JOHANNESBURG, 15 January 2009 - Good morning and a warm welcome to all of you. Our thanks to the Government of South Africa for hosting us today and to Minister of Health, Barbara Hogan for being here. I am also pleased to be joined by my colleague Dr. Jama Gulaid.
Today we launch UNICEF’s annual flagship report: “The State of the World’s Children 2009”, which this year focuses on maternal and newborn health.
The report shows that more must be done to address maternal and newborn health to help save and improve the lives of millions of children and their families.
Every year, more than 500,000 women die as a result of pregnancy or childbirth complications.
Around 70,000 of these deaths are among girls and young women 15 to 19. This is not only a tragic personal loss for the family it also leaves a long-term impact on the health and wellbeing of children and the development of communities and countries.
Around 99 per cent of maternal deaths take place in the developing world where having a child remains among the most serious health risks for women. Twenty one per cent of maternal deaths take place in just three countries: the DRC, Ethiopia and Nigeria.
In Niger, for example, the country with the highest lifetime risk of maternal mortality, 1 in 7 women will die from complications related to pregnancy or giving birth. The comparable risk in the developed world is 1 in 8,000.
Since 1990 the base year for the Millennium Development Goals, complications related to pregnancy and childbirth have taken the lives of an estimated 10 million women. That is equal to around 20 per cent of the total population of South Africa.
In addition, every year, some 4 million newborns die within the first 28 days of life from largely preventable causes. That is about 40 per cent of all under-five deaths every year. The burden is disproportionately heavy in Africa and Asia. Ninety five per cent of maternal deaths occur in Africa and Asia combined and 90 per cent of newborn deaths occur in Africa and Asia.
In southern Africa a high number of maternal and newborn deaths are related to HIV/AIDS. The health of the child is inextricably linked to the health of the mother.
The report shows that most maternal and neonatal deaths can be prevented through proven interventions, including:
- adequate nutrition;
- improved hygiene practices;
- antenatal care;
- skilled health workers assisting at births;
- emergency obstetric and newborn care;
- and post natal visits for both mothers and newborns.
These interventions should be delivered through a continuum of care linking households to health systems. Research indicates that around 80 per cent of maternal deaths could be prevented if women had access to essential maternity and basic health care services.
The good news is that between 1995 and 2005 skilled birth attendant coverage increased from 54 per cent to 62 per cent in the developing world. During the same period ante-natal care rose from 60 percent to 75 per cent. Yet around 50 million births in the developing world or about 40 per cent of all births remain without skilled health personnel.
For example in Ethiopia only 6 per cent of births are attended by skilled healthcare workers. Harmful cultural practices such as early marriage must also be addressed.
Girls who marry early are at higher risk of HIV/AIDS, abuse and having children at an age where their bodies are not ready for childbirth. Girls who give birth before age 15 are 5 times more likely to die in childbirth than women in their 20s. A child born to a girl under the age of 18, has a 60 per cent greater chance of dying in the first year of life.
And girls must go to school. Women who are educated are more likely to be healthy and to give birth to healthy babies who will survive and grow into adulthood. Educating girls and young women is one of the most powerful ways of breaking a vicious cycle of poverty and creating a supportive environment for maternal and newborn health.
At the household level, awareness needs to be increased about the importance of recognizing danger signs and ensuring that care for the woman or infant is sought right away.
Changes must also be made at the community level to address issues such as infrastructure and financial resources to ensure access to health care.
And finally, health workers must be available, trained, and have the appropriate equipment.
Progress has been made in reducing child mortality but much more must be done especially in addressing maternal and newborn health. The world must approach this task with a shared sense of urgency and a collaborative response. Results will be measured in lives saved and lives improved. Thank you.