A new role for Africans in global maternal health

Check out this post from Dr. Fred Sai, co-host of Women Deliver 2010 and former advisor to the Ghanaian government on reproductive health and HIV/AIDS. You can follow the live stream of the Women Deliver 2010 conference from June 7th to 9th at www.womendeliver.org/webcast.

This March, the Lancet released new statistics that revealed an unprecedented drop in the number of women who die every year during pregnancy and childbirth. The study found that from 1980 to 2008, maternal deaths globally have fallen from 500,000 each year to 340,000. Having spent some 40 years working on women and children’s health in Ghana and across Africa, I welcomed this progress. But as the world celebrated, I also couldn’t help but wonder, “Where is Africa?”

It is an unfortunate truth that progress for the world at large does not necessarily mean progress for Africa. In 1980, almost a quarter of maternal deaths occurred in African countries. Today that figure has doubled to more than half. All but one of the 30 countries with the worst maternal mortality statistics are in Africa. And while countries like Ghana and Rwanda have seen a steady decline in maternal deaths over the past 15 years, others such as Malawi, Lesotho, Zimbabwe, Nigeria and Cote d’Ivoire actually have higher maternal mortality rates than they did in 1990.

Addressing maternal mortality in Africa is complex and challenging. Our countries face increasing rates of HIV, entrenched and debilitating poverty, food shortages, weak education and health care systems, problematic governance, corruption, and civil conflict. These are huge issues in their own right, but they also have significant impact on maternal, newborn and child health. The challenges, however, are not the whole story.

Many African leaders understand the urgency of addressing the maternal health crisis, despite its complexity. They have a sister, a niece, or a daughter who has died—or if they do not, they certainly understand the broader impact maternal death has on their countries. Women are the heart of African economies. They transport two-thirds of all goods that are moved and produce 60-80 percent of the food in the developing world. And maternal and infant deaths account for $15 billion in lost productivity.

It doesn’t need to be like this. I am confident that we can address this crisis if we shift our approach and start investing in women. We must increase women’s access to health services. We must promote business development and support women with grants and loans. We must ensure that girls have access to quality education. And we must work to convince our neighbors, be they relatives or countries, to prioritize women and girls in all that they do.

Many African governmental, academic and civil society leaders have answered this call and taken bold, local action to address this urgent issue. For example in November 2009, leading African science academies gathered together to produce scientific guidelines for reducing maternal mortality across the continent. In my home country of Ghana, two successive governments have championed free maternal health care for all. Ghana is now seeing what improving maternal health can do for a country. Despite the global recession, the economy has been growing, and of all African countries, it has made some of the most progress on the Millennium Development Goals.

African leaders are also insisting, rightfully, that their voice on this issue be heard. In less than two weeks, I will be joining 16 health and finance ministers and 15 members of parliament from 22 countries in Africa at Women Deliver, the largest global conference on maternal health in the past decade. Just weeks before the June G8/G20 meeting in Canada—where maternal health will be a top priority—Women Deliver will call on member states to increase their financial commitments to women and girls.
In July, African leaders will gather again at the Summit of the African Union. Here they are expected to renew the Maputo Protocol (which I should point out was drafted by African leaders) and includes perhaps the most comprehensive set of women’s rights ever recorded in an international treaty. With strong efforts like these, African governments have shown the depth of their commitment to these issues. Now, we need to follow through.

African countries are not alone in this struggle. In fact, in recent years, maternal deaths in the United States have also taken a dramatic turn for the worse. And addressing maternal health globally requires more than just African commitments. It depends on action from donor countries, other developing countries, businesses, and non-government and multilateral organizations alike. But African countries have the most to lose in this struggle and also the most to gain. This issue is about our family members and friends; it is about our economies and our countries; and it is about the survival and future of our children.

Reducing maternal deaths is not a simple battle, and the increasing ratio of maternal death in African countries will continue to shame and burn me until we see progress across the continent. I do, however, rest a little bit easier seeing the momentum around this issue. And I hope that when the next round of statistics are released, the story is about African progress—progress that was spearheaded by Africans. When you look at the statistics, you might also ask the question, “Where is Africa?” You can be sure that Africa is here. I urge you to support our effort.

-Dr. Fred Sai