Goal to slash maternal mortality in danger

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BANGKOK, Nov 23, 2006, 2006 (IPS/GIN via COMTEX) -- A scarcity of funds and a failure to translate national laws into action are undermining hopes the world will meet a key development goal in 2015 to help women, says a ranking U.N. official.

The fifth Millennium Development Goal (MDG) "will not be reached in many countries because of a lack of implementation of national laws and a lack of resources to fund programs the laws call for," Thoraya Obaid, head of the United Nations Populations Fund (UNFPA), said in an IPS interview.

This goal -- to reduce by three-quarters the maternal mortality ratio, given the estimates that over half a million women die every year during pregnancy or childbirth -- is one of eight targets the world's nations pledged to meet at a U.N. summit in 2000. The other goals include halving the number of people living on less then one U.S. dollar a day, eliminating gender disparities, reducing child mortality by two-thirds and halting the spread of killer diseases, like HIV/AIDS, by 2015.

A major problem is the slow progress among developing countries to implement laws that guarantee maternal health care and reproductive health rights, Obaid said on the sidelines of a conference here on population and development goals attended by 180 parliamentarians from 103 countries. "If there were laws, we can hold governments accountable. But if there were no laws you cannot hold them to anything."

The findings of a global survey released during the meeting, which ran from Nov. 20-22, revealed that 250 laws addressing concerns such as gender-based violence, empowerment of women and support for reproductive health had been passed in 77 countries. The U.N. has 192 member nations.

Obaid also faulted developed nations for failing to meet their share of the commitment made at a major population conference in the mid-1990s to fund sexual and reproductive health programs in the developing world through their overseas development aid (ODA) programs. "Within ODA, the commitment for sexual reproductive health from the donors' side has not reached the one-third level that was supposed to be met," she said.

Such limited funding of maternal health-care programs was not lost on the participants at the Bangkok event, the 2006 International Parliamentarians' Conference, the third such global event since 2002 to review the progress since the 1994 International Conference of Population and Development (ICPD).

"Funding for family planning, the first line of defense against maternal mortality, has dropped from 55 percent of total population funding in 1995 to 9 percent today," noted the "Bangkok Statement of Commitment," released at the end of the conference. "And funds for reproductive health commodities remain in short supply."

One reason behind that, participants at the conference conceded, was the shift in funding to deal with the killer disease HIV/AIDS over the past decade. "Funds for the treatment of AIDS has grown exponentially, while funds for its prevention remain scarce," adds the final declaration. "As a result, statistics on maternal mortality and morbidity remain virtually unchanged in some regions of the world, while statistics on HIV and AIDS reflect only slow change."

"No one should die as a result of sex, denial of accurate information or the lack of a condom, or a single birthing kit," Gill Greer, director-general of the International Planned Parenthood Federation, said in her keynote speech to the conference, which shed light on the alarming death rates due to inadequate maternal health care, unsafe abortion and the absence of HIV prevention services.

"In Niger the lifetime risk of dying from complications in pregnancy or childbirth is one in seven, in Sweden one in 29,800," she added. "However, we do not know the actual survival status of some 36 million women who give birth each year in countries which do not officially count maternal deaths."

World Bank estimates show that 74 percent of maternal deaths could be prevented if "all women had access to interventions to address complications of pregnancy and childbirth," she said. "Yet some 200 million women a year are not accessing the contraception they desire or need in order to space or prevent pregnancies."

Asia-Pacific region countries offer a window into this problem, noted a publication released this week by the Economic and Social Commission for Asia and the Pacific (ESCAP), a regional U.N. body based in Bangkok.

"Among all reproductive health indicators, perhaps the least progress has been made in reducing levels of maternal mortality," writes Philip Guest in the Asia-Pacific Population Journal. "Even in countries such as Malaysia, which is recognized as having a reliable vital registration system, maternal deaths have been shown to be under-reported by a large amount."

According to World Health Organization (WHO) estimates in 2004, there were close to 253,000 maternal deaths a year across Asia, of which south-central Asia had the highest rates, 207,000 annual deaths.

"A significant contributor to maternal mortality is unsafe abortion," adds Guest of the Population Council, an international public health non-governmental group. "Of the total estimated number of unsafe abortions (10.5 million in Asia in 2000), over 7 million occurred in south-central Asia."

"This issue is difficult to convince governments, unlike telling them about the need to build a road," says Malinee Sukavejworakit, secretary-general of the Asian Forum of Parliamentarians on Population and Development, a Bangkok-based body lobbying the region's legislatures on development issues.

And even after governments agree to accept the challenge of reducing maternal mortality in their countries, no universal model will provide a solution, adds Yasuo Fukuda, a Japanese parliamentarian and a leading figure in this campaign.

"The solutions have to be diverse, taking into consideration the different needs of every country," he said. "But we have to overcome two common obstacles -- legislative action and getting the budget to implement the actions."