Female Empowerment in PoliticsThe high rate of preventable maternal mortality rates in developing countries continues to be a cause of concern. The World Health Organization (WHO) defines maternal mortality “as the death of a woman from pregnancy-related causes during pregnancy or within 42 days of pregnancy.” Maternal mortality occurs almost entirely (99%) in low-income countries. The maternal mortality ratio (MMR) of impoverished countries estimates 239 maternal deaths per 100,000 live births. This rate is 12 per 100,000 in high-income countries. Research shows that female empowerment in politics links to reduced maternal mortality rates.

Reasons for High Maternal Mortality in Developing Countries

Female Representation in Government

Global female representation in government has increased to more than 20% while maternal mortality has declined by 44% since 1990. Is this a cause-and-effect scenario or merely coincidence? A recent study titled, “Maternal Mortality and Women’s Political Participation” offers data to support that it is not just happenstance and that female empowerment in politics has a direct effect on maternal mortality levels.

In 2020, female participation in parliament reached 24.9% globally. One reason for the rise in women’s representation in government is the fact that several countries are adopting gender quotas. Gender quotas secure a number of seats in government for women. At least 130 countries have adopted gender quotas and have an average of 26.9% female representation. Countries that have implemented quotas have seen maternal mortality decline at an accelerated rate. Estimates have determined that gender quota application results in an average of a 9-12% drop in maternal mortality.

Female Policymakers Prioritize Women’s Health

Health is a vital contributing factor in empowering women. Women statistically prioritize policies aimed at improving female conditions at a higher rate than their male counterparts. These policies often target issues such as education, child marriage and maternal health. Countries with gender quotas in place show an estimated 8-11% rise in “skilled birth attendance” and a 6-11% rise in the use of prenatal care.

A paper that Cambridge University published in 2016 asserted that an increase of only 1% in women’s representation in government resulted in five fewer maternal deaths and 80 fewer infant deaths out of 100,000 live births. These studies and statistics conclude that women’s participation in legislatures improves the health of its female constituents.

Eradicating Maternal Mortality

Female empowerment in politics contributes to the Sustainable Development Goals (SDGs). The Sustainable Development Goals, which the U.N. established, include reducing maternal mortality (SDG 3.1) and increasing the number of women in government (SDG 5.5). These goals are complementary to each other. By working toward SDG 5.5, which is to “Ensure women’s full and effective participation and equal opportunities for leadership at all levels of decision-making in political, economic and public life,” it is reasonable to conclude that the world could achieve, SDG 3.1, which is to “reduce the global maternal mortality ratio to less than 70 per 100,000 live births” by 2030, in tandem.

Rachel Proctor
Photo: Flickr

Maternal Mortality LaosIt is hard to imagine how giving birth can be fatal to so many women around the world. However, even in 2021, maternal mortality remains a significant issue, especially in developing countries where modern medicine is scarce and medical facilities are not easily accessible. Fortunately, these maternal mortality rates have been dropping all over the world, especially in Laos.

Birth Complications in Laos

Laos, or Lao People’s Democratic Republic, is a landlocked nation between Thailand and Vietnam. With a population of 7.2 million, the country suffers from a declining fertility rate. In 2020, women in Laos had an average of 2.7 children, yet this rate was more than doubled just 30 years ago. In addition to infertility, women in Laos are at a greater risk for birth complications. According to the U.N., a mother’s risk of dying in Laos due to delivery and post-delivery complications is one in 150. This number is especially alarming when compared to statistics in Europe, where a woman’s risk of death is one in 3,400.

Declining Maternal Mortality Rates

Since the turn of the millennium, maternal mortality rates have dropped significantly all over the world due to the spread of modern medicine. According to the World Health Organization (WHO), the maternal mortality ratio dropped by approximately 38% worldwide in less than 20 years. Similar encouraging statistics are emerging from Laos. Eksavang Vongvichit, the nation’s former health minister, discusses Laos’s progress in tackling this issue: “We’re in third place worldwide in terms of bringing down the maternal mortality rate… We’ve brought down the number of maternal deaths from 450 out of 100,000 live births down to 220.”

