Category Archives: Women and girls

Southern Africa: Gender violence still hinders women’s freedom

GenderLinks

It seems incongruous that we celebrate Women's Month, yet stories of conflict and gender based violence (GBV) flood today's headlines. Whether it is the abduction of girls in Nigeria, the unending trial of Oscar Pistorius or the young woman raped and murdered last over the weekend because of her sexuality- the horrific immediacy of violence is all too apparent. Yet the majority of cases go unreported, unnoticed and justice is not served. It is also evident in conflict and post-conflict situations where rape is often used as a weapon of war. While everyone is vulnerable to violence, women and girls remain disproportionately affected.

 

While we honour the women who marched against the Apartheid pass laws in 1956 and the efforts of many individuals who have toiled towards improving the status of women, we also need to take a moment to reflect as we take stock of what we have achieved. This is particularly important at this time as we fast approach the 2015 deadline for the SADC Gender Protocol on Gender and Development target of halving GBV. We need to face up to the reality that twenty years into democracy, South Africa and the entire Southern African region remain a far cry from this ‘dream.'

 

GBV no doubt weakens the efforts toward all goals set out in the SADC Gender Protocol Studies by Gender Links in six countries of the SADC region reveal that GBV is pervasive, with the highest prevalence reported in Zambia, where 89% of women from the Kasama, Kitwe, Mansa and Mazubuka experienced violence in their lifetime. Meanwhile 86% of women in Lesotho, 68% of women in Zimbabwe, 67% of women in Botswana, 50% of women in South Africa (Gauteng, Limpopo, Western Cape and KwaZulu Natal) and 24% of women in Mauritius have experienced GBV.

 

Men on the other hand are affirming their hand in this violence: from 73% men in Zambia to 22% men in Mauritius reported perpetration of violence at least once in their life time. The studies further show that there is serious under-reporting of violence across the region, and the scourge thrives in this culture of silence and denial.

 

Studies also show that GBV is inextricably linked to gender inequalities. In the SADC region it is embedded in the patriarchal social system which perpetuates the subordination of women. According to a GL attitudes survey, while both men and women claim to believe in equal treatment between women and men, it is shocking and rather infuriating to learn that on average more than three quarters of men believe that a woman should obey her husband.

 

More saddening is the fact that equal proportions of women affirm this assertion.

 

Women and girls are expected to subservient at all stages of their life cycle and this comes with a hefty price tag- unequal access to all rights whether in the economy, in education and in the health sector- to name just a few. A study undertaken by Swedish International Development corporation Agency (SIDA) Zimbabwe revealed that responding to GBV costs about $2 billion in that country alone. That money could invested in more productive areas, such as infrastructure, business development, or education. The higher productivity that would result, from building a school rather than a jail, for instance, cannot be overemphasised. This underscores the urgent need for a paradigm shift to a more preventive approach. Although SADC generally enjoys peace, acts of conflict and related violence have been reported especially during elections and amid the widespread scramble for resources such as land water and jobs.

 

Thirteen SADC Heads of State signed a Protocol committing their countries to integrating gender firmly into their agendas, repealing and reforming all laws and changing social practices which subject women to discrimination. Linked to this is the obligation that all laws on violence against women (VAW) provide for the comprehensive testing, treatment and care of survivors of sexual offences which shall include emergency contraception, access to post exposure prophylaxis at all health facilities to reduce the risk of contracting HIV and preventing the onset of sexually transmitted infections. In line with international and continental instruments, the Protocol also commits member states during times of armed and other forms of conflict to take necessary steps to prevent and eliminate incidences of human rights abuses, especially of women and children, and ensure that the perpetrators of such abuses are brought to justice.

 

However, it is most unlikely that the target of enacting such legislative measures will be met by 2015, let alone that of halving GBV. One major shortfall in the current Protocol targets is the lack of specific indicators to measure governments' progress. Countries need to ensure that interventions designed to combat violence are based on accurate empirical data. This requires not just the compilation of accurate information, but also of indicators that make the data accessible for non-specialist decision makers and allow public scrutiny of interventions. There is a glaring policy gap in regards to the magnitude of sexual violence in conflict settings. Women in peace and security decision making are relatively few while crimes perpetrated during conflict are seldom viewed with a gender lens yet women often bear the brunt of political instability.

 

To date, 13 SADC countries have enacted laws on domestic violence and on sexual harassment. Eleven have laws on sexual assault and specific laws on human trafficking. While this is relatively commendable, a consistent pattern observed in many settings in Africa is that of robust policy formulation coupled by weak patterns of implementation, resulting in relatively weak knowledge of and use of services. It is one thing formulating and readjusting legislature and another for the legislature to effectively bring positive change in the lives of the beneficiaries. Studies undertaken in different settings globally have recorded that knowledge of VAW laws is generally low, more so among the women, the intended beneficiaries.

 

There has been a positive shift towards a victim empowerment approach with several governments and NGOs up-scaling support towards survivors of GBV. Fourteen countries now offer accessible, affordable and specialised services including legal aid to survivors of GBV. Thirteen countries offer places of safety to the survivors. However, the number of available structures in the region is outnumbered by the survivors. Places of safety and legal aid, where available, continue to be mainly offered through local NGOs. Generally governments have not committed sufficient resources towards these services.

 

Now is the time for all to take a step back and re-strategise regarding tackling GBV in the region. We need to put our heads together and work towards strengthening the post-2015 agenda as far as eliminating GBV is concerned. The existing targets need strengthening and we also need to review and add other relevant realistic targets accompanied by indicators that cover all forms of GBV including female genital mutilations and hate crimes towards the minority groups. Governments need to spearhead these efforts rather than leave it to NGOs.

 

Linda Musariri Chipatiso is Gender Link's Senior Researcher and Advocacy Officer. This Article is part of the Gender Links News Service Women's Month Special series, offering fresh views on everyday news.

 

By Linda Musariri Chipatiso

22 August 2014

Source: http://www.genderlinks.org.za/article/southern-africa-gender-violence-still-hinders-womens-freedom-2014-08-22

500 days and counting: Progress for girls and women means progress for all

August 18 marks 500 days remaining before the Millennium Development Goals expire at the end of 2015. Some countries are on track to meet those goals and some are not, and central to the difference is their relative levels of investment in women and girls.

The MDGs emerged from an historic summit of world leaders to mark the new millennium nearly 15 years ago. Since then, countries that worked to boost girls’ education, women’s rights and comprehensive maternal, sexual and reproductive health care saw benefits not just for gender equality and longer lives for women and children but in other areas as well — against poverty and hunger, against diseases including HIV and AIDS, and toward a more sustainable environment. Investment in girls and women turned out to be the most cost-effective way to advance on all the goals.

