According to a new report released by the United Nations and partners, “approximately 800 women died from preventable causes related to pregnancy and childbirth” daily in 2020. The United Nations Maternal Mortality Estimation Inter-Agency Group studied global trends in maternal mortality between 2000 and 2020. Concerningly, the data shows that maternal deaths rose in several regions over the last few years. However, several organizations are working to improve global maternal health.
The Maternal Mortality Trends Report
Titled “Trends in maternal mortality 2000 to 2020,” the report is the combined effort of several U.N. agencies. The report covers 185 countries and territories, most of which are WHO member states. It presents comprehensive data about global and regional trends relevant to maternal health over the past two decades.
Several factors can increase the risk of maternal death. According to the WHO, some of the major ones are severe bleeding, infections, high blood pressure during pregnancy, unsafe abortions and delivery-related complications. Most of these are avoidable through simple health care and medical attention. However, according to Dr. Natalia Kanem, executive director of the UNFPA, the world faces a shortage of 900,000 midwives. Furthermore, the WHO states that “roughly a third of women do not have even four of a recommended eight antenatal checks or receive essential postnatal care.”
The Impact of Poverty on Global Maternal Health
Poverty has a significant impact on global maternal health. Poverty-stricken regions lack the medical resources and qualified personnel to provide women with adequate care during the maternity period. According to the Pan American Health Organization, the prevalence of maternal deaths is highest in countries impacted by poverty and conflict.
Data shows that, in 2020, the maternal mortality rate in low-income countries stood at 430 per 100,00 live births. In contrast, this rate stood at 12 per 100,00 live births in countries that were financially better off. To further demonstrate the devastating impact of poverty, the report stated that despite only 13% of the global population living in the least developed countries, women in these countries accounted for 42% of maternal deaths worldwide in 2020.
Due to the impacts of poverty, 70% of global maternal deaths in 2020 occurred in sub-Saharan Africa. This means that out of 287,000 global maternal deaths, 202,000 occurred in the region. Countries such as South Sudan, Chad and Nigeria have extremely high maternal mortality rates, with Nigeria noting the most maternal deaths in 2020.
Central and Southern Asia is another region with a high maternal mortality rate. In particular, the region had 47,000 maternal deaths in 2020, which is the highest outside of sub-Saharan Africa.
The Progress
Fortunately, the world made a lot of progress toward reducing maternal deaths between 2000 and 2015, during which U.N. member states adopted the Millennium Development Goals. As a result, the global maternal mortality rate fell by 34.3% between 2000 and 2020. The number of global maternal deaths almost halved during the two decades.
Regions with some of the highest numbers of maternal deaths noted the most progress since 2000. The maternal mortality rate dropped by 33.1% in sub-Saharan Africa between 2000 and 2020. Northern Africa and Western Asia saw a drop of 46.8% while Central and Southern Asia saw a massive drop of 67.5%. Even the least developed countries reduced their maternal mortality rate by 47.4%, according to the U.N.’s report.
Current Efforts
U.N. Member States adopted the 17 Sustainable Development Goals in 2015. SDG 3 aims to “ensure healthy lives and promote well-being for all at all ages.” In particular, SDG 3.1 aims to “reduce the global maternal mortality ratio to less than 70 per 100,000 live births” by 2030. Many organizations are working to achieve this target.
The WHO runs a Maternal Health Unit that “provides leadership for improving maternal and perinatal health and well-being and ending preventable maternal mortality” through education, surveillance and advocacy.
The UNFPA, UNICEF, the WHO and the International Confederation of Midwives (ICM) created the Framework for Action to Strengthen Midwifery Education, which launched in 2019 at the 72nd World Health Assembly. It includes a comprehensive blueprint for building high-quality midwifery education systems.
The WHO developed a Midwifery Education Toolkit to provide “midwives with all the training required to care for healthy women and their newborns, prevent unnecessary interventions while ensuring lifesaving actions and enable health professionals to work effectively in a multi-disciplinary team.”
Additionally, the WHO is a partner organization in the French Muskoka Fund. Initiated in 2010 by the French government, the fund aims to improve maternal and child health in nine African countries. Besides supporting policies, the fund provides access to essential health care, medicines and professionals. The French government renewed commitments to the fund twice already since 2015 and Denmark pledged support for the fund in 2018. In 2021, the French government announced a commitment of €10 million annually until 2026 for the Muskoka Fund.
In order to achieve the target set by SDG 3.1, a global effort toward improving global maternal health is needed. Investment in health care and facilities along with education and advocacy will help reduce maternal mortality worldwide.
