Wednesday, October 6, 2010

Zero tolerance for maternal deaths - Our target

Three individuals, identified only as Jimmy, Priscilla and Elizabeth, recounted how they lost their babies under conditions they described as 'avoidable', in different health-care facilities in Accra.

With tears in her eyes, Priscilla narrated before a sizeable crowd at a national forum on maternal health, how she narrowly escaped death as a result of bleeding after delivery. At the end of it all, she lost her baby.

Jimmy, who sounded emotional and occasionally, had to stop talking to prevent himself from breaking down in tears, recounted how his wife, a first-time mother, nearly lost her life through childbirth and ended up losing the baby at a big government hospital in Accra.

For her part, Elizabeth told the painful story she had narrated many times, about the baby she lost at a private health facility she considered as a first-class one. To her, it was the case of lack of adequate professional and proper care.

In the three narrations and many others which were presented at the forum, one thing that ran through was that at the time the women needed professional assistance, it was not received or when it was, it came too late, or was not available.

The forum being referred to here had the theme, "Stand Up and Take Action Against Maternal Deaths in Ghana", and was organised by the Alliance for Reproductive Health Rights (ARHR) in Accra, in collaboration with the Health Platform. That was part of activities marking this year's "Stand Up and Take Action Against Poverty" commemorated by the United Nations Development Programme (UNDP).

The purpose of the national forum, according to the organisers, was to inspire action among all stakeholders in order to improve maternal health in the country.

The event is very important, now that Ghana has officially indicated that it was not possible for the country to reduce its current child mortality of 451 per every 100,000 live birth births as contained in the 2008 Ghana MDGs report which was launched recently. The MDGs report was produced by the National Development Planning Commission (NDPC) and the United Nations Development Programme (UNDP).

At the launch of the Ghana MDGs report, it came out that while the country is said to be on track to achieving the MDGs I and II which relate to the reduction in poverty and hunger by 2015, it was not likely to achieve goals IV and V, which involved reduction in child and maternal mortality.

Part of the report stated "Maternal mortality rate at 451 deaths at 100,000 live births is high and Ghana is unlikely to attain the target of reducing by three quarters, the maternal mortality ratio between 1990 and 2015, even though maternal health care has improved over the past 20 years".

The national forum also came off at the time that world leaders were meeting in New York to assess progress made towards the attainment of the Millennium Development Goals (MDGs) by 2015. In addition, the organisers of the national forum launched the second edition of the Civil Society Organisation's (CSOs) Health Millennium Development Goals (MDGs) monitoring report produced by the Alliance for Reproductive Health Rights.

The content of the report, which was described by participants as excellent, is divided into eight main parts, namely, child health, care-seeking behaviour, sanitation, immunisation and maternal prophylaxis, use of treated bed nets, maternal health, HIV AIDS and tuberculosis and malaria. The report also addresses the identified goals, targets and indicators of the official MDG list, as well as priorities indicated in the Ghana Health Service's current Programme of Work (PoW).

The report, which was reviewed by the Director of the Local Government Institute, Dr Esther Ofei Aboagye, was officially launched by Dr Rose Mensah-Kutin of ABANTU for Development. It focused on the performance and progress Ghana had made in achieving the health goals of the MDGs from the perspective of beneficiaries in those selected districts in the country.

Giving a review of the document, Dr Ofei-Aboagye named the selected districts as Agona East, Bongo, Builsa, Komenda-Edina-Eguafo-Abrem (KEEA) and Kwahu North.

She said the current report also expanded on the previous effort which involved three districts Bongo, KEEA and Kwahu-North.

Dr Ofei-Aboagye said the low knowledge of the danger signs in pregnancy as shown in the report was a problem for which efforts to find a solution must be stepped up.

However, she said the report indicated that the fact that more women were participating in antenatal care was rewarding, while the fact that women recognised the importance of formal facilities in the event of obstetric emergencies was also encouraging.