Women Deliver was organized to point out this connection. At three global conferences of activists and decision-makers from around the world — in London in 2007, in Washington, D.C. in 2010 and in Kuala Lumpur in 2013 — it provided statistics and case studies that proved the truth of its slogan, “Invest in women — it pays!” Every year brought more proof and better examples of investments in girls and women in which everybody won. So today, as the international community begins final MDG assessments and considers future plans, we are proud to announce that the next triennial Women Deliver conference will be held on May 17-19, 2016 in Copenhagen, Denmark.

Like the previous three gatherings, this one will bring together advocates, policymakers, journalists, young people, researchers and leaders of the private sector and civil society to showcase what it means and how it works when women and girls become the focus of development efforts. It will document the great results around the world where investment in women rose.

The Women Deliver 2016 Conference will also be the first major global conference after the post-2015 development framework, so far called the Sustainable Development Goals, is decided. It will be a first chance for strategizing on ways to turn the MDG spurs for growth into the plowshares of a livable planet, to make startup programs sustainable over the long term, to bring pilot programs to national scale — in short, to firm up long-term support, ensure that girls and women are kept at the center of the new development plans from the beginning, and include them in operations and evaluations at every stage into the future.

Copenhagen was chosen because Denmark is a leader and champion for progress in sexual and reproductive health and rights. The Danish International Development Agency has already launched a new Strategic Framework for Gender Equality, Rights and Diversity to assist women and girls in seizing opportunities and resources to take full control over their own lives. The Ministry of Foreign Affairs of Denmark is fully in support of Women Deliver’s call for additional global commitment on behalf of girls and women.

The post-2015 development framework is being developed as we write, and Women Deliver is working  to ensure that decision makers prioritize maternal, sexual and reproductive health and rights, especially in countries where inequality prevails and where it would help development most.

Closing the gender gap in agriculture alone, for example, could lift up to 150 million people out of hunger. Investing $8.1 billion a year in voluntary family planning would reduce pregnancy-related deaths by 79,000 and newborn deaths by 1.1 million every year. Increasing girls’ school attendance by only 10 percent raises a country’s GDP by 3 percent. And eliminating barriers to employment for girls and women could raise labor productivity in some countries by 25 percent.

These are the facts of life in the 21st century. Imagine a world where no woman dies giving life, where no baby is born with HIV, where every girl can attend school and get a quality education, and where everybody has a chance to fulfill their potential. The post-2015 process can move us closer to that day — if it prioritizes the health, rights, and well-being of girls and women.

In these last 500 days, Women Deliver will build on the momentum generated by our previous gatherings to see that it happens. We will insist that adolescents and young people, who predominate in most developing areas, should get special focus. We will make sure that women are present at the tables where decisions are made. And we will continue playing a critical role in fueling the global movement for maternal, sexual and reproductive health and rights.

We will see you all in Copenhagen!

Aug. 18, 2014, marks the 500-day milestone until the target date to achieve the Millennium Development Goals. Join Devex, in partnership with the United Nations Foundation, to raise awareness of the progress made through the MDGs and to rally to continue the momentum. Check out our Storify page and tweet us using #MDGmomentum.

By Jill Sheffield and Katja Iversen

18 August 2014

Source: https://www.devex.com/news/500-days-and-counting-progress-for-girls-and-women-means-progress-for-all-84064

The Evidence Is In: Decriminalizing Sex Work Is Critical to Public Health

During the 2014 International AIDS conference, The Lancet medical journal released a series of articles focused exclusively on HIV and sex work. One study by Kate Shannon et al., demonstrates that decriminalization of sex work could reduce HIV infections by 33 to 46 percent over the next decade. Shannon’s team showed that “multi-pronged structural and community-led interventions” are essential to promoting the human rights of sex workers, as well as improving their access to HIV prevention and treatment. Dr. Chris Beyrer, the researcher who coordinated this Lancet series, told AIDS conference participants that“[e]fforts to improve HIV prevention and treatment by and for people who sell sex can no longer be seen as peripheral to the achievement of universal access to HIV services and to eventual control of the pandemic,” drawing an irrefutable line between the social, legal, and economic injustices sex workers face and their subsequent vulnerability to HIV.

 

The Lancet series authors join many other prominent public health voices in identifying the decriminalization of sex work as vital to preventing the spread of human immunodeficiency virus (HIV) and of acquired immune deficiency syndrome (AIDS). For two decades, sex workers rights’ activists throughout the world have pushed human rights, public health, and HIV and AIDS response leaders to recognize that they, along with people who inject drugs and men who have sex with men, are “key populations” without whom an effective HIV and AIDS response is impossible. In 2012, the World Health Organization (WHO) declared that “all countries should work toward decriminalization of sex work and elimination of the unjust application of non-criminal laws and regulations against sex workers.” In South Africa (with the largest population of people living with HIV in the world), the National AIDS Council is urging its government to decriminalize sex work—a demand that advocates and health policy professionals are making in dozens of other countries as well. Amnesty International, Human Rights Watch, and the UN’s Global Commission on HIV and the Law all endorse this position. The latter points out “the impossibility of governments stigmatizing people on one hand, while simultaneously actually helping to reduce their risk of HIV transmission or exposure on the other.”

 

Sex work has been decriminalized in New Zealand and one province (New South Wales) in Australia leaving sex work businesses subject to standard occupational health and safety regulations. Law enforcement treats the sale of sex as it does any other business, without any intrusion or interruption unless existing laws are being violated.

 

Decriminalization has resulted in higher rates of condom use and enables sex workers to organize community-based health practices that demonstrably improve health and reduce HIV risk. It also makes it possible for sex workers to report and for the police to address illegal acts as they occur, such as assault, theft of services, employment of minors, or client coercion. In this decriminalized setting, sex workers can be strong allies in the fight against trafficking, intimate partner violence, and child abuse since they can report incidents to the police and social service agencies without putting themselves at risk of arrest.

 

So, why is the HIV-AIDS field only just beginning to recognize the connection between the decriminalization of sex work and HIV? And why is the trend toward criminalizing populations involved in the sex trades increasing in the United States—moving in the opposite direction from other countries? The following are three contributing factors.

 

Conflating Sex Work With Trafficking

 

Public debate around sex work in the United States increasingly focuses on people who have been trafficked or otherwise coerced into the sex trade. Anti-trafficking advocates conflate sex work (people choosing to sell sexual services from among employment options available to them) with trafficking (people being forced into the sex industry against their will). Laws that criminalize all people selling sex (voluntarily or involuntarily) violate the rights of the former and undermine efforts to identify and assist the latter. The Global Commission on HIV and the Law states unequivocally that, “Sex work and sex trafficking are not the same. The difference is that the former is consensual, whereas the latter is coercive.”

