UNICEF to reduce risk associated with pregnancy (Mirror)

February 6, 2010

THE World Health Organisation (WHO) refers to maternal health as the health of women during pregnancy, childbirth and the postpartum period. While motherhood is often a positive and fulfilling experience, for too many women it is associated with suffering, ill health and even death.
According to health experts, the major direct causes of maternal deaths are haemorrhage, infection, obstructed labour, hypertensive disorders in pregnancy, and complications of unsafe abortion.
Each year, according to the WHO, more than 500,000 women die from complications in pregnancy and childbirth, even though the means exists to save the vast majority.
For its part, the United Nations Children and Education Fund (UNICEF) indicates that globally, one woman dies from complications in childbirth in every minute. That means that about 529,000 of them die each year and the vast majority of the deaths occur in the developing countries including Ghana.
The report went further to state that a woman in sub-Saharan Africa has a one in 16 chance of dying in pregnancy or childbirth, compared to a one in 4,000 risk in a developing country – the largest difference between poor and rich countries of any health indicator.
To find a solution to this problem, many global declarations and resolutions have taken place over the years. One of such events was when in September 2001, 147 heads of states collectively endorsed the Millennium Development Goals (MDGs) four and five whose objective is to reduce child mortality rate by two thirds and maternal mortality ratio by 3/4 by 2015.
Strongly linked to these is Goal six which is to halt or begin to reverse the spread of HIV/AIDS, malaria and other diseases which, to a large extent, also affect women.
As has already been mentioned, the major direct causes of maternal deaths are haemorrhage, infection, obstructed labour, hypertensive disorders in pregnancy, and complications of unsafe abortion. There are also birth-related disabilities that affect many more women and go untreated like injuries to pelvic muscles, organs or the spinal cord.
It is also known that at least, 20 per cent of the burden of disease in children below the age of five is related to poor maternal health and nutrition, as well as quality of care at delivery and during the new-born period.
The report from the UNICEF pointed out that yearly eight million babies died before or during delivery or in the first week of life. Further, many children were tragically left motherless each year, adding that these children were 10 times more likely to die within two years of their mothers' death.
Another risk to expectant women, according to UNICEF, is malaria, which can lead to anaemia, which increases the risk for maternal and infant mortality and developmental problems for babies. Nutritional deficiencies is said to also contribute to low birth weight and birth defects as well.
Looking at HIV infection, it has come out that it is an increasing threat because of the fact that mother-to-child transmission of HIV in low-resource settings, especially in those countries where infection in adults is continuing to grow or has stabilised at very high levels, continues to be a major problem, with up to 45 per cent of HIV-infected mothers transmitting infection to their children.
Many studies have revealed that majority of these deaths and disabilities are preventable, being mainly due to insufficient care during pregnancy and delivery. About 15 per cent of pregnancies and childbirth’s need emergency obstetric care because of complications that are difficult to predict.
It is why it is important to know that access to skilled care during pregnancy, childbirth and the first month after delivery is key to saving these women's lives – and those of their children.
To help in that direction UNICEF is said to be responding to the needs of mothers and their children by helping improve emergency obstetric care, since it has come out that almost half of births in developing countries take place without a skilled birth attendant.
Research shows the single most important intervention for safe motherhood is to make sure that a trained provider with midwifery skills is present at every birth; that transport is available to referral services; and that quality emergency obstetric care is available.
To achieve the desired objective, UNICEF is working with the United Nations Population Fund (UNFPA), WHO and other partners in countries with high maternal mortality which included Ghana in a well-defined supporting role as part of an emerging global partnership for maternal, new-born and child health.
In addition, UNICEF also helps by working with policy makers to ensure that emergency obstetric care is a priority in national health plans, including Poverty Reduction Strategy Papers (PRSPs) and Sector-Wide Approaches (SWAps), as well as assists its partners and governments with assessments, training and logistics.
With advocacy, technical help and funding, UNICEF helps local communities provide information to women and their families on signs of pregnancy complications, on birth spacing, timing and limiting for nutrition and health, and on improving the nutritional status of pregnant women to prevent low birth weight or other problems.
A comprehensive community programme also promotes and helps provide anti-malarial therapy and insecticide-treated bed nets.
Tetanus, a bacterial disease that’s a result of unhygienic and unsafe childbirth delivery practices, killed 200,000 new-borns and 30,000 mothers in 2001 alone. Along with buying and helping provide tetanus immunisations for pregnant women, UNICEF provides micro-nutrients to stave off anaemia and birth defects – all of which lead to healthier mothers and babies.
Another area the UN body is looking at is helping countries to prevent mother-to-child transmission of HIV. From 1998, UNICEF on behalf of other UN partners has been providing country support for prevention of mother-to-child transmission (PMTCT) programmes within existing maternal and child services in resource-poor settings. This includes advocacy on distributing ARVs to young women and parents with HIV/AIDS as part of UNICEF's support of what it terms the “3 by 5 Initiative” programme with the WHO, which aimed to ensure that three million people have access to anti-retroviral treatment by the end of 2005.
Services may also include voluntary and confidential counselling and testing for HIV/AIDS. If an expectant mother has the virus or AIDS, she is counselled on how to help prevent transmitting the disease to her child, including safer breastfeeding practices.
Again, UNICEF’s priority also benefits maternal and infant health – particularly education for girls, since it is a fact that educating girls for six years or more drastically and consistently improves their prenatal and postnatal care and childbirth survival rates. Educating mothers also greatly cuts the death rate of children under five. Educated girls have higher self-esteem, are more likely to avoid HIV infection, violence and exploitation, and to spread good health and sanitation practices to their families and throughout their communities.
According to the UNICEF, an educated mother is more likely to send her children to school, which could help break the cycle of poverty and reduce high maternal and infant mortality.