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What is blocking progress on MMR?

Many poor women in Yemen cannot access health care services because of their low income
(Muhammed al-Jabri/IRIN)

The maternal mortality rate (MMR) remains high as a result of poor health care and harmful social practices, including child marriage and female genital mutilation, a UN Children’s Fund (UNICEF) official in Yemen has said.

"Maternal mortality is very high in Yemen. Some 360 women die per 100,000 live births and that figure could be higher," said Naseem Ur-Rehman, UNICEF’s chief information officer in Yemen, at a press briefing on 18 January to launch the State of the World's Children 2009 report.

Eight women or girls die from pregnancy or childbirth complications every day in Yemen, he said; globally the figure is 1,500.

According to the UNICEF report, the lifetime risk of maternal death in Yemen is 1:39, making it the highest in the Middle East.

At the same time Yemen has the lowest percentage of births in the Middle East at which a skilled attendant is present: Delivery care coverage is 36 percent, and 24 percent of births take place in hospitals.

The report said a study by the World Health Organization (WHO) found that female genital mutilation/cutting, which is widespread in rural areas, affected the reproductive health of women: It caused severe pain, prolonged bleeding, infection, infertility and even death.

The report defines maternal mortality as “the death of a woman while pregnant or within 42 days of the pregnancy’s termination, regardless of the site or duration of the pregnancy, from any cause related to, or aggravated by, the pregnancy or its management”.

Shortage of health workers

UNICEF's Ur-Rehman said the lack of health workers was one of the reasons for the high MMR and neonatal mortality rates, adding that Yemen was among 57 countries where “the shortage of health workers is acute”.

“Worldwide, there is a shortage of 4.3 million health workers who provide care at the time of pregnancy and delivery,” he said, adding that there should be a minimum of 2.28 health workers per 1,000 people.

Yemeni health officials estimate there is one doctor per 10,000 people and that health services reach only 60 percent of the country's 21 million people.

Child marriages

Ur-Rehman said child marriage, which aggravates high fertility rates by giving girls a longer period in which to have children, added to the risks.

"Yemen faces this problem of child marriages. There are a large number of child marriages and they ultimately contribute to the deaths of children," he said.

Nabil Mohammed al-Ammari, executive director of the Yemeni Family Care Association, said lack of awareness about family planning and reproductive health care services also translated into a higher MMR.

He said his association carried out a survey in 2007 in 15 of the 21 governorates on the use of family planning methods and found that people preferred not to use them for fear of possible side effects.

Al-Ammari said social attitudes also had an impact on MMR. "A father of four or five daughters would love to have a boy even at the cost of having many children," he said.

According to UNICEF’s Ur-Rehman, three things can reduce the high MMR: better community and family support for pregnant women; comprehensive health insurance to cover the costs associated with pregnancy, child birth and post-natal care; and the setting up of establishments where pregnant women from remote areas can go for advice and help prior to their due date.

"Many of these women who are dying are too poor to get to health facilities. Some families take the mother to hospital, but she turns out to be dead on arrival,” he said.


This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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