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Battling to take death out of birth in Africa

Posted: Tuesday, May 13, 2008, 8:14 (BST)
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UNFPA also plans to inform women about pregnancy care.

"People don't know that women have a right to reproductive healthcare," Armah said.

Thousands of miles to the south of Sudan, in the sliver-like country of Malawi, the importance of grassroots education to fight maternal mortality has been recognised.

UNFPA says that nearly 2 per cent of live births in Malawi result in the death of the mother: that's 16 deaths a day from pregnancy or childbirth complications.

But a community in Dedza district, just outside the capital Lilongwe, is trying to change that.

In under two years, Chitowo community, working with UNFPA, has reduced maternal deaths to seven from 33.

"This has been possible because as a village we formed committees to encourage pregnant mothers to go for antenatal (care), monitor newborns, distribute bed nets and set up rules to follow on hygiene," said village chief Adamson Mwangwazu.

"We also fine those who deliver at home instead of in a health centre...We no longer lose a child or a mother like we used to."

This example is being copied in other communities in what is being dubbed Malawi's health revolution - albeit a revolution that is limited in scope because of the stranglehold that HIV/AIDS has on the country.


YOUNG ARE DYING

Through its local partners in Malawi, White Ribbon Alliance has enlisted the police's help in picking up pregnant women who are walking long distances to try to get to a clinic.

The group is also working with the ministry of health to find ways of retaining health staff in rural communities, by providing housing, power, schools and security.

McConville says cutting the maternal mortality rate will benefit everyone, and not only because women hold communities together and, in many places, do much of the farming work.

"If you get it right for mothers, you've got the health staff in place in the community, you've got the referral system to the next level, you've got the operating theatre, the anaesthetist, the electricity and communications.

"All of this will benefit a man with a broken leg or a child with a respiratory illness."

In south Sudan, Festo Juma's biggest immediate problem is lack of supplies and staff. He says he has been unable to persuade southern doctors working in Khartoum to return.

"Even here (in Juba), three-quarters of the midwives are village midwives, with no proper sense of emergency or knowledge of how to deal with problems," he said.

In the hospital, about 40 women die in labour each year, mostly because they arrive in a perilous state.

The babies who survive face their own battles: 135 out of 1,000 children in south Sudan die before they reach five years old, according to a government and UN survey.

And early marriage and pregnancy means teenagers are among those dying in childbirth.

"Of every 1,000 pregnancies, 200 are adolescents," Armah said. "The young are dying."



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