 

A commentary by Steen et al. in the recent Lancet series notes that “repressive and counterproductive police action,” including the arrest and incarceration of trafficking victims for the purposes of “rescue,” has overtaken far more effective responses in several countries. The understandable, but destructively over-simplified, mandate to “rescue and restore” sex workers is also being imposed in public health settings where providers are now charged with identifying and intervening with potential victims of trafficking in the sex trade. Certainly, health-care providers have a duty to watch for and help patients in abusive situations of all kinds. They also have a duty to understand the complexities of human experience, respond to patient-identified needs, and maintain that patients are experts of their own lives, whatever that may look like.

 

Lack of Access to Health Care for Sex Workers

 

Providing access to health-care services targeted to consumers’ needs is a vital part of any country’s HIV response. Without it, those most in need of prevention, care, and treatment are least likely to get it.

 

In a 2010 survey, 53 percent of medical students said they were not adequately trained to address their patients’ sexual issues comfortably. Far fewer professional medical curricula explicitly prepare students to understand that they will encounter sex workers as patients who, like all other patients, are individuals with a wide range of experiences, backgrounds, and needs that can best be treated with patient-centered care.

 

When sex workers receive demeaning and unprofessional treatment in health-care settings, they see health-care providers as an extension of the larger system that criminalizes them. A survey by the New York City-based Persist Health Project found that few sex workers disclosed their occupation to their health-care provider; only one study participant reported a positive experience after doing so. As one respondent explained, “I think for security reasons, I don’t usually disclose. Mainly because I don’t trust doctors … I sort of treat them like law enforcement.” Another noted that most health-care providers “have no clue who you are, no clue about your background, you can’t read them or know that they’re not going to try to lecture you or give you a stink-eye.”

 

St. James Infirmary, a peer-based occupational safety and health clinic for sex workers in San Francisco, corroborates these findings. Of their incoming patients, 70 percent had never previously disclosed their occupation to a medical provider for feared of bad treatment. Providing sex-worker friendly health care requires training health-care workers appropriately and supporting services designed specifically with and for the communities they serve.

 

Violence Risk Exacerbated by Criminalization

 

People usually envision a sex worker as someone soliciting on the street, but only about 20 percent of U.S. sex workers are street-based. The vast majority see clients in other venues including massage parlors, brothels, apartments they share with other sex workers, or a client’s hotel room. Many connect with clients online.

 

HIV risk is high among street-based sex workers who experience high levels of violence at the hands of clients and abusive law enforcement personnel. One important way they reduce this risk is assessing a potential client before getting into his car—looking for signals that he might be violent and relaying his license number to a colleague in case the worker disappears. This assessment time is also used to negotiate price and condom use. Law enforcement crack-downs compel sex workers to complete their negotiations quickly (in order to avoid arrest), depriving them of the time needed for assessment and negotiation.

 

Street-based sex workers have little or no protection if a client becomes violent or refuses to use a condom. Of the street-based workers surveyed in The Lancet study by Shannon et al., 25 percent reported being pressured by clients to have sex without a condom. Those working in remote areas (such as industrial parks) to escape local policing were three times more likely to report being pressured into having sex without a condom than the study population overall. The recent Lancet series data also shows that, in some countries, up to one-third of sex workers do not carry an adequate supply of condoms due to “condoms as evidence” policies that allow police to seize a sex worker’s condom supply and use it as evidence of their intent to engaged in sex work—a widely-used policy in several U.S. cities. 

 

Getting From Here to There 

 

Punitive laws against sex work are in place in 116 countries, including the United States, creating, according to the Open Society Foundations, “a state-sanctioned culture of stigma, discrimination, exploitation, and police and client violence against sex workers.”

 

Decriminalizing sex work in the United States is a long and challenging process, but there is a path to follow. The 1988 ban on federal funding for syringe exchange remained in place for 20 years and, after briefly lifting it in 2009, the Obama administration agreed to its reinstatement in 2011 at Congress’ insistence. Advocacy pressure to overturn it continues.

 

Thanks to the efforts of dedicated researchers and activists during the two decades between 1988-2009, public health professionals, medical institutions and virtually everyone working in the HIV-AIDS field learned why harm reduction practices are essential. Services to people who use drugs began to improve, although they are still inadequate, primarily because they are grossly under-funded. Progress has been made.

 

The U.S. National Institutes of Health (NIH) issued a consensus statement that addressed the need for syringe exchange but also observed that “[p]rograms targeting sex workers have been highly efficacious in other countries, but [in the U.S., programs] will encounter cultural and political barriers.” The public silence maintained on this issue for the last 17 years is emblematic of those barriers.

 

But sex workers’ rights organizations in most U.S. cities, though heavily marginalized, have not been silent. They are struggling to end “condoms as evidence” practices, train health-care providers, find or establish sex worker-friendly health-care services, and demand their rightful place as invaluable allies in ending human trafficking and preventing the spread of HIV. Like the harm reductionists who set up the first syringe exchange sites in the United States, they need the support of mainstream sexual and reproductive health advocates willing to learn from them and join them. Like the early harm reductionists, they need the rest of us to bring our money, skills, and political support this human rights struggle.

 

We can’t stop HIV in the United States without sustainable and long-term solutions to end the arrest, detention, and incarceration of sex workers in the United States, as well as end the violations against sex workers within the correctional system. A meta-analysis of more than 800 other studies and reports, published in the recent Lancet series, listed abuse experienced by sex workers as including “homicide; physical and sexual violence, from law enforcement, clients, and intimate partners; unlawful arrest and detention; discrimination in accessing health services; and forced HIV testing.” It added “protection of sex workers is essential to respect, protect, and meet their human rights, and to improve their health and well-being.”

 

Expert voices in support of community-led, sex worker-centered health care in the fight against HIV are becoming more and more numerous. When will the mainstream HIV and AIDS organizations and women’s health advocacy communities join loudly in this demand?

 

by Anna Forbes and Sarah Elspeth Patterson

13 August 2014

Source: http://rhrealitycheck.org/article/2014/08/13/evidence-decriminalizing-sex-work-critical-public-health/

Fears that schoolgirls kidnapped by Boko Haram are being used as suicide bombers after ten-year-old girl wearing explosives is rescued by police

About 250 schoolgirls were kidnapped in April by members of the militant group Boko Haram

Fears have been raised that the schoolgirls kidnapped by Boko Haram militants earlier this year are being used as suicide bombers.

 

The speculation has arisen after a number of female suicide bombings in Nigeria's biggest city of Kano, while a ten-year-old girl wearing explosives was also discovered in Katsina state.

 

The latest attack came on Wednesday when a female suicide bomber blew herself up at a college in Kano, killing six people. According to reports, the bomber was a female teenager.

