No woman should die giving life

In 2000, 189 countries, including the Philippines, signed their commitment to ending extreme poverty worldwide by achieving eight Millennium Development Goals (MDGs) by 2015. The MDGs are reduction of poverty, promoting education, gender equality, reducing child mortality, improving maternal health, combating HIV/AIDS, ensuring environmental security, and global partnership for development.

Many countries find MDG 5, i.e., which aims to reduce maternal mortality by three-fourths of the desired goal specific to their situation, to be the least likely to be achieved five years before the 2015 deadline.

According to Women Deliver, “globally, the MDGs are widely accepted as the path to ending poverty. But one central fact is not yet widely understood: none of these goals can be achieved without more progress in promoting women’s reproductive rights and protecting maternal and newborn health.”

Almost all maternal deaths, according to Women Deliver,  occur in developing countries; especially vulnerable are poor women. In fact, maternal mortality represents one of the greatest health disparities between rich and poor and between the rich and poor populations within every country.

The high mortality rate in the Philippines is a cause for worry. Maternal mortality rate is pegged at a high of 162 deaths for every 100,000 live births. That’s miles away from achieving the maternal mortality rate goal of 52 by 2015.

In understandable layperson language, ten mothers die daily because of childbirth-related causes. Do these women have to die while giving life?

It must be noted that MDG 4 has been significantly reduced, as revealed by the National Statistics Office MDG Watch. According to lawyer Elizabeth Aguiling Pangalanan who spoke at an earlier MDG conference, infant mortality was reduced, from 80 per 1,000 live births in 1990, to 34 and 25 per 1,000 live births in 2008. The 2015 goal is 26.7 and 19 per 1,000 live births.  

No similar good performance has taken place in the area of reducing maternal mortality. A number of conferences have been held to discuss how far gone, or behind, the Philippines is in meeting the goals, and possible solutions to reduce the number of women who die while giving birth, or in the course of pregnancy. The most recent , and for me, the most effective, was the Women Deliver Philippines conference held last week, which was organized by the Department of Health, the United Nations, Likhaan Center for Women’s Health, with support from the European Union. Dr. Junice Melgar, Likhaan executive director, worked to the bone to get financial support, and participants, for the successful Women Deliver conference.

Three hundred sixty five participants attended the conference, including representatives of private and civil society organizations, and regional development leaders. They were doctors, academicians, government officials, legislators, midwives, NGO representatives, health workers, young people, and media persons.

The conference covered a wide range of health- related concerns that have stymied the reduction of maternal deaths. These were parliamentarians’ moves to get a reproductive health bill passed, the need to recognize the great contribution being made by midwives in the reproductive health service, misconceptions on contraception, the youth’s access to sexual and reproductive health information and services, maternal mortality and human rights, and strengthening the health system, social and cultural barriers to understanding the reproductive health issue, and — the opposition of the Roman Catholic church to providing access to reproductive health measures.A special session on interfaith initiatives on safe motherhood was held.Moving documentary films about women dying in childbirth screamed about the need for government funding of reproductive health services especially for vulnerable poor women.

 The Women Deliver’s sad figures on the decline in the maternal mortality ratio reflected the findings presented two weeks ago by among others, NEDA Secretary Cayetano Paderanga Jr. at the launch of the Philippine progress report on the performance of the government on the 5th MDG. Mr. Paderanga said the Philippines is less likely to meet the MDG goal in maternal health.

At this same conference the special guest speaker was President Aquino III, who said the chances of meeting the MDGs were good, but, to the disappointment of advocates, he said progress could be expected with the eradication of corruption. In their seats, the conferees disagreed, as reducing maternal mortality is highly dependent on government investment, even as corruption is yet in the process of being eradicated.

At the Women Deliver conference, Health Secretary Enrique Ona ‘s paper, which was read by Undersecretary Mario Villaverde, said the goals of making motherhood safe and making childhood a healthy experience for Filipino children, have been “the centerpiece of action and reforms of the DOH in the last three years.” Credit for this is due on large part to the efforts of former Health Secretary Esperanza Cabral, who is now a United Nations Population Fund senior adviser.

Ona’s paper said that in 2008, the DOH began with its emergency effort to save mother and newborn lives through a bold and explicit policy that mainstreamed the rights of women and children to access critical health services particularly during childbirth. This builds on two decades of experience with the safe Motherhood Initiative, which showed that across countries and across settings, safe professional care during delivery offers the greatest opportunity to save lives. Maternal deaths can be prevented and many newborn lives will be saved just by making emergency care an absolute priority for all women during delivery. And yet, unhappily, this is the most neglected and inequitable component of our maternal and newborn health program.”