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Too many dying! No woman should die giving birth in this century

UN official blames hypertension, unsafe abortions among causes of Jamaica’s maternal deaths

BY ARLENE MARTIN-WILKINS Associate Editor - News martina@jamaicaobserver.com

Thursday, July 05, 2012    

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QUITO, Ecuador — Despite efforts to reduce Jamaica's maternal mortality rate over the last decade, there are fresh concerns that the country will end up far from the Millennium Development Goal (MDG) of reducing the number of deaths to 25 per 100,000 live births by 2015.

Alma Camacho, the United Nation's Population Fund's (UNFPA) regional advisor on sexual and reproductive health, yesterday singled out Jamaica among nine Caribbean and Latin American countries that are way above the maternal mortality estimates. The other two Caribbean Community countries are Haiti and Guyana.

Director of the Latin American and Caribbean Division of the UNFPA, Marcela Suazo, said no woman should die giving birth in this century.

"With all the technological advances, this shouldn't happen. Maternal mortality should not be a problem in this century. We have enough knowledge that should prevent women from dying while giving life," she said.

According to the Ministry of Health, Jamaica's maternal mortality rate has moved from 110 per 100,000 live births, to 78 at present.

But "we have to find a way to get it down", Camacho declared at yesterday's UNFPA workshop on population and development issues in Latin America and the Caribbean at the Swissotel in this capital.

Jamaica was one of 147 countries that in 2001 endorsed MDGs Four and Five to reduce infant and maternal mortality by two-thirds and three-quarters, respectively, by 2015.

The United Nations sees maternal mortality as a largely avoidable cause of death. It is estimated that there are well over half a million maternal deaths worldwide each year, 75 per cent of which result from complications during delivery and "the immediate post-partum period", according to the UN.

In the case of Jamaica, hypertension, followed by haemorrhage, embolism (where a blood clot or air bubble blocks a blood vessel), and unsafe abortions account for half of all maternal deaths. Indirect causes such as cardiac diseases, increasing cases of HIV/AIDS, and violence account for the remainder.

In a 2009 global report on maternal and newborn health, the United Nation's Children's Fund (UNICEF) observed that Jamaica's maternal mortality rate had not changed significantly in the last two decades.

"Ninety-one per cent of pregnant women in Jamaica receive quality antenatal care at least once during pregnancy, and about 97 per cent of births are delivered by skilled personnel. Yet, according to national reports, the country's current maternal mortality rate of 95 deaths per 100,000 live births has not changed significantly over the last two decades," UNICEF stated.

In May, Health Minister Dr Fenton Ferguson said the People's National Party administration would redouble its efforts to reduce maternal mortality to around 36 by 2015.

"Our target is to reduce the rate to no more than 36 per 100,000 by 2015. We hope to strengthen areas such as surveillance, quality of care, monitoring and evaluation to improve our chances of achieving the target," Ferguson said then.

"The Ministry of Health has sought the support of the broader community to help with the full and overall health of the pregnant woman to reduce the risks of succumbing to any condition she may develop or that may worsen during pregnancy," he added

Only about six months prior, the Jamaica Labour Party's Rudyard Spencer, who was then the health minister, said that Jamaica still had a lot more work to do if it is to achieve the MDG, despite improvements in reducing the rate over the last decade.

At the time he announced the renewal of the Safe Motherhood Programme at the Victoria Jubilee Hospital in downtown Kingston to help reduce the country's maternal mortality rate. The five-year programme, which was originally launched in December 2007, intends to promote and protect the "right to the enjoyment of the highest attainable standards of health and contributing to the well-being of the women and children of the region through advocacy, strategic partnerships and the generation of knowledge".

He also announced that the National Maternal Mortality Review Committee would be re-established to examine "why women die during and immediately after pregnancy".

The findings would then be used to formulate policies to improve maternal health among Jamaica's women.

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