The Ongoing Fight Against Maternal Mortality in Laos

Maternal mortality is a more frequent reality in developing countries. On average, women in low-to-middle-income countries more likely to die during or immediately after pregnancy than women in developed nations. This is largely because many birth-related deaths result from easily preventable causes, including severe bleeding, infections, high blood pressure, complications from delivery and unsafe abortions.

To prevent such avoidable deaths, numerous charities and NGOs are working on better educating reproductive healthcare workers in developing nations. The United Nations Population Fund (UNFPA) is a prime example of this work, being stationed in Laos and other developing nations all over the globe. In Laos, the program helped the Ministry of Health create better training programs for volunteers and midwives in reproductive care. This education includes bringing awareness to mothers about proper family planning, which covers how long to space out pregnancies and prevent undesired pregnancies. Not only will such education prevent unnecessary fatalities, but it will also aid families in properly planning for the future to break the cycle of poverty.

With the continued implementation of modern medicine and reproductive education in developing countries, there is great hope that the rate of maternal deaths will continue to decline in Laos.

– Amanda J. Godfrey
Photo: Unsplash

Maternal Care in BangladeshBack in 1972, Fazlé Hasan Abed started a small organization called the Bangladesh Rehabilitation Assistance Committee (BRAC). Originally dedicated to helping refugees after Bangladesh’s war for independence against Pakistan, the organization has since grown to serve 11 countries across Asia and Africa. One of the key focuses of BRAC is poverty alleviation and includes categories such as improving maternal care in Bangladesh.

BRAC’s Strategies for Poverty Reduction

BRAC engages several strategies to combat poverty, such as social enterprises. Social enterprises are self-sustaining cause-driven business entities that create social impact by offering solutions to social challenges and reinvesting surplus to sustain and generate greater impact. Some social enterprises include those seeking to promote access to fisheries, give people access to jobs in the silk industry and businesses that give seed access to farmers.

BRAC also prioritizes social development. These initiatives refer to BRAC’s on-the-ground programs. Social development efforts aim to build communities up by attempting to foster long-term development through the promotion of microfinance and gender equality and by eradicating extreme poverty.

The third focus of BRAC is investments. BRAC seeks to invest in local companies in order to create as much social impact as possible. This includes initiatives to expand affordable internet access for all and a range of other financial support services.

Finally, the organization founded a tertiary education institution called Brac University. The University, located in Bangladesh, aims to use its liberal arts curriculum in order to try and advance human capital development and help students develop solutions to local problems.

The BRAC Manoshi Maternal Care Initiative

Founded in 2007, the Manoshi program is specifically tailored to serve mothers and newborns by providing accessible care. There are a couple of unique methods that make this maternal healthcare initiative especially effective in reaching its goals of improving maternal care in Bangladesh.

One-third of people in Bangladesh live under the poverty line and a greater part of this group live in slums, making it difficult to access and afford necessary healthcare. Manoshi focuses primarily on empowering communities, particularly women, in order to develop a system of essential healthcare interventions for mothers and babies.

Manoshi’s Focal Areas for Community Development

  • Providing basic healthcare for pregnant and lactating women, newborns and children under 5
  • Building a referral system to connect women with quality health facilities when complications arise
  • Creating women’s groups to drive community empowerment
  • Skills development and capacity building for healthcare workers and birth attendants
  • Connecting community organizations with governmental and non-governmental organizations to further their goals

The main methods used in the Manoshi project to achieve desired outcomes are social mapping, census taking and community engagement.

Manoshi’s Impact on Maternal Care in Bangladesh

BRAC projected that improvement in healthcare access would cause neonatal mortality to decline by 40-50% and the most recent data from the Manoshi program shows just that. Manoshi’s data shows that from 2008 to 2013, both the maternal and neonatal death rates dropped by more than half. From 2007 to 2011, the percentage of births at health facilities increased from 15% to 59%, while national averages only increased from 25% to 28%, suggesting that mothers served by Manoshi have more access to resources and facilities for safe deliveries. Prenatal care also increased from 27% to 52% in the same years.

With the substantial impact of organizational programs like Manoshi prioritizing the wellbeing of women and children, advancements with regard to maternal care in Bangladesh will hopefully only continue upward.