 

It was the fourth suicide bombing carried out by a female in the city in the past week.

 

There was no immediate claim of responsibility, although militant group Boko Haram, which is fighting for an Islamic state in religiously-mixed Nigeria, has repeatedly bombed Kano as it radiates attacks outwards from its northeast heartlands.

 

Government spokesman Mike Omeria said security forces arrested three Boko Haram suspects in Katsina state, two of them female, on Tuesday.

 

One was a 10-year-old girl who had an explosive belt strapped to her by the others, he said.

 

Using female suicide bombers in the city appears to be a new tactic of Boko Haram, although they have used them on occasion for years in the northeast.

 

Two female suicide bombers blew themselves up at a trade show and a petrol station in Kano on Monday, killing one other person and injuring at least six others.

 

On Sunday, a female suicide bomber killed herself but no one else while trying to target police officers.

 

Concerns have now been raised the militant group is using the schoolgirls kidnapped earlier this year in Chibok in the suicide bombings.

 

Former education minister Oby Ezekwesili has warned the kidnapped girls may be 'indoctrinated or coerced into being used as suicide bombers', according to the International Business Times.

 

On Sunday Ms Ezekwesili tweeted: 'This new trend&serial pattern of "FEMALE SUICIDE BOMBERS" surely should PARTICULARLY worry us. It worries me stiff cos of our #ChibokGirls.'

 

The following day she wrote: 'Kano again and again. Female suicide bombers again and again – becoming trend. Our #ChibokGirls still in the enemy den. Are we THINKING?'

 

Meanwhile, the Human Rights Writers Association of Nigeria has urged the government to investigate the identity of the suicide bombers, the International Business Times reported.

 

In a statement, it said: 'In the event that these female suicide bombers are identified to have been the same kidnapped girls then the government should immediately deploy all resources and strategies to bring to an end, once and for all, this shameful scenario since the military have repeatedly stated that they are aware of the whereabouts of the kidnapped Chibok girls.'

 

In a separate incident on Tuesday, two suicide bombers killed 13 people in attacks on two mosques in the town of Potiskum, in Yobe state in the northeast, medical official Bala Afuwa, who received the bodies at a local hospital, told Reuters by telephone on Wednesday.

 

'Two of my uncles were killed,' said resident Mohammed Abubakar, whose family home is next to one of the mosques that were attacked. 'They had just returned from the mosque.'

 

President Goodluck Jonathan, who has come under heavy criticism for failing to end the five-year-old rebellion, pledged $500 million on Wednesday towards Nigerians living in states that are worst affected by Boko Haram violence.

 

Earlier this month kidnapped Nigerian schoolgirls who managed to escape from their Islamic extremist captors were reunited with the president.

 

He heard tales from some of the 57 who escaped after their abduction on April 15 before assuring them of his determination that those still in captivity ‘are brought out alive’.

 

Around 57 students managed to flee shortly after they were captured, but a committee investigating their disappearance said 219 of the girls are still missing.

 

According to a mediator working with Boko Haram two of the girls have died of snake bites while around 20 have fallen ill.

 

Boko Haram is demanding a swap for detained fighters in exchange for the girls.

 

Most of the schoolgirls are still believed to be held in the Sambisa Forest – a wildlife reserve that includes a mixture of thick jungle and open savannah.

 

The forest borders on sand dunes marking the edge of the Sahara Desert.

 

Sightings of the girls and their captors have been reported in neighboring Cameroon and Chad.

 

Chibok and nearby villages are targets because they are enclaves of staunch Christians in predominantly Muslim north Nigeria.

 

By James Rush

1 August 2014

Source: http://www.dailymail.co.uk/news/article-2713322/Fears-schoolgirls-kidnapped-Boko-Haram-used-suicide-bombers-ten-year-old-girl-wearing-explosives-rescued-police.html#ixzz39Vdj9GZn 

Poverty, child, maternal deaths high in India: UN report.

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United Nations: India continues to battle poverty, child and maternal deaths, according to a United Nations report on the Millennium Development Goals that said while several key global targets have been met, more sustained effort is needed to cover disparities by the 2015 deadline.

The 'Millennium Development Goals Report 2014', launched by UN Secretary-General Ban Ki-moon here yesterday, said many global MDG targets on reducing poverty, increasing access to improved drinking water sources, improving the lives of slum dwellers and achieving gender parity in primary schools have already been met.

Many more goals are within reach by their 2015 target date, the report said, adding that if current trends continue, the world will surpass MDG targets on malaria, tuberculosis and access to HIV treatment.

The report is the most up-to-date "global scorecard" on efforts to achieve the eight mostly anti-poverty goals agreed by world leaders at a UN summit in 2000.

It, however, said that some MDG targets related to largely preventable problems with available solutions, such as reducing child and maternal mortality and increasing access to sanitation, are slipping away from achievement by 2015, despite major progress.

"We know that achievements have been uneven between goals, among and within regions and countries, and between population groups," Ban said, adding that unless imbalances are addressed through bolder and more focused interventions, some targets will not be met, including in key areas such as childbirth, maternal mortality, universal education, and environmental sustainability.

The overwhelming majority of people living on less than 1.25 dollars a day belong to Southern Asia and sub-Saharan Africa, with one third of the world's 1.2 billion extreme poor living in India alone in 2010.

While Southern Asia has made "strong and steady" progress in reducing child deaths by more than halving its under-five mortality rate, yet nearly one in every three deaths still takes place in the region.India also had the highest number of under-five deaths in the world in 2012, with 1.4 million children dying before reaching their fifth birthday.

Despite progress in all world regions, the maternal mortality ratio in developing regions ? 230 maternal deaths per 1,00,000 live births in 2013 ? was 14 times higher than that of developed regions, which recorded only 16 maternal deaths per 1,00,000 live births in 2013.

Highlighting the extreme differences in maternal mortality among countries, the report said that almost one-third of all global maternal deaths are concentrated in the two populous countries – India and Nigeria.

India has an estimated 50,000 maternal deaths (17 per cent) while Nigeria has an estimated 40,000 maternal deaths (14 per cent).

The report further stated that despite a large increase in sanitation coverage, with an additional two billion people gaining access to an improved sanitation facility, it seems unlikely that the MDG target of 75 per cent coverage will be met by 2015.

"In 2012, a billion people still resorted to open defecation, a practice that needs to be brought to an end, as it poses a huge risk to communities that are often poor and vulnerable already," the report added.

"Open defecation is most prevalent in Southern Asia, Oceania and sub-Saharan Africa. The vast majority ? 82 per cent ? of people practicing open defecation now live in middle-income, populous countries, such as India and Nigeria," it said, adding that nearly 60 per cent of the one billion people practicing open defecation live in India.

