By Kristyn Zalota, Founder of CleanBirth.org
As we approach the 2015 deadline for achieving the Millennium Development Goals, it is clear that many countries will not achieve the 75% reduction in maternal mortality prescribed by MGD Goal 5. According to the World Bank, “…of all the MDGs, the least progress has been made toward the maternal health goal.”
The good news is there has been 45% drop in maternal mortality between 1990-2013 with the rate of maternal deaths shrinking from 380 per 100,000 live births in 1990 to 210 deaths per 100,000 live births in 2013.
There is consensus that future efforts must be focused on women in developing countries.
- 99% of the 800 women who die each day due to birth-related complications live in the developing world.
- Just 50% of women in developing areas receive sufficient antenatal care.
- More than 24% women/girls in sub-Saharan Africa lack family planning services, leading to unplanned pregnancies and HIV.
We also now know that within developing countries, there are often disparities in maternal care between rural and urban areas. UNDP finds, “In the developing regions, only 56 percent of births in rural areas are attended by skilled health personnel, compared with 87 percent in urban areas.”
Working in the Lao PDR to reduce maternal mortality, I have seen firsthand this rural-urban divide and the heartbreaking consequences: families without their mothers, mothers without their babies.
Like other developing countries, Lao PDR has made progress on MDG 5 but has fallen short of 2015 goal:
|Maternal Mortality Rate||650||405||357||260|
|Proportion of births
attended by skilled birth attendants (%)
*Sources: “MDGs Localization in Lao PDR” presentation by Ms. Phonevanh Outhavong; “Tools for national MDG monitoring Lao PDR” presentation by Thirakha CHANTHALANOUVONG
The Lao government acknowledges the need to improve the quality of services:
“MDG 5 … is not on track, the quality of health services [is] still poor” Ms. Phonevanh Outhavong, Deputy Director General of Planning Department, Lao PDR
Lao Mothers in rural areas in particular have not experienced a significant improvement in birth outcomes. The safe-delivery rate in cities is six times higher than in rural areas, due to “massive disparities in delivery assistance,” according to the UN.
My organization, CleanBirth.org, endeavors to address this divide by improve birth outcomes in a remote province in southern Laos. We train local nurses to enhance their skills and ensure that every mother receives safe birth supplies and education before they deliver.
Mothers need these supplies and prenatal counseling because their villages are often unreachable during the rainy season, with roads washed out and mothers isolated from nurses’ care in the rural clinics. Even in the dry season, mothers experiencing complications who travel to clinics are often met with inexperienced nurses unable to assist with challenging births. Mothers often don’t survive the transfer to a fully staffed hospital, because too much time has elapsed.
We work with our Lao non-profit partner and local nurses to understand what they need to change this reality.
Nurses have asked for training, which we provide with the help of midwives from Yale University, and additional supplies. We have given them what they asked for and will continue our collaboration until every mother in our area is cared for appropriately before, during and after birth. The road is long but together we are preventing the preventable deaths of mothers and babies.
Laos is just one country struggling to care for mothers. As the deadline approaches, let’s hope that every country learns the lessons the MDGs have taught us and sets new targets aimed at eradicating needless maternal deaths once and for all.
“MDGs Localization in Lao PDR” presentation by Ms. Phonevanh Outhavong Deputy Director General of Planning Department, MPI, Vientiane, 24 Jun 2014
“Tools for national MDG monitoring Lao PDR” presentation by Thirakha CHANTHALANOUVONG Lao Department of statistics, Ministry of Planning and Investment, The International Conference on the Millennium Development Goals Statistics (ICMDGS) ,October 19-21, 2011, Philippines.