– Thomas Gill
Photo: Flickr

4 Mobile Services Reducing Maternal and Child MortalityA woman in Africa is more likely to die from pregnancy or childbirth than a woman in Western Europe. The lack of nurses and midwives in comparison to Europe can make a significant impact on pregnancy and postpartum healthcare as well as maternal mortality in Africa. However, organizations and businesses are helping improve African women’s living conditions. Here are four mobile services reducing maternal and child mortality in Africa.

Springster

This mobile platform “connects marginalized and vulnerable girls to online content designed to equip them with knowledge, confidence and connections they need to navigate the complex choices of adolescence.”

Springster’s content can be accessed through social media channels like Facebook to provide a space for girls to engage in topics like puberty, education, money management and relationships. The app is based on sharing real-life experiences, helping girls make positive choices and change their lives for the better.

A major innovation with the app is Big Sis. Big Sis is a chatbot designed to provide personalized information about questions related to sexual health. This enables girls to find advice and answers 24/7. The app has impacted many girls’ lives with the reassurance and advice from shared stories and experiences from other girls like them. As a result, they are able to provide guidance and support from each other.

Mum & Baby

This service sends free health information via SMS three times a week to mothers, caregivers and partners. When people sign up for the service, they provide their age, location and stage of parenting they need help with from early pregnancy to taking care of a five-year-old.

After giving out personal information, Mum & Baby sends out personalized messages depending on the information given. Along with the messages, there is a free mobile site that does not use data. Instead, it offers articles, videos, tutorials and tools like the immunization calendar, due date calculator and pregnancy medicine checker.

A study was conducted to see the impact Mum & Baby has on people using the service. The study found 96% of users found the information via texts helpful and 98% of users say they would take action to care for themselves or their children.

Of the mothers and pregnant women surveyed, 95% of them say the information they received influenced their decision to breastfeed. Moreover, 96% of the people surveyed were influenced to get their kids vaccinated. More than 650,000 children were immunized as a result of free text messages.

RapidSMS in Rwanda

This mobile service has a similar style to Mum & Baby in the sense that it shares information via SMS. However, with this mobile platform, community health workers are equipped with mobile devices to collect and use real-time data on key maternal, neonatal and child health indicators.

The data is collected within the first 1000 days of life from pregnancy to childbirth to up to two years. This also includes a broad range of areas of childcare such as antenatal care, delivery, postnatal care, growth monitoring and even death indicators such as maternal and child mortality.

The indicators are recorded using the mobile platform and generate reminders for appointments, delivery and postnatal care visits. There is also an emergency care platform called Red Alerts. There is also a creation of a database of clinical records on maternal care delivery.

UNICEF did a study on RapidSMS to measure its effects on maternal and child mortality. It has contributed to some changes in the use of healthcare services and maternal and child mortality but has overall made improvements on health outcomes for mothers and children in Rwanda.

M-Mama’s Ambulance Taxi

This application “uses mobile technology to connect women in rural areas of Africa to emergency transport.” The project started in 2013 to help women in rural Tanzania gain access to healthcare where almost half of the women there give birth at home without the assistance of a healthcare worker. Many mothers and children die from preventable birth complications due to the lack of health systems and delayed access to care.

The people of M-Mama intend to change that and reduce maternal mortality rates which is a challenge faced by the U.N.’s Sustainable Development Goals.

The process of M-Mama’s ambulance taxi project starts when a patient makes a call to a 24-hour dispatch center. A call handler will then access the condition of the patient using the app, which would indicate whether the patient needs a transfer to a health facility. If healthcare is required, the nearest taxi will be notified and identified through the app, requesting the taxi driver to take the patient to the hospital. This way, taxis act as a cost-effective ambulance for the patient. The driver will then be paid after safely escorting the patient to the hospital.

Since M-Mama’s start, there has been a reduction in maternal mortality of 27% in the Lake Zone regions of Tanzania.

Conclusion

These mobile apps are reducing maternal and child mortality rates in Africa. Through the mobile services’ resources and aid, young girls can make better decisions and expecting mothers can get the help they need, despite their remote locations. Reducing maternal and child mortality by 1% can increase GDP by about 4.6% in African countries.

However, one issue that stands in the way is the lack of access to mobile phones and the internet. Women in Sub-Saharan Africa are 13% less likely to own a phone and 37% less likely to access the internet on mobile.

