Women the world over will be watching closely when the leaders of the rich world come to Canada in June. Prime Minister Stephen Harper has promised to rally the G8 to do something about the scandalously high number of our sisters and daughters who die in pregnancy and childbirth. Our long struggle to stop this massive tragedy could finally get the boost it needs to succeed.
You may have seen the numbers: a woman dies in childbirth every minute of every day; in Afghanistan, a woman giving birth is more than three times as likely to die as a Canadian soldier in combat; for women of child-bearing age, pregnancy is a leading cause of death in the 50 poorest countries. In Malawi, 1 woman in every 100 die in pregnancy or childbirth, while in India 78,000 mothers die in childbirth and from complications of pregnancy every year.
It is unacceptable that this is happening 10 years into the 21st century – and 10 years since world leaders promised to reduce maternal mortality by 75 per cent.
What must the G8 do? Let’s look at the countries that have achieved dramatic improvements in maternal health. Between 1990 and 1997, Honduras, one of the poorest countries in Central America, reduced its maternal mortality rate by an amazing 40 per cent, by deploying trained, skilled midwives and ensuring the availability of emergency obstetric care.
Sri Lanka, another poor country, has one of the lowest maternal mortality rates in the world, thanks to a government commitment to strengthening the entire healthcare system, including family planning, offered free or at low cost. In Sri Lanka, 97 per cent of births are now attended by a skilled professional.
In Nepal, the number of maternal deaths fell by nearly half between 1996 and 2006. Nepal achieved this by investing in health clinics for the poorest, introducing a voucher scheme that covered transport costs for all pregnant women, and providing free services for women in the poorest districts.
What part did aid donors play in this? First, they made good on their promises to provide financing. If in June the G8 only mouth again their pledge to someday reach the promised 0.7 per cent of national income in aid, we will continue to needlessly bury another half million women every year.
Second, in each case the donors delivered their aid directly to the government’s health budget to bolster the entire system of care. When donors bypass governments or earmark aid for specific diseases or projects, the range of health institutions on which mothers depend suffers.
Third, donors worked with governments to make care free. In Malawi, making maternal care free has result in a huge increase in antenatal visits to hospitals and assisted deliveries Malawi’s maternal mortality rate is terribly high, but free care is starting to make a real difference.
Last fall 10 poor countries pledged to make basic and emergency health care free if donors would help them cover the cost. We’d love to see the G8 take up that challenge.
Putting maternal mortality at the heart of improving health systems will ensure we address the world’s biggest inequity in health. And it will send the crucial message that women matter. A commitment from the G8 on women’s rights will help alleviate the compounding effects of women’s inequality on their chances of surviving pregnancy.
World leaders have the resources and the capacity to save the lives of millions of mothers. The only question is whether they have the will.
Sandhya Venkateswaran, a former management consultant, leads the Indian coalition "Don’t Break Your Promises," which seeks to hold the Indian government to its commitments on health and education.
Dorothy Ngoma is a nurse and Executive Director of the National Organization of Nurses and Midwives of Malawi. They are members of the W8 , eight extraordinary women who have dedicated their lives to fighting for health and education in their countries. They will be Ottawa this week as guests of Oxfam Canada.