– Siddhant Bhatnagar
Photo: Flickr
Community Kitchens Around the World
India
India is one of the many countries that saw community kitchens continuously popping up during the 2020 pandemic lockdown. During this time, these kitchens played a pivotal role in supporting hungry families and became communal staples that people continue to rely on today. The state of Jharkhand saw the most growth in this kind of organization with 2,500 women working across all its districts.
In India, the Jharkhand State Livelihood Promotion Society (JSLPS) provides funding for these groups. Through the government and the hard work of these women, the kitchens provide meals directly to citizens’ doorsteps and help support the communal trust in the government. They also have “low-cost kitchens” where they sell food for a very low cost which helps support hungry citizens. Across India, these kitchens are providing not only food but opportunity as well.
Nepal
U.N. Women along with the Government of Finland have been supporting women-ran community kitchens in Nepal. The partnership helped set up a total of 10 kitchens in four of Nepal’s provinces, employing 123 women. The women working in these kitchens work from sun up to sun down to ensure meals are ready and easily accessible to those struggling in their communities. Importantly, these women can use the wages they earn to support their own families while learning to be confident in their skills, independence and leadership abilities. Community kitchens in Nepal have been able to reach those who are most typically disadvantaged like women, migrants, refugees, people with disabilities and pregnant women. They have played a key role in restoring and creating stability in many people’s lives during and after the pandemic.
Peru
In Lima, the capital of Peru, women have been the sole supporters, funders and workers for these community kitchens since as early as the 1970s. In these kitchens, since they are not government funded, the women who devote their time to them are the ones who provide the cooking supplies, the kitchen space and the food. The women in these communities have established communal agreements that only they can run these kitchens, democratically, not for profit but for the betterment of their community. They decided together to pool whatever spare resources they could find and devote them to these kitchens. Through their selfless efforts, these women provide not only meals to the hungry but a safe space for women and children who face abuse at home. The women of Lima’s community kitchens are a shining example of how community effort and human empathy can change the world.
Final Thoughts
Community kitchens, which are often led by women, have become a powerful force in fighting global hunger while also promoting female empowerment. By providing meals to those in need, these kitchens contribute to the health and well-being of communities around the world. In addition, they offer an opportunity for women to be empowered and take initiative in their own lives as they lead these programs and gain skills that can help them achieve financial independence.
– Alexandra Curry
Photo: Flickr
International Women’s Day Marches Zero in on Middle East Injustices
Though first officially recognized by the United Nations in 1977, International Women’s Day emerged decades before, out of labor movements that took shape across North America and Europe around the turn of the 20th century. The movement has gained increased momentum over the years with the help of the U.N., which now offers four global conferences that center on supporting women’s rights and strengthening women’s political and economic presence.
The Current State of Women’s Rights in the Middle East
In recent months, Iran has seen growing protests for women’s rights. One of the main causes of recent public outrage in Iran is a string of poisonings of thousands of school-aged girls since November 2022. Though none of the poisonings have resulted in fatalities and Iran’s Interior Ministry has reported arrests in relation to the incidents, UNESCO has called for stronger action to protect the country’s girls and young women and ensure “their right to safe education.”
Interestingly, although Iran’s clerical leaders force women to cover their hair and dress conservatively in public, historically, the country’s religious groups have shown no clear objection to the education of girls and women, unlike in Afghanistan.
Between 2001 and 2018, there was a great increase in the number of women and girls enrolled in some form of education in Afghanistan. However, since the September 2021 postponement of the return to school for all Afghan girls over the age of 12, 1.1 million females have been indefinitely denied access to formal education. UNESCO reports that 80%, or 2.5 million, Afghan women and girls are currently out of school as a result of the postponement, compounding the some 30% of Afghan girls who have never entered the education system at all. According to Roza Otunbayeva, head of the U.N. Assistance Mission in Afghanistan, “Afghanistan under the Taliban remains the most repressive country in the world regarding women’s rights, and it has been distressing to witness their methodical, deliberate, and systematic efforts to push Afghan women and girls out of the public sphere.”
Looking Ahead for Women
As recent developments show, a lot more must be done to support girls’ and women’s rights in Iran and Afghanistan. Still, there are signs of progress and hope. For instance, in Afghanistan, numerous female-led local NGOs have persisted in working to help repressed women and children across the country despite a recent Taliban decree prohibiting Afghan women from working for NGOs. Their efforts have coincided with those of the Women’s Foreign Policy Group and the Center for Human Rights in Iran, which, in 2022, “published hundreds of articles on human rights issues and press releases on urgent developments, all in both English and Persian, directly distributed to over 4,000 government, UN, NGO and media leaders worldwide.”
