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VOL. 28, NO. 06, Sept 26 , 2008 (Ashwin 10 2065 B.S.)
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MILLENNIUM DEVELOPMENT GOALS
Uphill Task
The South Asian countries are unlikely to meet the target of maternal mortality despite steady improvement in the situation
By A CORRESPONDENT
With the progress in maternal mortality in South Asia still patchy, and notwithstanding fewer mothers dying during childbirth than in recent years, a new report by UNICEF entitled Progress For Children has stated the region is unlikely to meet the goals set out in Millennium Development Goals (MDG).
According to the report, South Asian women are among the least likely to have a skilled birth attendant at delivery. Only 41 percent of all births are delivered by a health professional in the region.
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Women: Plight Continues |
The proportion of rural women in Nepal whose birth was attended by a skilled birth health professional increased from 8 percent in 2001 to 14 percent in 2006. In India an estimated 14.4 million births per year are not attended by a skilled provider.
Nevertheless, there has been an improvement in regional coverage from 31 percent to 40 percent between 1995 and 2005.
India, Afghanistan, Bangladesh and Pakistan are among ten countries that account for almost two thirds of maternal deaths globally, but South Asia's maternal mortality rates have dropped by 22 percent between 1990 and 2005, according to the report that focuses on maternal mortality.
During the period of 1990 to 2005, South Asia's maternal mortality ratio has fallen by 22 percent from 650 per 100,000 live births to 500 per 100,000 live births. The report further says antenatal care coverage in South Asia is the lowest in the world, but improvements are also proceeding more rapidly than in any other region. While 46 percent of women benefited from one antenatal visit during the mid 1990s, this figure rose to 65 percent by 2005.
India and Nepal have both made progress of 20 or more percentage points, with rural improvements surpassing urban. Regional disparities based on household wealth are even greater. The wealthiest women are approximately 4 times as likely as poorer women to have professionally attended births in India, 8 times as likely in Bangladesh and 11 times as likely in Nepal.
Despite these improvements, South Asia still accounts for more than one third (187,000) of the estimated 536,000 women who died in 2005 from maternal causes – a higher proportion that any other region in the world.
India alone, with an estimated 117,000 deaths in 2005, accounted for about one fifth (22%) of the global total of maternal deaths, according to the report. Based on the present rate of progress, the world will fall short of meeting the MDG target (5A) of reducing the maternal mortality ratio (MMR) by three quarters between 1990 and 2015. Since 1990, the current average rate of reduction is less than 1 percent a year, which is well below the average of 5.5 percent (annually) needed to meet the target in 2015.
Hemorrhage (31 percent) is the leading cause of maternal deaths in South Asia followed by anemia (13 percent), sepsis/infections (12 percent) hypertensive disorders (9 percent), and obstructed labor (9 percent).
South Asia has some of the highest levels of maternal under nutrition in the world, a factor contributing to the risk of maternal mortality, as well as the high proportion of infants with low birth weight, the report adds. The report also cited the critical shortage of doctors, nurses and midwives in the region. Personnel shortages and the absence of human resources policies and strategies in some countries will constrain progress towards MDG 5. The MDG 5 targets can be met only if progress can be accelerated.
Governments, development organizations, and other partners, including civil society and the private sector, need to invest both the funds and commitment necessary to improve maternal health.
