Maternal Health Tops Development Agenda

Each year an estimated 340,000 women die in childbirth. The vast majority of those deaths occur in developing countries. Women's groups and health experts, meeting in Washington this week, are seeking $12 billion to improve women's rights and health.

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It's a staggering figure. Each year an estimated 340,000 women die in child birth. The vast majority of those deaths occur in developing countries, but progress is being made. Even so, women's groups and health experts meeting in Washington this week are seeking $12 billion to improve women's rights and health. NPR's Brenda Wilson reports.

BRENDA WILSON: This year, the issue of maternal health has risen to the top of the international development agenda. Thousands of women, country representatives and health experts are at the Washington conference called Women Deliver. Their focusing on a central fact of women's lives - that they have babies, often not in the best of circumstances.

The delegates are hearing from people like Dr. Farhana Dewan, an obstetrician and gynecologist from Bangladesh. Eighty-five percent of the women there still live in rural area. But the government is making a big effort to deliver babies safely at new district health centers and in rural homes.

Dr. FARHANA DEWAN (Ob-Gyn): We have trained people to go (unintelligible) at the grasss root level and also we have taught, well, all the women will not be able to come to the center to come and deliver. So what can we do? We can train people to go and deliver them at home and refer the women in case of complications.

WILSON: The women in these areas don't really have the power to decide for themselves that they want to go to the health centers.

Dr. DEWAN: The women who (unintelligible) who are in the village - they have to depend on the opinion of their husband and the mother-in-law and in-laws and all that.

WILSON: So the government offers vouchers as an incentive to get them into health centers.

Dr. DEWAN: Of course she has to be poor. They won't give it to the rich people. And when she comes for check-up, she gets money. And when she comes for delivery, she gets money. The response is very good, because women who get money, they go back and send some other people also.

WILSON: Since 1990, the government's efforts have reduced deaths from pregnancy and childbirth by 53 percent. The idea is catching on in sub-Saharan Africa as well. But in many villages it's the elders who have to be acknowledged, says Mary Issaka, a midwife from eastern Ghana.

Ms. MARY ISSAKA (Midwife): We have had opinion leaders making decision for the woman. If a woman is in labor, she cannot just get up by herself and go to a health facility by herself. She cannot make a decision by herself, unless the opinion leader says so.

WILSON: Issaka persuaded the village elders that it was better for the women to seek her out when they went into labor.

Ms. ISSAKA: You know, they feel that if you deliver by yourself, it shows that you are faithful to your husband or you feel that you are brave. So you need them to understand that, no, if you want to show bravery and at the end of you die or you lose your baby, you've lost.

WILSON: Since the government started providing free health care to pregnant women in 2003, no woman has died and no woman has lost a baby in her district. Issaka, who is being honored as midwife of the year at the Women Deliver conference, says she shares her duties with one other midwife in an area of 20,000 people.

Maternal health is improving in many countries around the world - in Sri Lanka, Egypt, Honduras and Rwanda. Governments are educating women, improving their status, and providing family planning. But some of these gains are being offset by AIDS. Frederica Hanson, the United Nations population funds advisor in Ghana, says AIDS carries such a stigma that it keeps pregnant women from seeking care.

Ms. FREDERICA HANSON (United Nations Population Funds Advisor): When these women die, we don't get to know about it. We just bury them silently.

WILSON: A recent study found that there would've been 60,000 fewer pregnancy-related deaths if it had not been for AIDS.

Brenda Wilson, NPR News.

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