in Africa


The ongoing 15th African Union (AU) summit is committed to deciphering the decades-long mystery of the high maternal mortality in Africa, which contributes to about 47 percent of global maternal deaths with sub-Saharan Africa accounting for the lion's share.

Money has long been regarded as the panacea to the chronic disease of maternal deaths in the region. A universal belief is that "the buck stops with bucks" in Africa since insufficient funding has led to lack of health services and facilities, medical personnel brain drain of and deficient pre- and post-natal care.

But money is not the only reason behind the alarmingly high maternal mortality in Africa. A few other elements are also to blame on the paradox of "losing life while giving life" on the continent.

In most African rural areas, expectant mothers are mostly taken care of by traditional birth attendants at their households, rather than at hospitals which are of longer distance and higher cost. The typical and entrenched mentality is that "Since my mom and mom's mom deliver at home, why cannot I?" So the mothers-to-be turn to midwives in the villages or untrained relatives or friends.

According to the recently released UN Millennium Development Goals (MDG) Report 2010, only 46 percent of the deliveries in the sub-Saharan Africa are attended by skilled health personnel in 2008, a stark contrast to the average figures in the world's developing regions and the developed regions that stand at 63 percent and 99 percent respectively.

Even in Kenya, East Africa's largest economy, more than 56 percent of the pregnant women choose to deliver at home.

Christopher Omolo, a senior manager at the Kenya National Bureau of Statistics, said that some women who gave birth at home did not think a clinic was necessary. But the harsh truth is that poorly equipped with merely a wad of cloth and a pair of scissors, even the most experienced midwife in the village will find it impossible to handle deadly labor complications such as hemorrhage and high blood pressure.

Thus a large number of avoidable maternal deaths become inevitable.

Besides, harmful cultural practices, especially female mutilation (FGM), contribute significantly to the maternal deaths across Africa. It is estimated that FGM is still practiced in over 28 African countries. World Health Organization statistics showed that an estimated 92 million girls from 10 years of age and above have undergone FGM in Africa.

In many African rural areas, the FGM operations, which may lead to irreversible damage to a girl's reproductive organ, are being conducted under poor medical conditions, leaving the bleeding genital area to heal itself. The cruel cultural practice adds to risks of hemorrhage, infection and obstructed labor in the girls' future delivery, which may undoubtedly cause more maternal deaths.

Days ago, Ugandan activists against female genital mutilation were requesting that it be included among the issues to be discussed during the ongoing AU summit.

Another reason behind the high maternal mortality in Africa is women's inferior social status. The high rates of maternal mortality highlight the issue of gender inequality in Africa, the AU Commissioner for Social Affairs Bience Gawanas told media before the summit.

African women's inferiority to men leads to school dropouts and forced early marriages. A woman without proper education would not be self-protective in terms of reproductive health and a teenage forced into early marriage risks her unprepared body in the intercourse, both of which may raise the maternal death odds.

The UN MDG report indicated that the number of teenage pregnancies per 1,000 women in sub-Sahara has remained as high as 120 since 1990 while the figures for East Asia and the world's developing regions on average stand at five and 52 respectively.

At present estimates, if no urgent corrective measures are taken, 2.5 million maternal deaths and 49 million maternal disabilities will hit the continent in the next decade. Africa needs to address the multiple concerns rather than regarding the issue of high maternal mortality merely as a problem of money.

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