As these nonprofits work to secure equality and rights for the women of the Middle East — and women everywhere — the global unity demonstrated on International Women’s Day has inspired growing awareness of the need to address the injustices that women around the world face every day.
Photo: Flickr
Fragility and Rule of Law in Iraq
Rule of Law
Since the fall of Saddam Hussein, Iraq has made progress in building a more effective and sustainable rule of law. However, significant challenges still remain. Corruption, sectarianism and weak institutions continue to pose obstacles to the development of a truly robust legal system in Iraq.
The ongoing conflict with the Islamic State (ISIS) has brought to light the fragility of Iraq’s legal system, particularly in relation to the treatment of civilians and the use of military courts. The situation highlights the need for Iraq to ensure that its counter-terrorism measures adhere to human rights and the rule of law.
The crisis of the rule of law has global implications that reverberate throughout the international legal order and national legal systems. The post-9/11 fallout from the “war on terror” has contributed to this crisis as organizations such as Al-Qaida and the Islamic State challenge the existing systems of government both nationally and internationally. The ripple effect of this crisis extends far beyond the borders of Iraq and Syria, impacting legal systems worldwide.
The People of Iraq
Fragility and rule of law in Iraq have contributed significantly to the country’s poverty crisis. A 2021 report by NPR stated that corruption, political instability and weak institutions have hindered economic growth and development in Iraq, leading to rising poverty levels. The report further highlighted that the country’s legal and regulatory framework is often opaque and inconsistently applied, making it difficult for businesses to operate and for individuals to access justice.
This has resulted in a lack of investment, high unemployment rates and a struggling private sector, leaving millions of Iraqis living in poverty. According to the World Bank, approximately a quarter of Iraq’s population lives below the national poverty line, which translates to more than 8 million people. The lack of a stable rule of law has also contributed to an environment of violence and conflict, further exacerbating the poverty crisis by forcing people to flee their homes and disrupting economic activities.
Taking Action
The international community can play a vital role in supporting Iraq by offering technical assistance, training and financial support to help build a stronger and more independent justice system. Despite the ongoing challenges, there are reasons for hope. Iraqi civil society is becoming increasingly engaged in promoting accountability and transparency and there are signs that the government is taking steps to address corruption and sectarianism. With sustained effort and support, it may yet be possible to establish a rule of law that serves the needs of all Iraqis and contributes to a more stable and peaceful future for the country.
The Free Yezidi Foundation is a beacon of hope for the Yezidi community in Iraq, a group of people who regard themselves as “strangers in their own land,” according to The Conversation, living in refugee camps where poverty continues to deepen. Founded in 2014, the organization has made it its mission to provide justice and accountability for the atrocities committed against the Yezidi people by ISIS.
The foundation’s work is multi-faceted, including the collection of evidence and documentation of crimes, advocacy for the prosecution of perpetrators and support for survivors’ recovery and rehabilitation. The foundation also offers legal assistance to Yezidis who have been displaced or lost their homes and raises awareness about the community’s plight both in Iraq and globally. The Free Yezidi Foundation’s efforts promote the rule of law and uphold the right of the Yezidi community.
As the challenges facing Iraq’s rule of law continue to evolve, it is vital that efforts to strengthen the legal framework remain a top priority. By strengthening the rule of law in Iraq, the nation can move toward stability and resilience all while lowering poverty rates.
– Noura Matalqa
Photo: Flickr
Gender Wage Gap in Nigeria
International Women’s Day is a worldwide celebration of women and an opportunity to talk about the importance of gender equality. The theme for International Women’s Day 2023, celebrated on March 8, was the potential of innovation and technology for furthering gender equality. A look into issues surrounding the gender wage gap in Nigeria reveals why this theme was so important.
Gender Equality in Nigeria
The World Economic Forum (WEF) defines the gender wage gap as the difference between average male and female wages, divided by the average male wage. Analyzing the gender wage gap highlights the issues surrounding unequal pay for men and women who work in similar roles. Though statistics on the gender wage gap are more consistently and accurately reported in OECD nations, the WEF estimated that in sub-Saharan Africa in 2021, women received 32.7% less pay than men who held similar positions. Comparatively, the average gender wage gap in the European Union was 10.6% in 2021.
Ranking 123 out of 146 countries in the 2022 Global Gender Gap Report, Nigeria has a long way to go when it comes to gender equality. However, in 2022, the country ranked 16 places higher than the previous year, evidence of the momentum in Nigeria to address the country’s gender inequality. One of the most significant breakthroughs has been a recognition of the importance of women using technology.
