Public Health AffairsThe way towards safe motherhood [Archives:2005/872/Health]

By Dr. Saleh Al-Habshi
Msc. in Public Health
While the world's population will reach 10 billion by 2020, there are 120 million married women worldwide having unmet needs. Whereas health, social, and economic status of women still needs much attention, particularly in developing countries.

Every minute of every day, somewhere in the world, a woman dies as a result of complications arising during pregnancy and childbirth. That number was calculated to be approximately 600000 deaths annually, the vast majority of which in developing world. The tragedy is that these women die not from disease but during the normal, life-enhancing process of procreation. The death of a woman during pregnancy or childbirth is not only a health issue but also a matter of social injustice. The majority of those deaths could be prevented if the adequate health care was provided in place and time and by a trained staff.

The World Health Organization (WHO) defined Maternal Mortality (MM) as the death of a woman while pregnant or within 42 days of termination of pregnancy, regardless of the site or duration of pregnancy, from any cause related to or aggravated by the pregnancy or its management.

MM is an indicator of disparity and inequity between men and woman and its extent a sign of woman's place in the society and their access to social, health, and nutrition services and to economic opportunities.

In developed countries Maternal Mortality ratio (MMR) averages 27 maternal deaths per 100000 live births, while in developing countries the ratio is nearly 20 times higher, at 480 per 100000, and may be as higher as 1000 per 100000 in some regions (1999).

Yemen is one of the countries, which early adopted policies addressing population growth. The average marriage age of females is 22.3 years, with least marriage age 15 years. The Yemeni community suffered a lot due to increased MM. In 1997 MMR was 1400 per 100000 live births. Total fertility rate (TFR) reached 8 at that time. The efforts done by the MoPH and International Organizations led to an apparent decrease of TFR towards the current figure 6.5 and MMR to 1000 per 100000 live births (2003). Coverage with nursing and midwifery personnel should be increased specially in rural areas to exceed the current figure 4.5 per 10000 population. More attention must be given to MM by promoting reproductive health services and raising the awareness of the community.

Safe motherhood is a human right:

Of the human rights currently acknowledged in national constitutions and in regional and international human rights treaties, many can be applied to safe motherhood.

The International Conference on Population and Development (Cairo, 1994), the Fourth World Conference on Women (Beijing, 1995) and the Safe Motherhood Technical Consultation (Colombo, 1997) have helped to focus the attention of the international community on the need for accelerated action to achieve the World Summit for Children (New York, 1990) goal of reducing MM by half. The Safe Motherhood Consultation placed MM in the context of human rights, urging governments to use their political, legal, and health systems to fulfill the obligations imposed by their endorsement of various international human rights instruments. Experts from WHO, UNFPA, UNICEF, the World Bank, the Population Council, the International Planned Parenthood Federation, and other national and international agencies concerned with safe motherhood reviewed progress over the past 10 years and concluded that it is possible to reduce MM significantly with limited investment and effective programme and policy interventions.

Impact of Unsafe Motherhood:

High levels of MM are not only a “woman's problem””. Poor maternal health and its inevitable corollary – poor infant and child health – affect everyone. Women are the mainstays of families