-one per cent of pregnant women in Jamaica receive quality antenatal care at least once during pregnancy, and about 97 per cent of births are delivered by skilled personnel. Yet, according to national reports, the country’s current maternal mortality rate of 95 deaths per 100,000 live births has not changed significantly over the last two decades.
“Pregnancy and childbirth are one of the most exciting and magical times of a woman’s life,” said UNICEF Jamaica Deputy Representative Nada Marasović, commenting on the report. “New mothers and their children should never face the tragic prospect that they may not survive during or after this extraordinary period.”
Three-quarters of all maternal deaths are caused by complications during delivery and the immediate post-partum period. According to the Ministry of Health and Environment, the leading cause of maternal deaths in Jamaica is hypertension. Other major causes are embolism, hemorrhage and the increasing number of unsafe abortions.
These direct causes account for half of all maternal deaths in Jamaica, while indirect causes, including cardiac diseases, the increasing prevalence of HIV/AIDS and the impact of violence, account for the other half. According to the Ministry of Health and Environment, the number of maternal deaths resulting from direct causes has fallen in recent years. However, the number of deaths from indirect causes is on the rise, particularly those caused by cardiac diseases.
Maternal mortality is largely preventable and the most effective interventions are known. These include providing essential obstetric care and skilled attendance at birth, and increasing access to quality maternal health care and family planning services.
The Ministry of Health and Environment, in collaboration with UNICEF, the United Nations Population Fund (UNFPA) and the Pan-American Health Organization (PAHO), has made a concerted effort in recent years to meet the goal of reducing Jamaica’s maternal mortality rate to 25 deaths per 100,000 by 2015. This target is in keeping with the Millennium Development Goal #5 to reduce maternal mortality by 75 per cent between 1990 and 2015.
Significant achievements include the implementation of weekly high-risk antenatal clinics, expansion and equipping of some maternity wards, and the provision of in-service education for doctors and nurses on safe motherhood and reproductive health.
The challenges to reduce maternal mortality remain daunting. They include a shortage of trained midwives, the need for more local standards and protocols for the management of obstetric emergencies, unwanted pregnancies and other reasons causing unsafe abortions, and inadequate public education.
The Strategic Plan for Safe Motherhood 2007-2011 is the latest effort being implemented across the island by the Ministry of Health and Environment, with support from UNICEF, UNFPA and PAHO. It is a four-pronged plan to create an enabling policy environment, enhance the quality of care for pregnant women and their children, improve the surveillance of maternal deaths (timely reporting and investigating), and increase public education about the issues of safe motherhood.
To lower maternal mortality across the world, The State of the World’s Children recommends essential services be provided through health systems that integrate a continuum of home, community, outreach and facility-based care.
According to the report, the ten countries with the highest lifetime risk of maternal death are Niger, Afghanistan, Sierra Leone, Chad, Angola, Liberia, Somalia, the Democratic Republic of Congo, Guinea-Bissau, and Mali.