The Reason Technology is So Important
Information and Communication Technologies (ICT) have unlocked a new world of opportunities while also creating a further barrier to development and growth for those who cannot access them. This barrier divides, not only along economic lines but also along gendered ones; the creation and use of ICT continue to be male-dominated. As technology plays an increasingly prevalent role in our personal and professional development, equal access to ICT is crucial for achieving future equitable development across the globe.
In Nigeria, ICT availability and accessibility, or lack thereof, among women and girls have played a key role in perpetuating the gender gap. The ability to use and understand ICT is critical to women’s progress in such areas as education, employment, innovation, independence, health and financial stability. Yet, the gap between male and female ICT literacy rates in Nigeria is 48.6%, highlighting the inequitable barriers that women face in their personal and professional development. Investment in this area has the potential to help significantly reduce, not only the gender wage gap but the many other areas of gender inequality that persist in Nigeria.
Solutions
Awareness of this issue in Nigeria has been a significant driver of recent progress. In 2006, the Nigerian Government established a Universal Service Provision Fund (USPF), which aimed to provide everyone with basic internet and telephone service access. As of 2018, Nigeria was one of only three African nations whose USPF specifically referenced the importance of closing the divide in access between men and women. The Nigerian USPF is used to support projects such as the Rural Broadband Initiative and the E-accessibility project. By 2021, 219,000 Nigerian citizens had benefitted from digital training as a result of USPF initiatives.
Research suggests that the following steps could lead to huge progress in closing the digital gender divide:
These aims are only achievable, however, through collaboration between domestic and international agencies, government bodies and businesses.
Between 2018 and 2020, Equal Access International partnered with USAID to develop the Tech4Families initiative, which aimed to reduce the digital gender divide by addressing the barriers to women and girls accessing technology at the family level. The first aspect of the project was a 12-part radio program that discussed women in the world of technology, and the second aspect consisted of focus groups that brought family members together. Through the focus groups, Tech4Families enabled families to reflect on the barriers women face when using ICT, discuss practical ways to tackle them, and plan outreach activities to share their new attitudes and ideas with the wider community.
Tech4Families led to significant shifts in community attitudes toward female use of technology in Northern Nigeria, where more than 60% of women do not have access to the internet. By the end of the project, 50% of women and 80% of girls who participated shared that they felt empowered and encouraged to use technology at home. One family member shared that the work of Tech4Families made them “want to put more effort into ensuring that women use the internet in [their] home and workplace.”
While there is much more action that the global community must take, the momentum to increase ICT accessibility among women and girls marks a turning point for decreasing the gender wage gap in Nigeria.
– Polly Walton
Photo: Flickr
SOLA Ensures Education for Afghan Girls
Girls’ Education in Afghanistan
Historically, girls and women in Afghanistan have faced barriers to accessing education. The problem first began in 1992, after the fall of the Communist regime in Afghanistan. The Taliban seized control and immediately began to cut back educational opportunities for women.
In 2001, a U.S.-led invasion overthrew the Taliban, removing the group from power. From 2001 to 2018, nearly every statistic pointed to an improved system. School enrollment rose from 1 million to 10 million students, the number of teachers rose by almost 60% and the female literacy rate increased almost twofold from 17% to 30%. In particular, the number of girls in primary school increased from “almost zero in 2001 to 2.5 million in 2018,” UNESCO says. Furthermore, the number of Afghan girls enrolled in higher education rose from about 5,000 in 2001 to around 90,000 in 2018.
Before the Taliban seized power for a second time, the outlook for educational opportunities for girls was a positive one. As the Taliban did when it first came to power, the group began to reduce educational opportunities for women once again. According to UNESCO, 30% of Afghan girls have never taken part in primary education. In December 2022, the Taliban suspended women’s tertiary education, impacting more than 100,000 girls and women.
How SOLA Makes an Impact
The School of Leadership, Afghanistan welcomed its first inaugural class of girls in 2016. SOLA and its founder Shabana Basij-Rasikh continue to pave the way for the education of Afghan girls despite the seemingly grim outlook. According to SOLA’s website, it took merely four days for the school to move from Kabul to Rwanda after the fall of Afghanistan to the Taliban.
Classes continued and Afghan girls from around the world come to SOLA to learn with a student population totaling well over 100 girls between 6th and 12th grades. While SOLA is only a small school, it is making a significant impact on the education of Afghan girls. SOLA is a beacon of hope for young Afghan women hoping to access education.
SOLA covers a variety of curricula for its students. All main classes are taught in English, which allows students to develop their language skills while learning geography, math, science and history. The school also teaches courses on the Quran, ensuring that the girls can maintain their religious background and beliefs while developing a secular education. SOLA even makes some sports, like swimming, available to the students.
