AU meet to find solutions to maternal and child deaths

This year’s African Union summit, to be held in Kampala next week will take maternal and child health as its theme. Leaders at the meeting are expected to agree that there are still challenges in reducing maternal and child deaths generally across most African countries. While target four and five of the Millennium Development Goal (MDG) aim at reducing by two-thirds the number of mothers and children who die every year during child birth and childhood illness, many countries are nowhere near meeting that target.

African women still die in great numbers while giving birth. In fact estimates show that an African woman has a 1 in 22 risk of dying from preventable complications of pregnancy and child birth compared to a 1 in 7,300 risk among women in developed countries. In Uganda where maternal and child mortality rates remain unacceptably high, maternal mortality stands at 435 per 100,000 live births while under-five mortality is at 137 deaths for every 1,000 births. These figures, according to public health experts have barely changed since 1990 when the MDG targets were set and the country is unlikely to meet its end of the bargain.

Dr Hassan Mohtashami, the deputy representative of the United Nations Population Fund (UNFPA) in Uganda said most of these deaths can be prevented through three simple, cost effective interventions.
“Ensuring access to family planning services is one way we can reduce maternal deaths. It’s a simple calculation; the less number of pregnancies, the less chances of dying. It’s not about population control but health of the mother and having a good family planning programme all over the country,” he says. Currently, only 23 per cent of women have access to contraceptives.

Dr Mohtashami said family planning alone can reduce by a third, the number of women who die every year because of pregnancy related complications. Another cheap intervention, he says, is having a midwife present during delivery.“If you have a skilled health worker with a mother during delivery, it will help her to detect if there is any complication and immediately do something to save the life of the baby and mother.” This, intervention he said has the potential of saving another one-third of the deaths, meaning that the two interventions have the potential of saving up to two-thirds of women who would otherwise have died.“The remaining can be saved by Emergency Obstetric Care. If a mother needs specialised and sophisticated care by a doctor like caesarean and blood transfusion, then there should be a centre equipped with these facilities where mothers can be referred,” said Dr Mohtashami.

He said this strategy was used by Sri Lanka which has the same economic status with many sub Saharan African countries but has now managed to reduce its maternal mortality to 27 per 100,000 live births. But challenges still abound in Uganda. One of the biggest obstacles to reducing maternal deaths is the shortage of health workers poor health infrastructure. To meet the MDG target, Uganda needs to reduce its maternal mortality rate to 132 per every 100,000 live births by 2015- a target that already looks far from being achieved.

Cutting child deaths

The same challenge is being faced in reducing child deaths. Since the beginning of the MDG countdown in 1990, Uganda has reduced child mortality by about 15 per cent, according to Ms May Anyabolu, the deputy representative of the UN children’s Fund (Unicef) in Uganda. But to reach the MDG target, child mortality should reduce to 56 per 1,000 births-a practically tall order for Uganda to achieve over the remaining five years. Ms Anyabolu said this target would be achieved if governments put in place more concrete commitments since over 70 per cent of the deaths are caused by preventable disease like malaria, pneumonia and diarrhea.

“More needs to be done to keep children alive. These efforts only require massive acceleration in the health sector but also a multi-sectoral effort as well as full commitment of the political leaders,” she explained. And it’s the political will from heads of states that the citizens will be looking up to, to address some of these underlying challenges when the African Union summit opens next week here in Kampala.