With the 2015 deadline for achieving the landmark goals less that 550 days away, the report said many of MDGs have been met or are within reach. Among the targets that have been met is that the world has reduced extreme poverty by half.

In 1990, almost half of the population in developing regions lived on less than 1.25 dollars a day. This rate dropped to 22 per cent by 2010, reducing the number of people living in extreme poverty by 700 million.

Efforts in the fight against malaria and tuberculosis have shown results with an estimated 3.3 million deaths from malaria being averted between 2000 and 2012 due to the substantial expansion of malaria interventions.

The intensive efforts to fight tuberculosis have saved an estimated 22 million lives worldwide since 1995.

"If the trends continue, the world will reach the MDG targets on malaria and tuberculosis," it said.

Access to an improved drinking water source became a reality for 2.3 billion people and the target of halving the proportion of people without access to an improved drinking water source was achieved in 2010, five years ahead of schedule.

In 2012, 89 per cent of the world's population had access to an improved source, up from 76 per cent in 1990.

Hunger also continues to decline, but immediate additional efforts are needed to reach the MDG target, the report said.

The proportion of undernourished people in developing regions decreased from 24 per cent in 1990?1992 to 14 per cent in 2011?2013. However, progress has slowed down in the past decade.

"Meeting the target of halving the percentage of people suffering from hunger by 2015 will require immediate additional effort, especially in countries which have made little headway, the report added.

Launching the final push towards the United Nations targets, Ban appealed to member states that the global post-2015 objective must be to "leave no one behind".

Ban said the world is "at a historic juncture, with several milestones before us."

Citing gains made in the fight against malaria and tuberculosis and access to HIV treatment, Ban underscored that the report makes clear "the MDGs have helped unite, inspire and transform…And the combined action of Governments, the international community civil society and the private sector can make a difference."

"Our efforts to achieve the MDGs are critical to building a solid foundation for development beyond 2015. At the same time, we must aim for a strong successor framework to attend to unfinished business and address areas not covered by the eight MDGs," said the UN chief.  

PTI

 

First Published: Tuesday, July 08, 2014, 08:44

Source: http://zeenews.india.com/news/health/health-news/poverty-child-maternal-deaths-high-in-india-un-report_28670.html

World leaders review progress on Maternal health

PMNCH-Forum_2014_PMNCH

Prime Minister Erna Solberg of Norway, Co-chair of the MDG Advocates Group, and Graça Machel, Chair of The Partnership for Maternal, Newborn & Child Health (PMNCH), joined world leaders and the reproductive, maternal, newborn and child health (RMNCH) community to review progress toward achieving the  Millennium Development Goals focused on women and children’s health, and to identify targets for healthy women and children for the post-2015 sustainable development agenda.

 

The high-level panel of the MDG Advocates—a group of eminent personalities working to focus attention on the need to deliver on the vision for the Millennium Development Goals (MDGs) and to end poverty by 2030—met in Johannesburg at the 2014 PMNCH Partners’ Forum, cohosted by the Government of South Africa, PMNCH, Countdown to 2015, A Promise Renewed, and the independent Expert Review Group.  The Panel discussed several new reports released at the Forum, including the Countdown to 2015 report for 2014, which tracks progress in the  75 countries that account for the vast majority of maternal and child deaths, and the Success Factors for Women’s and Children’s Health report, which analyzes 10 countries that have made rapid progress toward the MDGs.

 

“Globally, we have made good progress on the MDGs,” said Prime Minister Solberg. “But more can and must be done. With fewer than 550 days until the Millennium Development Goals deadline, time is of the essence to scale up our efforts on behalf of women, children and adolescents.”

 

The leaders called for the new sustainable development agenda to be rights-based, equity focused and to place healthy women, children and adolescents at its core.  Leaders called for the new framework, which will be debated by the UN General Assembly in September, to focus on ending preventable maternal, newborn and child mortality, and to  ensure sexual and reproductive rights, including universal access to quality sexual and reproductive services.

 

Since 1990, both maternal and child mortality have halved and 50 million more children go to school each year. But many challenges remain and further rapid progress on health outcomes will require addressing the multiple determinants of health. For instance, every year 14 million girls are forced into marriage, and in many countries, women and girls still do not have access to adequate education.

 

“Across the world, the rights of women and girls continue to be grossly violated. The burden of poverty on women is ever present.” said Graça Machel.  “Every woman should have access to resources and gain space to assert her aspirations. Nobody should die in child birth. All girls should go to school with their brothers and master the tools for a productive life. ”

 

The Panel also previewed the PMNCH Partners’ Forum Communiqué, which will focus on working across sectors—including education, infrastructure, and economic development—to ensure a comprehensive, broad-based approach to improving women’s and children’s health. The Communique, which was endorsed by the MDG Advocates, called for this comprehensive response to be enshrined in specific new global development goals.

 

“We proved that Innovative Financing can help us to reach the MDGs” said Philippe Douste-Blazy, United Nations Special Advisor on Innovative Financing for Development. “New partners are uniting in South Africa to commit energy and resources towards innovation and saving lives.”

 

Dr. Carole Presern, Executive Director of PMNCH,  said, “Today, we leave with renewed energy to make sure that women, newborns, children and adolescents do not die from easily preventable causes; that sexual and reproductive health and rights are respected and that everyone, everywhere should be able to look forward to a healthy, happy and productive life..”

 

Source: http://www.spyghana.com/world-leaders-review-progress-maternal-health/

International leaders and public health experts call for women and children to be at the centre of the post-2015 development agenda

More than 800 leaders and public health experts from around the world opened a landmark two-day meeting in Johannesburg to review new data and call for accelerated action to improve maternal, newborn and child health. The Partnership for Maternal, Newborn & Child Health (PMNCH) 2014 Partners' Forum was opened by Graça Machel, Chair of PMNCH and African Ambassador for Committing to Child Survival: A Promise Renewed, who is making her first public appearance since the end of her mourning period after the death of her husband, Nelson Mandela.

"The world has made remarkable progress to improve health and expand opportunities over the past 14 years. Despite all efforts, there is still much more to be done," said Graça Machel. "Women and children have not been covered adequately. We must ensure that all women, adolescent girls, children and newborns, no matter where they live, are able to fulfill their rights to health and education, and realize their full potential."

In support of the UN Secretary-General's Every Woman Every Child movement, the Partners' Forum builds on two months of high-level meetings in Toronto, Prague, and Washington, DC, where global leaders and health experts met to discuss strategies to promote the health of women and children. At this Forum, leaders discussed steps to assist countries that have lagged behind in efforts to improve reproductive, maternal, newborn and child health, and made specific recommendations for how to maintain the focus on women and children within the post-2015 development agenda. Notably, participants also pledged their financial and policy support and a range of new resources to support the implementation of the new Every Newborn action plan (ENAP), a roadmap to improve newborn health and prevent stillbirths by 2035.