The importance of formal education for Afghan girls cannot be understated. For Afghan girls who cannot come to SOLA, SOLA’s website says, “we will find opportunities to bring SOLA to them. We will work to build a global network of sisterhood between these girls and our SOLA students and alumnae and we will nurture and support the members of this sisterhood who will be well-prepared to return to Afghanistan and rebuild their homeland.”
Moving Forward
SOLA’s vision is to “educate Afghan girls: to create a leadership generation of women who will one day return home to Afghanistan and rebuild all that the Taliban have destroyed. What began in Kabul continues now in Rwanda,” its website says.
The history of educational opportunities for Afghan women is complex. SOLA aims to ensure that young Afghan girls have a chance at a bright future by continuing their education outside of war-torn Afghanistan.
– Ezra Bernstein
Photo: Flickr
Efforts to Address HIV/AIDS in Ghana
HIV/AIDS and Poverty
HIV and poverty have a two-way connection. Conditions of poverty increase the risk of contracting HIV and HIV contributes to the condition of living in poverty. According to the International Labour Office, “Poverty also drives girls and women to exchange sex for food and to resort to sex work for survival when they are excluded from formal sector employment and all other work options are too low-paying to cover their basic needs.”
HIV/AIDS can also push people into poverty due to the expense of medical care/treatment. “HIV/AIDS causes impoverishment when working-age adults in poor households become ill and need treatment and care because income is lost when the earners are no longer able to work,” the ILO explains. Losses of human capital and reductions in the labor force also slow a country’s economic growth.
The far-reaching impacts of HIV/AIDS show that the epidemic stands as a significant obstacle to poverty reduction and progress toward the 17 Sustainable Development Goals, particularly in the poorest countries.
Ghana’s Progress
In 2020, UNAIDS announced a new set of targets for countries to strive toward in the fight against HIV/AIDS. The goals, with a target date of 2025, aim for “95% of all people living with HIV to know their HIV status, 95% of all people with diagnosed HIV infection to receive sustained antiretroviral therapy and 95% of all people receiving antiretroviral therapy to have viral suppression.”
According to the Ghana Aids Commission, currently, 71% of individuals living with HIV are aware of their status, 99% of HIV-positive individuals are on sustained antiretroviral treatment and 79% of those individuals have achieved viral suppression. With just two years to go, significant action is necessary to ensure that Ghana meets these goals.
A Differentiated Service Delivery (DSD) Approach
According to the World Health Organization, Ghana is working toward these UNAIDS goals with the use of a Differentiated Service Delivery (DSD) approach. This person-centered approach adapts health services for people with HIV/AIDS so that service delivery is improved and the health care system does not become overburdened.
For example, a “multi-month dispensing approach” can allow virally suppressed patients to receive their medications for multiple months at a time. This lowers the workload of health workers as patients need to visit less frequently and also saves patients from making multiple trips to the clinic.
The implementation of the DSD approach has seen positive results. For example, Kpone Polyclinic in Ghana has increased its success rate of providing ART from 85% to 99% in just one year as of March 2023.
PEPFAR’s Efforts
The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has worked in Ghana for 20 years. Over the last 14 years, PEPFAR has invested $140 million in efforts to address HIV/AIDS in Ghana. PEPFAR Ghana supports community organizations in dissolving stigmas surrounding the disease, encouraging people to undergo HIV testing and for infected individuals to begin a treatment program promptly.
Looking Forward
Ghana aims to achieve universal health care. Its vision for 2030 is for all of the country’s people to have “timely access to high-quality health services irrespective of their ability to pay at the point of use.” Although conditions in Ghana are improving, large gaps are still present in the control of HIV/AIDS in Ghana. With the continued assistance from supporting countries and ongoing work in Ghana, incidents of HIV/AIDS in Ghana can reduce along with poverty.
– Leah Smith
Photo: Flickr
Impact of COVID-19 on Poverty in Serbia
The COVID-19 pandemic created a sense of instability across the globe, not least among those living on the edge of poverty. The immediate impact of COVID-19 on poverty in Serbia was predominantly apparent among particularly vulnerable groups, such as people working in the informal sector. For workers, COVID-19 heightened job insecurity despite the government’s efforts to constrain the rate of poverty in Serbia with generous financial packages.
The Informal Sector
On March 15, 2020, Serbia declared a national emergency due to COVID-19. To mitigate the negative impacts, the Serbian government focused efforts on financial aid packages for the public. However, this financial assistance failed to reach some of Serbia’s most vulnerable groups. This includes those employed in the informal sector.