She also indicated that nonmedical factors such as transport challenges to facility-based health care institutions in rural areas, attitude of care givers, differential interpretation of the policy on free maternal care and what the National Health Insurance Scheme paid for and what it did were still barriers to maternal health and, therefore, should not be ignored in discussions aimed at improving maternal health.

Dr Mensah-Kutin, who chaired the programme, said it was unacceptable for a woman to be pregnant for nine months only to lose the baby or her life and called for concerted efforts to address the situation, adding that "zero tolerance for maternal deaths should be our target".

Mrs Elizabeth Vaah, who set up the Vaah Foundation for Maternal Health after she lost her new-born baby in a hospital in Accra early this year, called on policy makers to stop paying lip-services to maternal mortality and embark on urgent measures to address the issues.

For her part, the Executive Director of ARHR, Ms Vicky Okine, said the apparent sluggish progress in achieving the health-related goals required a new strategy and renewed commitment from both the government and civil society.

In her welcoming address headed: "Five years to move to 2015 - are we on track to achieve health related MDGs?", Ms Okine said the apparent sluggish progress in achieving the health-related goals required a new strategy and renewed commitment from both the government and civil society.

She, however, acknowledged some initiatives undertaken by the government to reduce the high maternal mortality rate and mentioned the introduction of free maternal care in 2008 and pointed out that it helped nearly half a million more women to receive healthcare which they would not have otherwise received.

"These gains, notwithstanding, hundreds of people in Ghana and, indeed, developing countries do not get any healthcare at all, because there are no accessible health centres where they live or they are too costly to reach", she stated.



Source: Daily Graphic

Monday, September 27, 2010

FG spends N3bn to curb maternal mortality

By Mustapha Salihu, Kano
Monday, 27 Sep 2010
The Federal Government has committed an initial appropriation of about N3bn for the Midwives Service Scheme which has been solely financed by it, but with technical support from the international development partners.
National Primary Health Care Development Agency zonal coordinator North West, Dr. Abdullahi Garba revealed this in an interview with pressmen at the end of a training workshop for 42 medical doctors in Kano under the scheme.
Garba who represented the Executive Secretary of NPHCDA, Dr. Muhammad Pate disclosed that the scheme funded by the FG through the Office of the Millennium Development Goals has delivered tremendous impact to justify the huge investment.
He revealed that over 800 midwives have been recruited so far under the MSS and deployed to 653 primary health centres across the 36 states and the Federal Capital Territory, Abuja.
The zonal coordinator pointed out that all the 163 General Hospitals nationwide were provided with ICT facilities to link the Primary Health Centres stating that the primary objective of the scheme was to bring the services to the doorstep of the needy.
According to Garba, the public health sector has been greatly improved since the introduction of the MSS.He affirmed that the success of the scheme has drastically reduced the pressure on General and Specialist Hospitals, which are meant to be strictly research centres to handle complicated cases.
He said, “Before this scheme, the story was very bad. The maternal mortality index was high, and we lost a lot of mothers during childbirth. This ugly situation has changed since the introduction of the scheme.
“The Federal Government is very committed to this scheme. It believes the generation must continue and that if we allow this maternal mortality to increase, it will spell doom for the progress of the country. So, the FG is so committed to reversing the ugly trend”, he vowed.

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» Malaria: Killer at large::Vanguard (Nigeria)

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EU maintains support for RP's MDG health targets | ABS-CBN News | Latest Philippine Headlines, Breaking News, Video, Analysis, Features

EU maintains support for RP's MDG health targets | ABS-CBN News | Latest Philippine Headlines, Breaking News, Video, Analysis, Features

Harper tells UN to focus on child, maternal health

CTV.ca News Staff
Date: Tue. Sep. 21 2010 10:04 PM ET

Prime Minister Stephen Harper called on delegates at a UN summit on global poverty to turn their attention to reducing child mortality and improving maternal health around the world.