"We are privileged as a country to host this important meeting about the urgent need to improve women's and children's health. This global gathering gives us the opportunity to learn from each other's successes and challenges, and to identify new approaches," said Dr. Aaron Motsoaledi, South African Health Minister. The Government of South Africa is a Forum co-host, together with PMNCH, Countdown to 2015, A Promise Renewed and the independent Expert Review Group.

Despite improvements, 289,000 women still die every year from complications at birth and 6.6 million children do not live to see their fifth birthday, including nearly 3 million newborns. At least 200 million women and girls are unable to access family planning services that would allow them to control when they have children.

The world has been especially slow in improving health outcomes for newborns. Globally, each year, 2.9 million newborns (first 28 days of life) die and 2.6 million are stillborn (die in the last three months of pregnancy or during childbirth). Recent data published in The Lancet Every Newborn Series indicate that 15,000 babies are born and die every day without ever receiving a birth or death certificate. The accompanying analysis found that 3 million maternal and newborn deaths and stillbirths in 75 high burden countries could be prevented each year with proven interventions that can be implemented for an annual cost of only US$1.15 per person.

Responding to this crisis, partners at the Forum launched the ENAP, endorsed by the World Health Assembly in May 2014. The action plan is based on concrete evidence to further reduce preventable newborn deaths and stillbirths. Signalling their support for the full and prompt implementation of the plan, Forum attendees announced 40 new commitments. These commitments are in support of the UN Secretary-General's Every Woman Every Child movement and come from a diverse group of stakeholders, including governments, civil society organizations and the private sector.

"There is absolutely no reason for so many newborns to die every year when their lives can be saved with simple, cost-effective solutions," said Dr. Flavia Bustreo, Assistant Director-General for Family, Women's and Community Health at the World Health Organization. "The WHO remains committed to support countries and work with partners as the plan gets implemented, and to the accountability agenda, which includes reporting on progress achieved every year until 2030."

New data is critical to inform discussions about changing this reality. Today, partners at the Forum released the Countdown to 2015 Report for 2014, which presents the latest assessment of progress in the 75 countries that account for 95 percent of all maternal and child deaths each year. The report finds that in several countries, more than half of the mothers and children in the poorest 20 percent of the population still receive two or fewer of the eight interventions deemed essential for preventing or treating common causes of maternal and child death, including vaccinations, skilled birth attendance, pneumonia and diarrhea treatment, and access to family planning. The analysis shows that, in these 75 countries, a median of 39 percent of deaths of children under age five occur during the first month of life, underscoring a need for improved access to quality skilled delivery care for mother and baby around the time of birth, when most stillbirths and maternal and newborn deaths occur.

"We have affordable interventions that we know work. There's no excuse for not bringing them to the women and children who need them," said Dr. Mickey Chopra, Chief of Health at UNICEF and co-Chair of Countdown to 2015. "The health and well-being of our next generation, and the right of millions of children to live happy, productive lives, is at stake."

One other report was also launched at the 2014 PMNCH Partners' Forum: Success Factors for Women's and Children's Health Report spotlights 10 "fast track" countries making considerable progress in reducing maternal and child deaths, showing that rapid progress is possible despite significant social and economic challenges. The report showed the benefits of investing in high-impact interventions such as skilled care at birth, immunization, and family planning.

Delegates at the Forum emphasized the importance of ensuring that future efforts focus on countries that are making slow progress, and on poor and marginalized populations, including newborns and adolescents. Delegates also urged political leaders to work across different sectors—including education, skills and employment, water supply and sanitation, nutrition, energy, roads, and women's empowerment—to ensure an integrated approach to improving the health of women and children.

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PMNCH

The Partnership for Maternal, Newborn & Child Health (PMNCH) is a partnership of 625 organizations from across seven constituencies: governments, multilateral organizations, donors and foundations, nongovernmental organizations, healthcare professional associations, academic, research and training institutions, and the private sector. Hosted by the World Health Organization and launched in 2005, the vision of the Partnership is the achievement of the Millennium Development Goals, with women and children enabled to realize their right to the highest attainable standard of health in the years to 2015 and beyond.

Government of South Africa

The Government of South Africa recognizes that success in achieving better health outcomes as a country depends on partners' collective ability to build relationships and work across sectors. We are highly committed to improving the lives of women and children, and the reduction of maternal and child mortality remains a critical area of focus in South Africa. In 2012, South Africa launched the Campaign on the Accelerated Reduction of Maternal and Child Mortality in Africa (CARMMA) strategy, setting goals of reducing maternal and neonatal mortality by more than half between 2013/2014 and 2018/19.

Countdown to 2015

Countdown to 2015 is a global movement to track, stimulate and support country progress towards the health-related Millennium Development Goals, particularly goals 4 (reduce child mortality) and 5 (improve maternal health). Established in 2003, Countdown is supra-institutional and includes academics, governments, international agencies, professional associations, donors, nongovernmental organizations and other members of civil society, with The Lancet as a key partner. The Countdown Secretariat is hosted by the Partnership for Maternal, Newborn & Child Health. Countdown focuses specifically on tracking coverage of a set of evidence-based interventions proven to reduce maternal, newborn and child mortality in the 75 countries where more than 95% of maternal and child deaths occur. Countdown produces periodic publications, reports and other materials on key aspects of reproductive, maternal, newborn and child health, using data to hold stakeholders to account for global and national action. At the core of Countdown reporting are country profiles that present current evidence to assess country progress in improving reproductive, maternal, newborn and child health.

A Promise Renewed

Committing to Child Survival: A Promise Renewed is a global movement to end preventable child deaths. Under the leadership of participating governments and in support of the United Nations Secretary-General's Every Woman Every Child strategy, A Promise Renewed brings together public, private and civil society actors committed to advocacy and action for maternal, newborn and child survival. A Promise Renewed emerged from the Child Survival Call to Action, convened in June 2012 by the Governments of Ethiopia, India and the United States, in collaboration with UNICEF. The more than 700 government, civil society and private sector participants who gathered for the Call to Action reaffirmed their shared commitment to scale up progress on child survival, building on the success of the many partnerships, initiatives and interventions that currently exist within and beyond the field of health. A Promise Renewed is represented on the Forum steering committee by USAID and UNICEF.

Independent Expert Review Group (iERG)

The UN Commission on Information and Accountability for Women's and Children's Health was established by WHO at the request of the United Nations Secretary-General to accelerate progress on the Global Strategy for Women's and Children's Health. Starting in 2012 and ending in 2015, the iERG is reporting regularly to the United Nations Secretary-General on the results and resources related to the Global Strategy and on progress in implementing this Commission's recommendations.