The informal sector in Serbia includes jobs in agriculture, construction, admin support, retail trade and manufacturing. A survey from 2019 discovered that 18.7% of households had employment in the informal sector. Another research study indicated that one in five people in Serbia work informally. The informal sector is an unstable sector of the labor market due to poor worker regulations and job insecurity.
Even prior to the pandemic, those employed informally faced a higher risk of falling into poverty due to the instability of the sector. As COVID-19 arrived in Europe, many industries in Serbia saw thousands of job losses. Many people reported a significant reduction in household income and increasing financial pressure but lacked access to the government’s financial aid packages.
Since the pandemic, informal employment has increased by more than 30%. This could be connected to the staggering loss of jobs among people previously employed in small and medium enterprises (SMEs) and companies having to cut down employment hours.
These factors forced people to take up informal employment to maintain an income flow. Estimates indicated that more than 700,000 people who worked for SMEs found themselves unemployed due to the pandemic. The growth of these informal industries suggests that a greater proportion of the Serbian population now faces job insecurity and the risk of falling into poverty.
Small Successes
However, the impact of COVID-19 on poverty in Serbia is not as intense as that of neighboring countries. Serbia had one of the lowest increases in poverty over the course of the pandemic. This is no small feat for a developing country with a significant proportion of people living close to the poverty line. Despite facing the most significant global crisis of the 21st century, Serbia’s poverty level post-pandemic remained the same as pre-pandemic levels, at 17.9%. While this is a noteworthy achievement, one should keep in mind that Serbia remains one of the poorest countries in Europe. However, the stabilization of the poverty rate during these last few years gives hope that Serbia can continue the pattern of gradual and consistent poverty reduction.
Looking Forward
Amid these small wins, Serbia is looking forward to recovering from pandemic stressors. Ongoing efforts are necessary to rebuild industries most impacted by the pandemic. Additionally, by renewing former jobs and creating more security in the informal sector, the risk of poverty will reduce. In 2021, Serbia received a €200 million loan from the EU Investment Bank for a project to help impacted SMEs recover post-pandemic. The initiative seeks to restore 47,000 jobs and create more than 5,000 new ones.
Serbia is seeing positive recovery results so far. A 2022 report by the EU found that participation in the labor market is increasing in Serbia as the country continues to economically rebound from COVID-19 and youth employment is on the rise. However, the report recognized that to significantly support SMEs in their recovery, further efforts are necessary.
– Ariana Mortazavi
Photo: Flickr
The Current State of Global Maternal Health
The Maternal Mortality Trends Report
Titled “Trends in maternal mortality 2000 to 2020,” the report is the combined effort of several U.N. agencies. The report covers 185 countries and territories, most of which are WHO member states. It presents comprehensive data about global and regional trends relevant to maternal health over the past two decades.
Several factors can increase the risk of maternal death. According to the WHO, some of the major ones are severe bleeding, infections, high blood pressure during pregnancy, unsafe abortions and delivery-related complications. Most of these are avoidable through simple health care and medical attention. However, according to Dr. Natalia Kanem, executive director of the UNFPA, the world faces a shortage of 900,000 midwives. Furthermore, the WHO states that “roughly a third of women do not have even four of a recommended eight antenatal checks or receive essential postnatal care.”
The Impact of Poverty on Global Maternal Health
Poverty has a significant impact on global maternal health. Poverty-stricken regions lack the medical resources and qualified personnel to provide women with adequate care during the maternity period. According to the Pan American Health Organization, the prevalence of maternal deaths is highest in countries impacted by poverty and conflict.
Data shows that, in 2020, the maternal mortality rate in low-income countries stood at 430 per 100,00 live births. In contrast, this rate stood at 12 per 100,00 live births in countries that were financially better off. To further demonstrate the devastating impact of poverty, the report stated that despite only 13% of the global population living in the least developed countries, women in these countries accounted for 42% of maternal deaths worldwide in 2020.
Due to the impacts of poverty, 70% of global maternal deaths in 2020 occurred in sub-Saharan Africa. This means that out of 287,000 global maternal deaths, 202,000 occurred in the region. Countries such as South Sudan, Chad and Nigeria have extremely high maternal mortality rates, with Nigeria noting the most maternal deaths in 2020.
Central and Southern Asia is another region with a high maternal mortality rate. In particular, the region had 47,000 maternal deaths in 2020, which is the highest outside of sub-Saharan Africa.
The Progress
Fortunately, the world made a lot of progress toward reducing maternal deaths between 2000 and 2015, during which U.N. member states adopted the Millennium Development Goals. As a result, the global maternal mortality rate fell by 34.3% between 2000 and 2020. The number of global maternal deaths almost halved during the two decades.