The more investment there is to reduce maternal and child mortality in Africa, the more it will generate social and economic benefits for Sub-Saharan Africa. To do that, governments and non-profit organizations need to work to close the gender gap and develop mobile health services. These efforts will help women be informed and make healthier decisions.

– Jackson Lebedun
Photo: Flickr

How the Maternal Mortality Rate is Decreasing in Sierra LeoneThe capital of Sierra Leone, Freetown, is historically known for being a home for freed slaves during the transatlantic slave trade, giving Sierra Leone a prominent place in history. However, the small west African country boarding Guinea has faced many adversities. One is the significant increase in adolescent pregnancies and fertility being some of the highest in the world. Women in Sierra Leone have “a one in 17 lifetime chance of dying during pregnancy, delivery or its aftermath.” This article will discuss the main reasons for the decreasing maternal mortality rate in Sierra Leone.

Data Behind the Mortality Rate in Sierra Leone

For the government of Sierra Leone, keeping a consistent record of deaths was nearly nonexistent during the Ebola outbreak. According to an article by Financial Times, Dr. Sesay, who is “the government’s director of reproductive and child health,” conducts the government’s response to the maternal deaths. According to Dr. Sesay, procedures are set out to lower the maternal mortality rate in Sierra Leone. “We’ve put in place a maternal death surveillance and response team, and developed a technical guideline. When a death is reported, they go and confirm.”

Part of the surveillance is ensuring that reporting the deaths is imperative. This requires health workers within communities to report the deaths to major health facilities. Furthermore, this is vital to decreasing the maternal mortality rate in Sierra Leone as it ensures that all families are accounted for and not misrepresented in the sample population. However, the same health workers reporting the data are the same ones attempting to save these expectant mothers’ lives, which stretches on the ground workers.

Looking at the Numbers

Maternal mortality in Sierra Leone had reached 1,070 deaths between January to June of 2020. According to a report by the ministry of health and sanitation in Sierra Leone, from January to March of 2020, there was a total of 581 maternal deaths. And from April to June of 2020, the total was 489 maternal deaths.

Equally as important, the predominant reference of data for maternal deaths is CRVS (Civil Registration and Vital Statistics). The issue is that Sierra Leone doesn’t recognize this system of data reporting. When this occurs, other data systems are created, such as surveys and various studies, which leaves more room for inaccurate information. The organizations the World Health Organization, the United Nations International Children’s Emergency Fund, the United Nations Population Fund and the World Bank Group have collectively concluded that not all deaths can be recorded due to “systematic error.” Meaning the data presented won’t be accurate due to the actual number being lower or higher and this will impact how the maternal mortality rate is decreasing in Sierra Leone.

However, when using CRVS, “records will be systematically lower than the true number because there will always be deaths that go unreported. This is referred to as a systematic error.” Along with systematic error, there is the possibility of “random error,” meaning when a health worker records inaccurate information. This increases the inaccuracy of maternal deaths in Sierra Leone. Considering health workers are underpaid and overworked, random error is present when recording maternal deaths.

How to Improve Maternal Mortality Rate Efforts

There are multiple ways of decreasing the maternal mortality rate in Sierra Leone. However, today’s most beneficial way is by increasing and encouraging education for traditional birth attendants (TBAs). Undergoing childbirth for many women in Sierra Leone in the past meant being at home and having a TBA present. Usually, a TBA is an elderly woman from within the community and is often referred to as “auntie” or “mother.” Although this may sound beneficial and comfortable, such as having a midwife or doula, according to the government, TBAs were the primary reason for the country’s maternal deaths.

If patients were to have any complications during delivery, the TBA would inform the patient that emergency transportation would take too long to arrive and going to the nearest clinic would take too much time. In most cases, patients would bleed out as healthcare officials would arrive too late. The government attempted to resolve this issue by ratifying a law in 2010 forbidding TBAs to assist in deliveries outside of a clinical environment. If a TBA and anyone else taking part in the process, including the expectant mother, were caught defying this law they would face extreme retribution.

Established in 2001, the non-governmental organization IsraAID is working towards providing “emergency and long-term development settings in 50 plus countries.” The organization also has a medical care program that targets “reproductive health,” along with expanding educational opportunities. For the maternal mortality rate to decrease, the government of Sierra Leone has to establish effective maternal mortality reporting data and education for TBAs.