In a short speech delivered at the UN headquarters in New York on Tuesday afternoon, Harper told delegates that "much remains to be done."

It has been 10 years since the formation of the UN Millennium Development Goals, which aim to reduce poverty around the world. Goals number four and five in the document address child and maternal health.

"It is a sad reality that each year, hundreds of thousands of mothers die in pregnancy, and nearly nine million children die before their fifth birthday," Harper said. "It does not have to be this way. Progress is possible, but only if we are all willing to take collective action."

During his speech, Harper hailed the adoption of the Muskoka Initiative for Maternal, Newborn and Child Health at last spring's G8 Summit north of Toronto. Harper said that the initiative aims to generate $10 billion over five years from world leaders, private foundations and other donors.

"When we speak of the Millennium Development goals, it will be critical that our words here today ultimately translate into simple realities, like food on the tables, improved health and a better life for children around the world," Harper said. "Together we must keep our promises and work towards practical, durable solutions."

Harper also announced that Canada will boost its contribution to the replenishment of the UN Global Fund to Fight Aids, Tuberculosis and Malaria for the years 2011 to 2013. The government's contribution will be about $540 million.

The prime minister is on the campaign trail at the United Nations this week to press Canada's bid for a seat on the powerful Security Council.

That Muskoka Initiative could prove the key to getting votes for Canada to assume one of the council's temporary seats, CTV Ottawa Bureau Chief Robert Fife told Canada AM.

"We're running against Germany and Portugal, but countries feel we are confident because of what we're doing today," he said. "People are confident we're going to win this (but) it's not in the bag yet."

Harper is also to address the General Assembly on Friday. However, the prime minister's UN campaign will be interrupted by domestic politics.

Harper raced back to Ottawa immediately after Tuesday's speech in order to be in Parliament for Wednesday's gun registry vote.

Fife reported Tuesday night the vote on Tory MP Candice Hoeppner's private member's bill to kill the long-gun registry is expected to be close.

"If all MPs show up for the vote, party sources say the Conservative attempt to kill the long-gun registry will fail by a vote of 153 to 151," Fife said late Tuesday.

"A word of caution though. Opposition party sources say it's still possible that some MPs who opposed the gun registry and flip-flopped may get cold feet, they may get the flu and the Conservatives are hoping that some of those Liberal MPs from Newfoundland will stay home to help their constituents deal with the flooding from Igor."

No matter the vote's outcome, Harper will return to New York to deliver his first speech to the UN General Assembly in four years.

Liberal Leader Michael Ignatieff has said Canada's chances of winning the vote for a seat on the Security Council have been hurt by the prime minister ignoring the UN for most of his time in office.

It has been a decade since Canada held a seat on the Security Council.

The 192 UN ambassadors will vote on the seat on October 12 in a secret ballot.

Canadians boycott Ahmadinejad speech

Harper's speech came hours after Canadian diplomats at the UN boycotted a speech by the president of Iran.

Western diplomats, including those from Canada, have in recent years made a show of walking out on Mahmoud Ahmadinejad whenever he addresses the UN General Assembly.

Catherine Loubier, spokesperson for Foreign Affairs Minister Lawrence Cannon, says the boycott was intended as a protest against Iran's human rights record and controversial nuclear program.

Ahmadinejad told the assembly that capitalism is facing defeat and is calling for an overhaul of the "undemocratic and unjust" global decision-making bodies.

He called on world leaders, thinkers and global reformers "to spare no effort" to make practical plans for a new world order.

He's proposing that the UN call the current decade the Decade for Joint Global Governance.

From http://www.ctv.ca/CTVNews/CanadaAM/20100921/harper-un-100921/

Friday, September 17, 2010

Coalition urges Nick Clegg to prioritise maternal health at next week's summit

Amnesty International UK, IPPF, Oxfam, Marie Stopes, Mumsnet, Save the Children, WaterAid, White Ribbon Alliance for Safe Motherhood

A coalition made up of Amnesty International, IPPF, Oxfam, Marie Stopes, Mumsnet, Save the Children, WaterAid, and the White Ribbon Alliance for Safe Motherhood last night (Thursday 16) urged Deputy Prime Minister Nick Clegg to ensure maternal health is made a top priority at next week’s United Nations Millennium Development Goal Review Summit (20 – 22 September).