Regions with some of the highest numbers of maternal deaths noted the most progress since 2000. The maternal mortality rate dropped by 33.1% in sub-Saharan Africa between 2000 and 2020. Northern Africa and Western Asia saw a drop of 46.8% while Central and Southern Asia saw a massive drop of 67.5%. Even the least developed countries reduced their maternal mortality rate by 47.4%, according to the U.N.’s report.
Current Efforts
U.N. Member States adopted the 17 Sustainable Development Goals in 2015. SDG 3 aims to “ensure healthy lives and promote well-being for all at all ages.” In particular, SDG 3.1 aims to “reduce the global maternal mortality ratio to less than 70 per 100,000 live births” by 2030. Many organizations are working to achieve this target.
The WHO runs a Maternal Health Unit that “provides leadership for improving maternal and perinatal health and well-being and ending preventable maternal mortality” through education, surveillance and advocacy.
The UNFPA, UNICEF, the WHO and the International Confederation of Midwives (ICM) created the Framework for Action to Strengthen Midwifery Education, which launched in 2019 at the 72nd World Health Assembly. It includes a comprehensive blueprint for building high-quality midwifery education systems.
The WHO developed a Midwifery Education Toolkit to provide “midwives with all the training required to care for healthy women and their newborns, prevent unnecessary interventions while ensuring lifesaving actions and enable health professionals to work effectively in a multi-disciplinary team.”
Additionally, the WHO is a partner organization in the French Muskoka Fund. Initiated in 2010 by the French government, the fund aims to improve maternal and child health in nine African countries. Besides supporting policies, the fund provides access to essential health care, medicines and professionals. The French government renewed commitments to the fund twice already since 2015 and Denmark pledged support for the fund in 2018. In 2021, the French government announced a commitment of €10 million annually until 2026 for the Muskoka Fund.
In order to achieve the target set by SDG 3.1, a global effort toward improving global maternal health is needed. Investment in health care and facilities along with education and advocacy will help reduce maternal mortality worldwide.
– Siddhant Bhatnagar
Photo: Flickr
Improving Mental Health in Peru
Mental health in Peru is a topic that has gained more attention in recent years, leading to significant research findings and help from government efforts and NGOs alike. This is especially important as mental disorders are present in 20% of adult Peruvians. This number increases to 20.7% in kids older than 12 years old.
Schizophrenia, depression, anxiety and alcohol dependence were the most common disorders detected at a national level. Women more frequently receive diagnoses of depression, while alcoholism and substance abuse affect more men. Moreover, yearly suicide rates are higher than ever before, with 31% of the total number of suicides in Peru taking place in 2020, 2021 and 2022.
Past traumatic experiences, environmental stressors and poverty are the main factors for developing mental health problems. Traumatic experiences in Peru mostly stem from domestic violence and the internal armed conflict that took place from 1980 to 2000. These issues make victims more vulnerable to developing mental health conditions, especially if these experiences are situated in a person’s formative years, as in the case of abused children.
Childhood Trauma in Peru
In Peru, 68.9% of children aged 9 to 11 and 78% of children aged 12 to 17 have suffered psychological or physical abuse at least once in their lives. Additionally, 67.6% of women aged 18 or older have suffered from psychological, physical and/or sexual violence. In a survey from 2019, 46.1% of respondents stated they believe parents have the right to physically punish their children and 33.2% of respondents stated that they agree with the statement that unfaithful women should receive some sort of punishment from their partner.
Peru’s internal armed conflict of the 1980s is a particular source of trauma for some Peruvians since an approximate total of 69,280 people died or went missing during the conflict. The loss of loved ones, fear, distrust and the resulting sense of hypervigilance can lead to anxiety disorder and/or substance abuse. Research confirms this connection by finding a higher prevalence of anxiety and alcoholism among adults in Peru’s rural areas. These outcomes are not surprising, given that 79% of the conflict’s victims resided in Peru’s rural areas.
Outside of abuse and conflict, environmental stress also has negative repercussions for both the mind and body. Noise and proximity to street residue are the main contributors to environmental stress in Lima, Peru’s capital. Lima’s lowest income districts have less efficient trash management services, putting its residents at a higher exposure to garbage on the street. On the other hand, psychosocial stressors stem from Peruvians’ fear of crime, violence, poverty and concerns regarding their health that lead to feelings of worry, sadness, anger and discontent.