—Montana Moore
Photo: Flickr

empowering women improvesIn recent years, great strides have been made in improving women’s and children’s health. Fertility rates in both low and middle-income countries have significantly declined and life expectancy has increased by more than 10 years. Despite this progress, the WHO reports that a vast majority of maternal deaths (94%) occur in low-resource settings and most could have been prevented through adequate maternal care and other factors. Political and societal efforts to mitigate these disparities as well as ground-level health interventions are key to guarantee enduring improvements in women’s and children’s health. Empowering women improves maternal and child health outcomes in several ways.

Empowering Women Improves Maternal Health

Although the role of women’s empowerment as a social determinant of maternal and child health outcomes has not been as widely acknowledged as other social determinants such as education, it is a leading opportunity to improve the well-being of women and children around the world. Women’s empowerment is positively associated with an array of positive maternal and child health outcomes,  such as improved antenatal care, contraceptive use, child mortality and nutrition levels.

Improved Maternal Health in Guinea and India

Another facet of maternal health that is linked with women’s empowerment is increased access to quality maternity care. The Republic of Guinea has committed to alleviating maternal and child health disparities by increasing women’s liberty. According to the 2018 Guinea Demographic Health Surveys, mothers who received higher quality antenatal care (ANC) also exhibited several aspects of women’s empowerment, such as having a proactive role in healthcare decisions and being employed.

In Varanasi, India, women’s autonomy and empowerment were also found to positively influence maternal health. A study of 300 women found that women with greater autonomy were more likely to deliver their baby in a clinic and employ higher levels of antenatal care.

Improved Maternal Health in Africa

Uniformly, a regional analysis of Africa revealed that dimensions of women’s empowerment impacted maternal health and utilization of health services. Researchers found that having greater control over money or household decisions correlated with higher Body Mass Index (BMI) in the Democratic Republic of Congo, Ghana, Uganda and Zambia. This is important because low maternal weight is a risk factor for low birth weight babies and adverse infant outcomes. Additionally, facility delivery was significantly associated with positive attitudes toward gender roles in Nigeria. Delivering in a clinic plays a large role in reducing maternal mortality as the majority of fatal pregnancy complications can be prevented if intervened by a skilled clinician.

Empowering Women Improves Child Health

In addition to improving maternal health, empowering women improves and enriches the health of their children. Studies have found a nexus between women’s empowerment and good child health outcomes, including higher utilization of health care services and immunizations, improved nutritional status and lower child mortality.

Women in Nepal who own land are significantly more likely to have authority over household decisions,and similarly, children of mothers who own land are significantly more likely to be a healthy weight. The connection between land ownership and feelings of empowerment mean women are more likely to use income to contribute to the well-being of the children and the family overall.

Organizations for Women’s Empowerment

Mending educational and economic inequalities and disadvantages that women and girls face are fundamental in empowering women and marking long-term and sustained improvements in women’s health. Offering scholarships, making schools a safe environment for girls and transforming beliefs and gender-biased social norms that perpetuate discrimination and inequality are avenues to create equal education opportunities. Additionally, governments and policymakers are pertinent to allocate resources necessary for gender equity and improving female health.

Self Help Groups (SHGs) are a great example of a simple yet effective solution to empower women who live in lower-income communities. Find Your Feet is an organization based in the U.K. that is working in Malawi and rural India to end rural poverty. The organization works with families in remote areas of Asia and Africa by helping them earn incomes and expand access to vital services. A key facet of its work is geared toward women’s empowerment and it has created SHGs throughout the poorest districts in India.

The Way Forward

Empowering women is a catalyst for not only better maternal and child health outcomes, but investing in a woman’s health and empowerment has a ripple effect, helping families, communities and countries to rise out of poverty.

– Samantha Johnson
Photo: Flickr

Maternal Health in Yemen
The Yemen civil war, which began in early 2015 and still devastates the nation today, has created the world’s worst humanitarian crisis. A total of 24 million people require assistance. This crisis affects all aspects of life in Yemen, including healthcare. Millions are without access to life-saving medical treatment and supplies, leading them to die of preventable diseases, such as cholera, diabetes and diphtheria. Pregnant women and infants are particularly vulnerable during this health crisis as adequate medical care throughout pregnancy and birth is essential. Maternal health in Yemen is of the utmost concern now.

