The unconscionable global toll of death during childbirth

As Printed in the National Post February 4, 2010

Every minute of every day, a woman dies giving birth. The toll is staggering: 530,000 pregnant women a year perish, 95% of them in developing countries. Remarkably, 80% of these maternal deaths are from five entirely preventable or treatable causes: sepsis, hemorrhage, eclampsia, obstructed labour, or as a consequence of a septic abortion.

For every death, dozens of women sustain life-altering and irreversible injuries. Many develop obstetric fistulae that leave them incontinent of urine and feces, and pariahs within their own developing-world communities.

In very poor countries, a mother’s demise is a virtual death sentence for many of her children. Those under a year old have an 80% chance of dying in childhood; and of those under five, more than half will not reach adulthood.

Although the solutions to deal with this catastrophe are well known, maternal health receives little attention and resources from international donors.

The Canadian government has just announced that maternal and child health will be on the agenda at this summer’s G8 Summit in Ontario. This is a welcome announcement, but the summit cannot be just another milquetoast, feel-good document. The leaders must announce a comprehensive International Action Plan to reduce childhood and maternal mortality.

What should the Action Plan include?
Last summer, at the pre-G8 Conference on International Health in Rome, parliamentarians from around the world developed a concrete plan to reduce maternal mortality called “Strategic Investments in Times of Crisis.” This was given to the G8 and G20 leaders at their meeting a few days later. The plan called for strategic investments in access to primary care: basic surgical facilities, medications, a full array of family planning options, diagnostics, adequate nutrition, clean water, power, and most importantly, trained health-care workers.

With these assets in place, most obstetrical complications can be treated, along with 80% of the other medical problems one encounters in the emergency department. This includes the major killers in developing countries — gastroenteritis, which kills 2.2 million per year, pneumonia (2.1 million), malaria (two million) and HIV/AIDS (two million).

From an economic perspective, every dollar invested in primary maternal care reduces health-care costs by $4 and social costs by a staggering $30. Yet, there has been a tendency for governments, international aid organizations and NGOs to focus on specific diseases. This can actually harm the overall health of a population, because it diverts resources from the primary care system.

Effective capacity building — both bricks and mortar and human resources is key to saving lives. One way to accomplish this is to fund our universities, colleges, professional associations and non-governmental organizations to partner with institutions in the developing world so they can “train the trainers” in countries of greatest need. Engineering departments could help to train engineers and hydrologists; medical facilities could train doctors, nurses, and lay people with basic skills in health care; business schools could train people in management so that the assets of a medical system could be used effectively.

The G8 and G20 leaders who met in Italy last year were given a plan of action to reduce maternal mortality. They can use this as a template to mobilize the world’s most powerful nations when they meet in Ontario this summer to end this global tragedy. It is time to stop this human catastrophe. It is time for action.

- Dr. Keith Martin is a physician and Liberal MP who chaired the drafting committee at the 2009 G8 International Parliamentarians’ Conference in Rome, which put together a plan of action to reduce maternal and infant mortality. He has also developed the Centres for International Health and Development Initiative that will link the capacity-building capabilities of universities in North America with the needs of institutions in low-income countries.

The unconscionable global toll of death during childbirth

This entry was posted on Thursday, February 4th, 2010 at 1:00 pm and is filed under Foreign Affairs and International Development, Health, In the Media, International Health, Op-eds. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.