Improving Mental Health in Peru
The Peruvian government is actively working on making mental health care services more accessible for all citizens. The Health Ministry (MINSA) has 248 active Community Mental Health Centers, which are establishments specialized in mental illnesses and psychosocial problems. Furthermore, the MINSA developed Central 113, a hotline that health professionals operate to provide medical information and guidance. This hotline is accessible 24/7, and option #5 is dedicated to psychology and mental health. Both state approaches are free of charge.
Moreover, the government approved the Health Ministry’s Guidelines for Mental Health Care during COVID-19. This document expands on children’s mental health with an added focus on COVID-19 and its effects. It highlights issues such as childhood abuse (physical and psychological) as a major cause for future mental health problems and it offers advice such as respecting a child’s individuality, encouraging them to freely express their emotions and limiting the amount of information they are prone to consume through the internet. The document calls for a nationwide, multidisciplinary application of the guidelines, from health institutions to regional and local governments and even police departments.
At the international level, Partners in Health is a social justice organization that has provided women with free mental health services. Its care plan offers therapy for trans women and in 2015, it constructed a safe house in Lima for all women living with schizophrenia. In 2022, 6,219 women received treatment through their Mental Health Programme.
Looking Ahead
Mental health in Peru has earned more attention in recent years. It is a broad topic, with mental health problems stemming from reasons that are mostly country or region specific. Thankfully, the Health Ministry is actively contributing to mental health research and providing solutions such as Central 113 and the development of the Community Mental Health Centers. In addition, NGOs such as Partners in Health are making mental health services more accessible across the country. With continued efforts from external and state organizations, hopefully more Peruvians can look forward to improved wellbeing in the years to come.
– Luciana Mena
Photo: Flickr
Foreign Aid to China
General Aid to China
Since the revolution in 1949, foreign aid to China has increased bilaterally and multilaterally, supporting social reform and development initiatives. In terms of foreign relationships and support, international organizations, such as the World Bank, still support China by investing billions in various development projects in transportation, public administration, water and sanitation, agriculture and more.
The United Nations Development Program (UNDP) has also focused on poverty relief in China. For instance, in partnership with the Alibaba Group, the UNDP launched the Rural Taobao project in 2014, which established e-commerce platforms in rural areas to provide access to goods and services that were previously unavailable. This public-private sector collaboration has helped many people in rural areas sell their products online and has created job opportunities for local residents.
Special Projects
Like other countries, China has also received foreign aid from various countries and international organizations, particularly in the aftermath of natural disasters such as earthquakes and floods. For instance, in May 2008, the Singapore Red Cross provided support worth S$150,000 to victims of the Sichuan earthquake, including assistance to meet the shelter, food, water and health care needs of 120,000 people in Lushan county.
In addition to responses to natural disasters, USAID has supported a range of poverty reduction projects in China, such as improving access to clean water and sanitation, supporting the development of small and medium enterprises and strengthening civil society organizations. However, the United States has reduced its foreign aid to China over the years.
This is due to the increasingly tense bilateral relationship between the world’s two superpowers and related geopolitical implications. Instead of having a much larger investment realm, the U.S. has focused aid on Tibetan communities, rule of law initiatives and climate change policy, particularly in areas where international attention and humanitarian assistance are crucial and localized, as these programs align with the values and interests of the United States.
The decision to provide foreign aid to China depends on various factors, including the specific development needs of China and the donor country’s priorities and resources.
Aid From China
In recent years, China has become a large donor of foreign aid itself, particularly to developing countries in Africa and Asia. Since 2000, China has spent $843 billion on bilateral aid, financing 13,427 bilateral aid projects in 165 countries, making it the biggest new player in this domain. The 2021 version of China’s approach to foreign aid and development priorities document “offers high-level principles that China claims to ascribe to.”
Although some concepts are carried over from previous papers, the 2021 version expands on the vision “articulated by its predecessors,” with “many of its new terms seeming to be in direct response to recent critiques of China’s flagship push to fund physical and digital infrastructure overseas through the Belt and Road Initiative.”
The Belt and Road Initiative (BRI) is a global infrastructure development strategy the Chinese government proposed in 2013. The initiative aims to connect Asia, Europe and Africa through a network of roads, railways, ports and other infrastructure projects, with the goal of promoting economic development and trade. According to the World Bank, the initiative involves more than 70 countries and represents more than “one-third of the global trade and GDP and approximately 60% of the world’s population.”
The BRI is controversial, with some countries accusing China of using it to expand its global influence and engage in “debt-trap diplomacy.”
A Significant Role in China’s Development History
Foreign aid has played a significant role in China’s development history, with foreign aid to China increasing bilaterally and multilaterally since 1949. However, there has been a significant downward trend in foreign aid to China as China has become a key donor of foreign aid itself.
– Scarlett Ren
Photo: Flickr