Yemen has one of the highest maternal mortality rates in the world with 17% of the female deaths in the reproductive age caused by childbirth complications. Maternal health in Yemen has never been accessible to all women. This crisis has escalated even further during the Yemeni civil war. However, global organizations are acting to save the lives of these pregnant women and infants who desperately need medical care.

Yemen’s Maternal Health Crisis: Before the Civil War

Even before the war began in 2015, pregnant women were struggling to get the help they needed. Yemen is one of the most impoverished countries in the world — ranking at 177 on the Human Development Index (HDI). Poverty is a large factor in the insufficiency of maternal health in Yemen as impoverished women lack the finances, nutrition, healthcare access and education to deliver their babies safely.

Many Yemeni women are unaware of the importance of a trained midwife during childbirth. Of all the births in rural areas, 70% happen at home rather than at a healthcare facility. Home births increase the risk of death in childbirth as the resources necessary to deal with complications are not available.

The Yemeni Civil War Increased the Maternal Health Crisis

Since the civil war began, the maternal mortality rate in Yemen has spiked from five women a day in 2013 to 12 women a day in 2019. A variety of factors caused this spike. The war has further limited access to nearly every resource, including food and water. This, in turn, depletes the health of millions of women and thus their newborns.

Also, the civil war has dramatically decreased access to healthcare across the nation. An estimated 50% of the health facilities in the country are not functional as a result of the conflict. Those that are operational are understaffed, underfunded and unable to access the medical equipment desperately needed to help the people of Yemen. This especially affects pregnant women — who require medical care to give birth safely.

Organizational Aid

Though the situation in Yemen remains dire, various global organizations are acting to assist pregnant women and newborns. The United Nations Children’s’ Emergency Fund (UNICEF) is taking the initiative to help millions across Yemen, including pregnant women. The organization has sent health workers and midwives into the country’s rural areas to screen and treat pregnant women for complications.

Similarly, USAID trained more than 260 midwives and plans to send them into Yemeni communities to help pregnant women and infants. USAID is partnering with UNICEF, the World Health Organization (WHO), the Yemen Ministry of Public Health and Population and other organizations to ensure that maternal health in Yemen, as well as all types of healthcare, are adequate and accessible for all affected by the civil war.

Maternal health in Yemen, while never having been accessible for many, is now in crisis as a result of the Yemeni civil war. While the situation is still urgent, organizations such as USAID and UNICEF are fighting to ensure that all pregnant women and infants in Yemen have access to the medical care they desperately need.

Daryn Lenahan
Photo: Flickr

Maternal Mortality
Maternal mortality refers to the death of a woman due to causes related to or aggravated by her pregnancy and/or childbirth. Almost all (99%) of maternal deaths occur in developing countries, and 68% occur in Sub-Saharan Africa alone. The Trends in Maternal Mortality 2000-2017 report is a joint effort by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Its statistics showcase huge global health disparities that leave African mothers extremely vulnerable, showing that maternal mortality in Sub-Saharan Africa is a prevalent issue.

Health Inequality in Maternal Healthcare

Almost all maternal deaths are preventable, yet in 2017, Sub-Saharan Africans suffered from the highest maternal mortality ratio (MMR) of 533 maternal deaths per 100,000 live births, or 200,000 maternal deaths a year. All three countries with the highest MMR globally with over 1,000 deaths per 100,000 live births, considered an extremely high rate, are in Sub-Saharan Africa: South Sudan (1,150), Chad (1,140) and Sierra Leone (112). In comparison, the 2017 MMR in North America and Western Europe was 18 and five.

The fact that MMR is under 10 in many countries means that current technology and medical knowledge are already capable of reducing MMR to almost zero. The global imperative is to improve health infrastructure and education in developing nations so that they, too, can access services and resources available to protect mothers in the developed world.

The Importance of Access

Lack of access to health facilities and medical professionals is among the main reasons for maternal deaths. Currently, in Africa, there are 985 people for every nurse/midwife and 3,324 people for every medical doctor. This means that many pregnant women do not receive antenatal, delivery and newborn care, which greatly increases their risk of dying from severe bleeding, infections or other complications. Ensuring that there are accessible and affordable health facilities for all women would eliminate risks of preventable and treatable deaths.