Representatives including Kate Allen (Amnesty International UK Director), and Justine Roberts & Carrie Longton (Mumsnet Founders) and WaterAid’s Mary O'Connell presented a giant-sized card to the Deputy Prime Minister which sent a stark reminder that all pregnant women should be able to access their right to the highest standards of health care.

Nick Clegg received the ‘Every Day should be Mother’s Day’ card at Mumsnet’s headquarters in central London where he was doing a live webchat with the Mumsnet community.

The card comprised pictures from Amnesty activists who had sent in personal photographs of women with their children. The message in the card reminded the UK Government to uphold its global commitment to improve health care for pregnant women.

Every year more than 350,000 women die as a result of pregnancy or other childbirth-related factors. Tragically for 99 per cent of these women, their deaths could have been avoided. Yet poverty, inequality and discrimination have resulted in far too many women dying during their pregnancy.

Next week world leaders – including Nick Clegg – will meet in New York to discuss progress on anti-poverty goals – the Millennium Development Goals. Of the eight Goals the target to improve maternal health – which includes reducing the number of pregnancy-related deaths by 75 per cent and increasing access to sexual and reproductive services – is lagging the furthest behind.

Amnesty International’s UK Director, Kate Allen presented the card to Nick Clegg. She said:

“Ten years ago, the international community recognised that alarming rates of women were dying needlessly due to pregnancy or childbirth-related factors. Yet despite this, very little has improved for the world’s poorest women.

“As Nick Clegg heads off to the New York Summit, we hope this card reminds him that all pregnant women should have access to the best available health care, as a basic human right.”

Brigid McConville, UK Director of the White Ribbon Alliance for Safe Motherhood said:

“We now have the opportunity of a lifetime to really change the life chances of women, babies and children. We congratulate the government on making maternal health a priority, we urge them to continue the leadership that has been shown by the UK in recent years – and make sure that there is now urgent action to make sure the promises of world leaders to end the needless deaths of women in childbirth are kept.”

Carrie Longton, Founder of Mumsnet said:

"It was great that both Nick Clegg and David Cameron committed to the Manifesto for Motherhood before the general election, and we're delighted that Nick Clegg has put maternal health at the top of his agenda this September. We really hope that his commitment results in a positive outcome for the many women around the world who will otherwise die needlessly this year, through birth and pregnancy-related complications."

Although most of the highest rates of maternal mortality are found in sub-Saharan Africa – with Afghanistan being the exception to this rule – challenges to pregnant women’s health are found in all continents of the world.

In the USA, Amnesty reported that African-American women are four times more likely to die of pregnancy-related complications than white women, and these disparities have not improved for more than 20 years.

Meanwhile in Peru, women in rural areas are twice as likely as those in urban areas to die from causes related to pregnancy, and indigenous women are regularly discriminated against in health centres. They are often refused their request to give birth in the vertical position – an ancestral tradition amongst many indigenous women in Peru which is faster and easier for women. Because of language barriers with most health workers not able to speak local languages, indigenous women are more likely to be incorrectly diagnosed should any complications arise.

In Chad, only one per cent of the poorest women are attended by skilled health personnel during delivery, compared with 48 per cent of the wealthiest women.

Kate Allen added:

“World leaders must stop falling short on their promises. They should put into practice systems to ensure that discrimination, inequality and poverty no longer prevent hundreds of thousands of women from accessing their basic right to adequate health care. This must be done as a matter of urgency.

