Jan 26, 2009 News
…highlights need for acceleration of progress on maternal mortality
Health Minister Dr. Leslie Ramsammy has called for the establishment of a new worldwide fund which countries can access to reduce the incidence of maternal and child deaths.
At the launching of the United Nations Children Fund (UNICEF) “State of the World’s Children” Report for 2009, on Thursday, January 22, Minister Ramsammy said that the fund should be able to support an essential package of health services for safe motherhood and childhood.
He explained that the package should include quality reproductive health services as a universal entitlement, ante natal care, skilled health workers assisting at birth, access to emergency obstetric and new born care, adequate nutrition, and post natal care for mothers and new borns.
According to Dr. Ramsammy, whilst it is known what the package should include, the resources are not always at hand to put it together.
“Whilst we know what the package ought to be, we are not in a position to deliver it to every mother in every community,” Minister Ramsammy said.
He explained that while the Millennium Development Goals (MDG’s) correctly identify the issue as social injustice and highlight it as a national obligation, the Goals does not see the solution as a global responsibility.
Dr. Ramsammy also revealed that, in the last 20 years, 300 women have lost their lives giving birth in Guyana, while more than 8000 children in the same period have lost their lives in the first twenty-eight days.
“This may seem like small numbers, but for me, when I think that 80 percent could have been prevented, I don’t think that we need more calls to action,” the minister said.
However, he added that data from the Ministry of Health indicates that there is a reduction in maternal and mortality deaths in Guyana.
It was noted that maternal deaths reduced from greater than 20 per 10,000 before the 1990’s to 14 in 2005, and 11 in 2008; while mortality deaths have reduced from greater than 80 per 1,000 before the 1990’s to 53 in 1999, and now 19 at the end of 2008.
Globally, more than 10 million pregnant women died during childbirth over the last 20 years, and it was explained that more than 86 percent of these deaths were preventable.
Additionally, more than nine million children under the age of five died last year, while that figure for the last 20 years is more than 200 million.
“These are preventable deaths. Is there a worse scandal in the world? Is there, I ask? We can do better. The MDG’s have established goals for the reduction of these embarrassing disgraceful numbers… requiring countries to reduce deaths by 66 percent for children, and 75 percent for pregnant women.”
At the World Health Assembly last year, Minister Ramsammy, in his capacity as Chairperson, had called for the complete elimination of all preventable deaths by 2025.
“We must be bold. Every preventable death must be a call to action. Pregnancy should not be a forecast of death for every woman. It is a forecasted death today. No country in the Americas should have a life expectancy of below 70 by 2025.”
Guyana’s goal is to attain life expectancy of 70 by 2012, as the life expectancy at the end of 2007 was 68.
In this regard, Minister Ramsammy said, Guyana is well on track to achieving its goal.
However, he pointed out, this will only be possible if all preventable maternal and child deaths are avoided.
“We cannot achieve our life expectancy target unless we also resolve the issue and remove the inequity and the injustice of maternal and child deaths.”
Taking this into consideration, he added, the report continues to underline the great social injustice that confronts mankind; and the inequities which divide rich, developed countries and poor, developing countries starkly underlined the fact that the risk of a woman dying of pregnancy and child birth complications in a developing country is 300 times greater than that of a woman from a developed country. This, he said, is unequivocally unacceptable.
The social injustice also allows a child in a developing country to have a 14-times greater chance of dying before reaching 28 days than a child born in a developed country.
However, he added, there are the pneumonoccus and rotovirus vaccines which could reduce the deaths by more than half within one year; but, unfortunately, they are not made available to all children, because some countries are too poor to afford them.
Meanwhile, UNICEF Representative Johannes Wedenig said that the report stresses the importance of creating a supportive environment for maternal and newborn health, based on respect for women’s rights and the need to establish continuation of care for mothers, newborns, and children that integrate programs aimed at combating the main causes of maternal and neonatal deaths.
He added that, in Guyana, over 80 percent of deliveries takes place in health facilities, and are assisted by a qualified health worker, while the immunization programme is one of the most robust in the region, with coverage figures for children one year old exceeding 90 % for all antigens.
He also singled out the PMTCT for the success it is achieving, noting the rapid scale-up from just about eight sites in 2001 to over 130 sites, including nine in the hinterland.
These achievements, he said, have all contributed to reducing trends in mortality among women and children in Guyana, as evidenced by both routine surveillance data from the Ministry of Health and specially designed population-based surveys, such as the Multiple Indicator Cluster Survey.
Nevertheless, in spite of the commendable progress, Wedenig added, there still remain several challenges. The report stated that the maternal mortality ratio for the period 2000-2007 is at 120 per 100,000 live births locally.
“This is still a long way from Guyana’s target for MDG on maternal mortality, which is to reduce maternal mortality to 35 per 100,000 live births by 2015. To achieve this goal, Guyana must therefore accelerate progress on maternal mortality,” he said.
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