Adolescent Pregnancy

Improving sexual health education is key to eliminating adolescent pregnancies, which account for a significant portion of maternal mortality in Sub-Saharan Africa. Adolescent girls, especially those under 15, have a higher risk of maternal mortality compared to older women. In 2014, there were 224 adolescents per 1,000 cases of pregnancy in the Democratic Republic of Congo – the highest teenage pregnancy rate in the world, followed by Liberia (221) and Niger (204). Improvements in sexual health education would inform young girls of contraceptive options, family planning methods and safe abortion facilities.

Progress Tracker

Significant efforts have succeeded in reducing maternal mortality in Sub-Saharan Africa. From 2000 to 2017, Sub-Saharan Africa has achieved a substantial reduction of 39% of maternal mortality (from 870 to 533 maternal deaths per 100,000 live births). A significant number of countries in this region have reduced their MMR by more than half, such as Rwanda (79%), Mongolia (71%), Eritrea (63%), Zambia (60%) and Cabo Verde (51%).

WHO has stated that improving maternal health remains one of their key priorities. In 2015, the global health organization launched the Global Strategy for Women’s, Children’s and Adolescents’ Health aimed at ending all preventable deaths of women, children and adolescents. The UN’s Sustainable Development Goal target 3.1, also launched in 2015, aims to reduce global MMR to less than 70 per 100,000 live births by 2030. While the current MMR in Africa is still seven times less than the target, promising results from past and current campaigns indicate that a better future is within reach.

– Alice Nguyen
Photo: Flickr

Healthcare in Nigeria
Healthcare in Nigeria leaves a lot for people to desire. The system is inefficient and inequitable, although there are some stories of success. Here are eight facts about healthcare in Nigeria.

8 Facts About Healthcare in Nigeria

  1. Prior to the European colonization of Nigeria, the healthcare system consisted entirely of herbal medicine treatments. This system relied on the knowledge of practitioners and a strict apprenticeship program. Understanding the background of Nigerian healthcare is an important prerequisite for assessing the modern system.
  2. After Nigeria gained independence in 1960, the country put a radical new healthcare system in place. Primarily a welfare-based system, it was progressive for its time. The government offered free or heavily subsidized treatments and medicines. However, the subsequent downturn in oil prices destroyed this system. Augmented by political corruption, the government could not afford to continue subsidizing healthcare.
  3. Currently, Nigeria’s healthcare system ranks among the lowest in the world. A study from 2018 in the Lancet of Global Health Care Access and Quality looked at 195 countries around the world; Nigeria ranked 142nd.
  4. One of the biggest problems facing Nigeria is the lack of qualified workers in the healthcare sector. The densities of nurses, midwives and doctors are ineffective for a country the size of Nigeria. There are only 1.95 qualified healthcare workers per 1,000 citizens in Nigeria.
  5. The healthcare statistics in Nigeria are abysmal. Maternal mortality in Nigeria is among the worst in the world with a whopping 19% of global maternal deaths occurring in the country. Additionally, the infant mortality rate is far too high at 19 deaths per 1,000 births. In addition, the mortality rate of children under 5 is 128 per 1,000. Moreover, life expectancy in Nigeria is an incredibly low 54.4.
  6. Healthcare expenditures accounted for 3.7% of Nigeria’s GDP in 2016. Of total healthcare expenditures, 71.7% is from out-of-pocket spending – expenses that do not receive coverage from insurance or government subsidies.
  7. One of the biggest problems plaguing healthcare in Nigeria is inequality. For example, most of the healthcare workforce works in urban areas, specifically in the southern parts of the country. As a result, rural healthcare lags behind with fewer healthcare workers. Fortunately, Nigeria has identified this problem and is working to mitigate it. A successful approach that Nigeria initiated was the Midwifery Service Scheme. This program, started in 2009, took unemployed, retired and recently graduated midwives and placed them in rural areas for a year of community service. Simply getting more qualified healthcare workers in rural areas is proving to be a huge success.
  8. Healthcare in Nigeria is not all bad. Recent infrastructure improvements are helping end polio and fight diseases, such as Ebola and COVID-19. For example, Nigeria has implemented a decentralized disease control network and better vaccine storage methods.