30 June 2014

By All Africa

Source: http://allafrica.com/stories/201406300590.html?viewall=1

Invest in Adolescents and Young People for a Better Future

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The Partnership for Maternal, Newborn and Child Health (PMNCH) Partners’ Forum begins on June 30th in South Africa. The annual conference brings together global partners in the maternal, newborn, and child health communities to discuss trends, challenges, and opportunities in ensuring the wellbeing and empowerment of the world's children and women. With the Millennium Development Goals set to expire in 2015, this year’s conference will have a particular focus on envisioning the post-2015 development framework. Ahead of the event, Women Deliver launched a new infographic and co-hosted a Google+ Hangout with Girls’ Globe and young leaders to reignite a conversation about the importance of investing in the health and rights of adolescents and young people.

The new infographic brings attention to the current global status of today’s youth. It highlights the barriers that young people, particularly young women, face in fully realizing their rights and makes the case for meaningful youth participation in the development processes. The infographic joins six others in a series, all devoted to a variety of girls’ and women’s health and rights issues.

The Google+ Hangout was moderated by Julia Wiklander from Girls’ Globe and Women Deliver Young Leader Yemurai Nyoni from Zimbabwe and Kelly Thompson from the International Federation of Medical Students’ Associations, among others, joined the discussion. Participants shared their perspectives on why governments must recognize the human rights, including the sexual and reproductive rights, of young people, as well as include youth voices in the design and implementation of programs that affect their lives.

View the infographic here.

Source: http://www.womendeliver.org/updates/entry/invest-in-adolescents-and-young-people-for-a-better-future

 

SA making progress in reducing maternal mortality

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05-6-2014

 

Pretoria – The Department of Health has welcomed findings that South Africa is one of the 16 sub-Saharan countries that stand a chance of meeting the Millennium Development Goal (MDG) on maternal mortality by 2015.

According to the findings of the study undertaken by the University of Cape Town’s Hatter Institute for Cardiovascular Research in Africa, in conjunction with the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, the number of maternal deaths has dropped from about 376 000 in 1990 to about 293 000 in 2013.

Maternal mortality in the country has dropped by almost 7% a year over the past decade – at 171.4 maternal deaths per 100 000 live births.

The study showed that 30 countries had annual reductions in the Maternal Mortality Rate (MMR) of MDG 5 pace or better from 2003 to 2013.

“Eight of which were in sub-Saharan Africa (Botswana, Burundi, Kenya, Malawi, Namibia, Rwanda, South Africa, and Swaziland) and 10 in central and eastern Europe (Albania, Belarus, Bosnia and Herzegovina, Bulgaria, Estonia, Latvia, Lithuania, Poland, Romania, and Russia,” according to the findings.

However, the study noted that despite reductions in the number of maternal deaths, only 16 countries, seven of which are developing countries, are expected to achieve the MDG 5 target of a 75% reduction in the MMR by 2015.

Speaking to the GCIS Radio Bulletin, health spokesperson Joe Maila stressed the need to work very hard to make sure that the numbers decline even further.

“The numbers that are there right now are not as good and we want them to be less than what it is. We need to make sure that we work very hard to make sure that it indeed declines further.

“If we work together with all the people involved, one of the things we can do is to make sure that mothers – as soon as they are pregnant – come to our facilities within 14 weeks. That (way), we would be able to know what is it that we can do to make sure that we restore their health,” said Maila.

The findings were part of a study into maternal mortality across the globe over the past two decades. The study aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery.

MDG 5 established the goal of a 75% reduction in the number of maternal deaths per 100 000 live births between 1990 and 2015.

According to the 20 Year Review released by The Presidency in February, life expectancy in the country has increased from 52.7 years in 2002 to 59.6 years in 2013. The Infant Mortality Rate has decreased from 63.5 deaths per 1 000 live births in 2002, to 41.7 deaths per live births in 2013.

The under-five mortality rate has also decreased from 92.9 deaths per 1 000 live births in 2002 to 56.6 deaths per 1 000 live births in 2013. Severe malnutrition among children has decreased from 88 971 in 2001 to 23 521 in 2011. –SAnews.gov.za

Source: http://www.sanews.gov.za/south-africa/sa-making-progress-reducing-maternal-mortality

 

Maternal and Child Health in Kenya

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Why Are Women Dying to Give Life and Children Not Surviving to Experience Childhood?

A recent article Changing Lives, One Woman at a Time: Maternal Heath in Kenya by Siddharth Chatterjee, the United Nations Population Fund (UNFPA) Representative to Kenya and Dr. Abbas Gullet the SG of the Kenyan Red Cross (KRCS) concluded with the words: "no woman should die giving life."

Kenya is a country of incredible contradictions. As the richest country in East Africa,with $840 income per capita, Kenya is the closest to meeting the international middle -income threshold of $1,000. This is a significant rite of passage, but that annual income is still less than $3 per day. The peaceful elections in 2013 and reforms enhancing security and governance have renewed investor confidence-economic growth, estimated at 4.9 percent in 2013 and expected to increase to 5.7 percent in 2014.

Much progress has been made in approaching some of the Millennium Development Goals — examples include Kenya's poverty rate, which has declined from 56 percent in 2000 to 42 percent in 2009 (still a grotesque number). Primary school enrollment reached 84 percent in 2008-2011 (although we must remember this statistic does not account for quality of education, gender inequities in enrollments and secondary school outcomes). Certain health indicators have shown improvement — immunization coverage rates in 201 ranged from 73 percent (newborn tetanus) to 93 percent (MCV) and use of improved drinking water sources reached almost 61 percent (82.7 percent in urban areas).

Yet this nation, which is hurtling towards "development," boasts some of the worst outcomes for maternal and child health in Africa and the world. In 2010, 360 women died out of every 100,000 live births, ranking Kenya 51st on the list of the 75 countries where more than 95 percent of all maternal and child deaths occur. This represents a negligible improvement from 1990 during which 400 women died out of 100,000 live births (and a far cry from the MDG goal of a 75 percent reduction between 1990 and 2015). According to Save the Children's 15th Annual State of the World's Mother Report, Kenya moved 13 places up in world rankings last year but still holds the shameful 143rd place out of 178 countries that report maternal deaths.