“The world’s poorest women cannot wait another five years. People are dying needlessly and the international community simply isn’t doing enough to prevent it.”

from http://www.amnesty.org.uk/news_details.asp?NewsID=18994

More Maternal Education Saves Children's Lives - US News and World Report

More Maternal Education Saves Children's Lives - US News and World Report

Thursday, September 16, 2010

Canada Rolls Out Maternal & Child Health Plans in Africa

Minister for International Cooperation, Bev Oda, visited Mali and Mozambique this week to implement pledges concerning maternal and child heath that were made at the G8 Summit.

In these last few days, there has been a flurry of international activity surrounding maternal and child health in Africa as conditions in Africa’s Sahelian belt and Angola threaten maternal and child welfare. Canada, not to be left behind, has likewise begun to implement its own initiatives.

At the Group of Eight (G8) Summit in Muskoka this past June, Canada pledged $1.1 billion dollars to improving maternal, newborn and child health in Africa. The Canadian contribution accounts for a large portion of the $5 billion plan developed by G8 countries, which aims to aims to save the lives of more than 1.3 million children and 64,000 mothers in the coming years.

Bev Oda, Canada’s Minister for International Cooperation (and head of the Canadian International Development Agency), has been busy visiting health officials in Mali and Mozambique over the past couple of weeks. While Canada will encourage family planning, its main goals are training “health workers, strengthening Mali’s comprehensive primary health systems at the local level, improving nutritional health and reducing the effects of diseases on mothers, newborns and children under five,” according to statements released by Oda’s office.

In many developing counties, 75% of women live in rural areas. Most of these women do not have access to contraception. There is often a lack of medical and psychosocial support for women with unwanted pregnancies. Without knowledge about best practices for safe pregnancies, women may not get the optimal nutrition and care they need for both themselves and their babies.

In Mali, less than 7% of women are using contraception and most women will have 6-7 children in their lifetime. Especially in the context of endemic food insecurity, multiple and closely-spaced pregnancies can be dangerous to both maternal and child health.

For women without adequate health care, income and nourishment, the risk of maternal death is greater than a woman who has only one or two children. According to a 2005 study by the World Health Organization (WHO), the leading causes of maternal death are haemorrhage, infection, eclampsia (hypertensive disorder associated with seizures) and complications of unsafe abortions.

Exclusive breastfeeding for the first six months of a child’s life is recommended by the WHO as being the best means of feeding infants. The organization further recommends that children be fed on a combination of breast milk and other appropriate foods until they are at least two. However, if a new baby arrives before these years are up, the eldest child may be prematurely weaned. That child is then put at a greater risk of malnutrition. The child usually switches to a diet composed mostly of staple grains, which can lead to him/her developing severe micronutrient and protein deficiencies causing edema (swelling of the belly). This condition is known as kwashiorkor.

In some African languages kwashiorkor means “the deposed child” – sadly, an appropriate name.

The death of mothers is not just a women’s issue

From Thursday's Globe and Mail
Published on Wednesday, Sep. 15, 2010 3:45PM EDT

A woman dies almost every minute in childbirth, mostly in the developing world, and if I were not fortunate enough to live in Canada, I might have been one of those statistics.

My first child was a breech birth, my second child too big for me to deliver. If my doctor had not performed cesarean sections, there is no telling what could have happened to me and my babies.

I carry that thought with me every day, because now that I am a mother, everything is heartbreakingly personal: Every dead child could have been mine and every dead mother could have been me.

While that sometimes leaves me emotionally drained after reading the newspaper or watching the news on television, the constant reminder of my luck in being born a Canadian with access to exceptional care is galvanizing. It keeps me focused on the mothers throughout the world who endure horrifying labours without skilled birthing attendants, crippling backroom abortions or c-sections without any access to pain control, or the ones who die and the shattered families they leave behind.

It also gives me cause to celebrate small achievements such as the incrementally declining maternal death rates, which are proof that advocacy and hard work can have an impact.

