"Shocking" maternal mortality rates in Herat

Health officials have branded maternal mortality rates in the western Afghan province of Herat, as published in a new report, as shocking. "These are very high statistics and a cause for concern," Dr Friba Hayathamayun, a maternal and child health-care worker for the World Health Organisation (WHO) in the Afghan capital, Kabul, told IRIN on Monday. A recent report released by the US-based Physicians for Human Rights (PHR), entitled "Maternal Mortality in Herat Province: The Need to Protect Women's Rights", documented 593 maternal deaths in every 100,000 live births, with the majority in rural areas. This figure exceeds maternal mortality statistics in all of Afghanistan's neighbouring countries. According to PHR, in Pakistan it stands at 200 deaths for every 100,000 live births, Tajikistan 120, Turkmenistan 65, China 65 and Iran 60. Other shocking statistics revealed that 97 percent of the 4,637 respondents interviewed in Herat received untrained birth attendance. "There is an urgent need for trained staff to deal with births and especially complicated births," Hayathamayun added. According to the health expert, the main reasons behind the high maternal mortality rates were delays in decision-making by families just before the birth, and lack of transport and medical equipment. "Families don't like sending patients to hospital for cultural reasons, and many cannot even afford to pay for transport, so end up giving birth at home with help from relatives," she explained. "The rate of maternal mortality in a society is a critical indicator of the health and human rights status of women in a community," said senior medical researcher at PHR, Dr Lynn Amowitz. "What appears to be simply a public health catastrophe in Herat Province also speaks of the many years of denial and deprivation of women's rights in Afghanistan. Promoting rights such as access to adequate health care, food, shelter and clean water will directly improve their health." The report also included recommendations for urgent financial assistance. "Contributions from donors have failed to meet Afghanistan's desperate need, including urgently required funds for the health sector," it said. Meanwhile, WHO, which provides technical assistance to implementing partners in maternal health care has launched a pilot programme in the eastern and central regions to promote a maternal mortality reporting format and document cases in order to better establish statistics and causes. "We are hoping to expand this project in other provinces soon," Hayathamayun said.