Maternal mortality stubbornly high

Women in sub-Saharan Africa face the highest maternal mortality rates in the world, with up to one in 16 women running the risk of dying in pregnancy or childbirth, a new study has found. The study, conducted by the World Health Organisation, the UN Children's Fund (UNICEF) and the UN Population Fund (UNFPA), found that in Angola and Malawi one in seven women faced the risk of dying due to pregnancy or childbirth, compared with one in 2,800 for a woman from a developed region. In Zimbabwe, where researchers estimated that one in 16 women were at risk, the introduction in 1995 of user fees at clinics is thought to have been partly responsible for the high risks associated with childbirth. "At the same time, the health authorities stopped training traditional birth attendants (TBAs), to encourage women to attend the clinics for their ante-natal health care," UNICEF information officer Chantha Bloemen told IRIN on Wednesday. Although this policy has been reversed - medical care is free for pregnant women and children under five, and TBA training has been revived - health services had deteriorated due to inadequate funding and training, Bloemen said. "Women would go the clinic and receive poor services, and so decided to just do things the way their mothers did - with TBAs." In addition, Bloemen noted, the per capita allocation for the health sector had dropped from US $26 in 1991 to $14 in 2001. "On top of that, there's a brain drain of health workers moving across the border, so the services that are available are not so good. Zimbabwe's food crisis earlier this year, which left half the country's population dependent on food aid, also left many women anaemic and not strong enough for childbirth. Other causes of maternal mortality included women bleeding to death during childbirth, infections not healing and inadequately trained medical staff, especially in rural health centres, that were unable to cope with complications. HIV/AIDS had also left many women too weak to fight infections, or anaemic, Bloemen said. An estimated 33.7 percent of Zimbabwean adults are HIV-positive. In Angola, now emerging from three decades of civil war, researchers found that women delayed seeking treatment at the country's clinics, which were short of drugs and trained staff. "There are 3.3 million displaced people returning home and, although they have got incredible spirit, they are going to areas that don't have services - some are just ghost towns," said James Elder, UNICEF spokesman in Angola. "These new estimates indicate an unacceptably high number of women dying in childbirth, and an urgent need for increased access to emergency obstetric care, especially in sub-Saharan Africa," UNICEF Executive Director Carol Bellamy said in a statement. "The widespread provision of emergency obstetric care is essential if we want to reduce maternal deaths." For the full report: www.who.int