Pakistan Initiative for Mothers and Newborns (PAIMAN)

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Health centre births key to reducing maternal deaths

LONDON, Sept 28 (Reuters): Health centres staffed by trained midwives are the key to reducing maternal deaths in poor countries where more than half a million women die each year giving birth.

Pregnant women living in the most impoverished parts of the world are over 1,000 times more likely to die during labour, delivery or shortly afterwards than those living in richer nations.

But simple measures such as ensuring women have professional care and give birth in a health centre could reduce the numbers by 88-98 percent, according to research published on Thursday.

"The problem of maternal deaths is large. A woman dies each minute—day in and day out," Dr Carine Ronsmans, of the London School of Hygiene and Tropical Medicine, told a news conference to launch a special edition of The Lancet medical journal dedicated to reducing maternal mortality.

In a series of studies, Ronsmans and her colleagues identified where the problem is most acute, the leading causes of maternal deaths and a strategy to reduce the number of women dying in labour and childbirth.

Sub-Saharan Africa and South Asia have the greatest burden of maternal deaths. For every 300,000 women in Sweden, one will die from a pregnancy related complication. In South Asia the number is one in 43 and in sub-Saharan Africa one in 16.

"Our single main message that we would like you to come away with is that the health centre strategy is key," said Dr Oona Campbell who contributed to the research.

MONITORING AND ASSISTANCE

The strategy would insure that women and their babies are monitored during labour and the 24 hours afterwards when most deaths occur. Excessive bleeding, obstructed labour and hypertensive disorders are the leading causes of maternal deaths.

"Nearly one in four women in developing countries continue to be either alone or only with a relative to assist them at childbirth and this has not changes since the early 1990s," said Ronsmans.

She added that the problems can be treated but they require skilled midwives and doctors. To provide full care for women in health centres by 2030, it is estimated that about 700,000 more health professionals, nearly three times the current number, will be needed.

Campbell said the global development assistance for maternal and neonatal health was $663 million in 2003. To achieve universal coverage with a health professional, donors and governments must increase support for maternal health by an additional $1 billion in 2006 and more afterwards.

"Giving birth in a safe environment should not be a privilege of the rich," said Dr Francisco Songane, the director of the Partnership for Maternal, Newborn and Child Health, which consists of partner countries, UN agencies and foundations.

"Mothers must not pay with their lives when giving birth," the former minister of health in Mozambique added.

News Source: Reuters, September 29, 2006.