But there is still so much work to be done. On Monday, I will be in New York with my mother, Maureen McTeer, to attend the Women: Inspiration and Enterprise symposium hosted by the White Ribbon Alliance for Safe Motherhood, of which mom is the Canadian representative. Hosted by Sarah Brown, the alliance’s Global Patron and the wife of former British prime minister Gordon Brown, Arianna Huffington, co-founder and editor-in-chief of The Huffington Post, and fashion designer Donna Karan, the symposium will highlight the issues of maternal/child health as world leaders gather to reaffirm their somewhat tepid commitment to United Nations Millennium Development Goal 5, which calls for universal access to reproductive health by 2015.

A conference like this, and any similar initiative, is useful if it helps to prevent even one of the estimated 536,000 deaths (2005) of women a year from pregnancy-related causes or keep one woman alive for the one million children who are left motherless.

One of the main obstacles we have to overcome in this birth-and-death struggle is the view that this is merely a women’s issue. It is not. It is a global issue and it affects every person. Do we all not have a responsibility to protect the legacies of our mothers and the futures of our sisters and daughters? My daughter is 4 and currently wants to be a cowgirl and an astronaut. Dying in childbirth is not something I ever intend for her to contemplate.

To be more hard-hearted about this, the financial impact of maternal deaths is as shocking as the loss of life.

About $15.5-billion in potential productivity vanishes each year when mothers and their newborns die, or are left with long-term injuries, after birth or botched abortions. Mothers also perform countless hours of unpaid work as caregivers, teachers, health-care practitioners and chief executives all rolled into one, so when the mother dies, the family engine stops running and the broader community must step in to care for those left behind.

It is a tragedy if a woman dies in childbirth in Canada. It is just a sad, normal event if it happens in the developing world. That continued acceptance of the deaths of women is what we must change. I urge you to make a difference – through a donation, through advocacy, through pressing our political leaders to support fully Millennium Development Goal 5. Because, to quote the UN Population Fund, “no woman should die giving life.”

Catherine Clark is a writer and host of the national political television show Beyond Politics on CPAC.

Thursday, August 26, 2010

Maternal mortality in Nigeria

According to UNICEF " Every single day, Nigeria loses about 2,300 under-five year old and 145 women of childbearing age. This makes the country the second largest contributor to the under–five and maternal mortality rate in the world"

Research shows that, more than 70 percent of maternal deaths in Nigeria are due to five major complications: hemorrhage, infection, unsafe abortion, hypertensive disease of pregnancy and obstructed labour [NARHS,2003]. Also, poor access to and utilization of quality reproductive health services contribute significantly to the high maternal mortality level in Nigeria. According to the 2003 Nigeria Demographic and Health Survey, 30 percent of Nigerian women cited the problem of getting money for treatment, while 24 percent cited the problems of accessibility to health facilities and transportation [ORC Macro, 2004]. Also, 17 percent reported the problem of not getting a female provider in the hospital, while 14 percent reported the problem of not wanting to go alone. Again, 14 percent reported the problem of ignorance of where to go for treatment, while one in ten women complained of the bottlenecks in getting permission to visit hospitals [UNICEF, 2001].

Furthermore, majority of births in Nigeria (66 percent) occur at home [ORC Macro,2004] and only one-third of live births during the five years preceding the most recent demographic health survey occurred in a health facility [ORC Macro, 2004]. A smaller proportion of women receive postnatal care, which is crucial for monitoring and treating complications in the first two days after delivery [ORC Macro, 2004]. Only 23 percent of women who gave birth outside a health facility received postnatal care within two days of the birth of their last child [ORC Macro, 2004]. More than seven in ten women who delivered outside a health facility received no postnatal care at all [ORC Macro, 2004].

Maternal Health

According to WHO "Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. While motherhood is often a positive and fulfilling experience, for too many women it is associated with suffering, ill-health and even death"
Major Causes of maternal mortality are haemorrhage, infection, high blood pressure, unsafe abortion, and obstructed labour.