For children under five, mortality in Kenya is a much happier story, but not quite happy enough. Mortality decreased from 98.2 children per 1,000 live births in 1990 to 72.9 in 2012. On an absolute basis, Kenya is significantly off track of the MDG goal of a 75 percent reduction by 2015 but recently has seen a fall of more than 8 percent a year, almost twice the MDG rate and enough to halve child mortality in a decade. Still, "each day 15 women and 290 children die as a result of pregnancy complications — including giving birth, HIV and several curable and preventable childhood diseases." Kenya ranked 33rd globally in under-5 deaths (with approximately 35 percent of all neonatal deaths due to severe infections, followed by asphyxia, preterm births and congenital anomalies). Two-thirds of under-5 deaths are post-natal and leading causes include pneumonia and diarrhea. Over 34,000 stillbirths occur a year and 1/3 of children under-5 are stunted, a sign of chronic malnutrition.

Gabriel Demombynes (World Bank Nairobi office) attributes Kenya's success in cutting the rate of infant mortality (deaths of children under one year old) more than any other country to the relatively healthy economy, a functioning democracy and the increased use of treated bed nets from 8 percent of all households in 2003 to 60 percent in 2008. Using figures on the geographical variation of malaria, he calculated that half the overall drop in Kenya's infant mortality can by explained by the huge rise in the use of ITNs in areas where malaria is endemic.

So what is behind this painstakingly slow progress on maternal health in Kenya, especially in light of the enlightened approach to many development issues, including infant mortality? Clearly abject poverty as alluded to above is an overwhelming issue especially in rural areas. With 42 percent of the country still living below the poverty line, access to adequate health care is more than a challenge. Maternal morbidity and mortality in Kenya results from the interplay of social, cultural, economic and logistical barriers, coupled with a high fertility rate (3.76 children born per woman as per World Bank) and inadequate and under-funded health services ($17 US per capita in 2012 according to WHO data). Inadequate water supply, sanitation and hygiene resulting in WASH related illness is the reason for over 50 percent of the hospital visits in Kenya. According to the Kenya AIDS Indicator Survey released by the government in 2009, approximately 1.33 million adults were infected with HIV and many more unaware of the illness. A disproportionate number of those infected by HIV were women (8.7 percent vs 5.6 percent for men), contributing to negative health outcomes.

Tens of thousands of Kenyan women and girls in Kenya suffer from obstetric fistula, a childbirth injury causing leakage of urine and feces, a direct result of inadequate health services. While approximately 92 percent of women giving birth received some antenatal care in 2010 only 47 percent had the recommended 4 or more visits and 56 percent of Kenyan women deliver their babies at home (more in rural areas). Only 44 percent of births were assisted by health care professionals, well below the target of 90 percent of deliveries by 2015, and these rates of antenatal care and skilled birth attendance have declined over the past 10 years, particularly among the poor. Traditional birth attendants assist with 28 percent of births, relatives and friends with 21 percent and in 7 percent of births, mothers receive no assistance at all.

Together with income, education also plays a major role in determining maternal health outcomes, including fertility rates, access to family planning and antenatal coverage. Women with higher education are much more likely to receive antenatal care from a medical doctor than are those with no education (36 vs 21 percent) and clearly the higher the wealth quintile, the more likely a woman is to get antenatal care from a doctor. Although the Constitution of 2010 permits abortions to protect the life or health of a mother, women in Kenya continue to turn to unsafe procedures by unskilled practitioners en masse, due to lack of awareness of the law, stigmas against abortion, resistance from health workers and fear of prosecution by police.

Kenya would do well by drawing lessons and inspiration from success stories in other countries. Today, more than ever, actors at all levels, from large government bodies to small local non-governmental organizations (NGOs) are innovating programs that can directly impact maternal and reproductive health, thereby bringing the MDGs into the reach of many poor and underserved communities. Successful programs in countries like Ethiopia, India and Bangladesh have focused on two key facts; one, often the poorest women who are in dire need of health care live in hard-to-reach rural areas and two, mobile phone technology has expanded at a rapid pace in developing countries.

Since 2000, Ethiopia has reduced the risk of maternal death by nearly two-thirds (from 1 in 24 to 1 in 67). The country's Health Extension Programme created access to preventive services as well as high impact curative interventions at the community level. The deployment of more than 38,000 health extension workers bridged the gap between the community and hospitals, In addition, the Ethiopian government built 3,525 health centers and 16,048 posts to increase access to essential services to communities across the country.

Saadhan in India is a helpline that poor customers can call to access information regarding reproductive health. The service is supplemented by Community Health Workers who can then make house calls, provide information on contraception and refer patients to doctors.

The Indian government's 'Boat Clinics' are aimed at reaching geographically isolated communities in the north-eastern state of Assam. Boats carrying doctors, nurses, lab technicians and pharmacists make regular visits by boat and work with local community health workers to provide mothers and children with necessary services like routine immunization of children 0-5 years and pregnant mothers, vitamin A supplementation, general health check-ups and provision of family planning information and education.

In Bangladesh, the Demand Side Financing Pilot Program provides subsidies and vouchers to pregnant women so they can cover travel costs for regular antenatal health check-ups, deliver their children in hospitals or community health centres and to pay for medication. A similar program also exists in Cambodia.

In Kerala, a study from the International Center for Research on Women revealed that strengthening women's land rights reduces women's risks of HIV, protects women from poverty and sexual violence, and promotes child nutrition and schooling

Lessons from these parts of the world also show cash subsidies, conditional cash transfers and vouchers are all effective tools to aid poor mothers in accessing much-needed maternal health services.

Social workers and policy analysts from developing countries are now extolling the virtues of public-private partnerships (PPP) with regard to maternal and reproductive health care. PPPs combine the reach and muscle of large governmental bodies with the flexibility and ground-level reality understanding of smaller, private institutions.

For example, in Zambia, Merck for Mothers took the step of asking mothers in poor communities about their experiences and what was lacking. This type of 'market research' enabled them to tailor their services to fit the community in question.

Kenya's challenge is now two-fold. It must expand access and information regarding health care and it must make maternal health care affordable. The commitment to the cause already exists in Kenya. What is needed now is smart and decisive action.

The First Lady of Kenya, Margaret Kenyatta launched launched the Beyond Zero campaign on January 24, 2013 to accelerate the implementation of the national plan towards the elimination of new HIV infections among children. This is an appropriate starting point to address the deep and complex factors that have resulted in Kenya's dismal maternal mortality rates.

UNFPA and Kenyan Red Cross in concert with the Kenyan government have an opportunity here to transplant and adapt these lessons from other developing countries in order to implement them in a Kenyan context. From there, successful examples could also be exported to other sub-Saharan African countries, making Kenya a true leader in the continent and an incubator for innovative social policy.

Indeed, "no woman should die giving life," anywhere in the world.

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Dr. Annie Sparrow, a paediatrician and public health expert, is an Assistant Professor of Global Health and Deputy Director of the Human Rights Program at Icahn School of Medicine at Mount Sinai in New York City.

 

Source: http://www.huffingtonpost.com/anniesparrow/maternal-and-child-health_1_b_5454692.html