Today, Nigeria faces an uphill battle. The country needs to address healthcare inequality and a lack of a qualified healthcare workforce to continue developing on a global scale. The country has taken some measures to modernize its healthcare infrastructure and more are on the way.

– Evan Kuo
Photo: Flickr

Women's Rights in Bangladesh
Since achieving independence in 1971, Bangladesh has lifted 15 million citizens out of poverty and made great strides in tackling food insecurity. However, while its government has been tirelessly working to develop economically, it has also been fighting another battle for women’s rights in Bangladesh.

Despite a patriarchal social framework, Bengali women have held the right to vote since 1947, and the country elected its first female Prime Minister in 1991. Women fought for their country in Bangladesh’s Liberation War, and the constitution that the country subsequently adopted promised equal opportunities for women in all areas. The following six facts about women’s rights in Bangladesh explain how the country has tried to uphold that promise, and what challenges remain.

6 Facts About Women’s Rights in Bangladesh

  1. The government has enacted numerous policies over the past decade focused on women’s rights in Bangladesh. The Ministry of Women and Children Affairs has increased allowances for widows, eased the burden on lactating mothers in urban areas and provided job training in fields such as agriculture and electronics. The National Women Development Policy of 2011 aimed to establish equal rights for men and women but also included specific goals such as assistance for female entrepreneurs. To oversee the implementation of the development policy, the government formed a 50-member National Women and Child Development Council chaired by Prime Minister Sheikh Hasina. Hasina has also vocally supported women’s empowerment in global forums such as the UN.
  2. Men still dominate the country’s political system. With Hasina leading the country since 2009 and the main opposition party also being led by a woman, Bangladesh might appear to be a model for women’s empowerment in politics. However, out of 350 seats in the Bangladeshi parliament, only 22 currently belong to directly elected female legislators while 50 are reserved for women who are not directly elected. Female politicians and activists have described a culture of exclusion within the two main political parties, reinforced by male politicians who view their female colleagues as inferior. Still, the proportion of women in parliament has continued to rise over the past decade and women hold seats in 12,000 local political offices.
  3. Maternal mortality has dropped 60% since 2000. This drop has been the result of effective investments in prenatal care. The Government and United Nations Population Fund (UNFPA), the UN’s sexual and reproductive health agency, has provided critical support by coordinating midwife training programs. Trained midwives alleviate a major risk factor for maternal mortality, which is a lack of healthcare access for pregnant women. More than half of Bengali women opt to give birth at home, but the proportion of births in which trained health personnel are present has been growing and now makes up more than half.
  4. Violence against women and child marriage remain major problems. Two out of three married women in Bangladesh have experienced domestic violence at some point in their lifetime. Religious law dictates customs such as marriage and cements discrimination against women. Almost 60% of girls are married before their 18th birthday, and their husbands’ families may abandon them if they are unable to bear children. Grassroots and international NGOs have attempted to change this status quo; for example, Girls Not Brides Bangladesh is a partnership of 25 organizations that lobbies the government and promotes advocacy. The government has answered by passing the Domestic Violence Prevention and Protection Act in 2010 and the Child Marriage Restraint Act of 2017, but the results of these efforts have yet to materialize.
  5. Civil society organizations have played a key role in improving women’s rights in Bangladesh. An example of a nonprofit that is supporting Bengali women is the South Murapa Underprivileged Women’s Cooperative Society. This organization provides medical care to women in Cox’s Bazar district. The group’s chairperson, Kulsuma Begum, escaped an abusive husband at the age of 16 and immediately set out to help pregnant women in disaster zones. Apart from domestic organizations like Begum’s, international charities such as Save the Children have made large gains in infant health and early childhood education.
  6. The COVID-19 pandemic has exacerbated existing inequities. An interagency evaluation by UN Women identified several factors that could erode women’s rights in Bangladesh due to the pandemic, including lack of healthcare access, unequal care work burden and a lack of decision-making power in the pandemic response. Experts also documented a rise in gender-based violence during the initial shutdown, fueling a spike in calls to national trauma hotlines. Luckily, local organizations on the ground have organized cash-for-work activities for women, such as mask making.

The Road Ahead

In the months to come, the COVID-19 pandemic will continue to present challenges for Bangladesh, especially the country’s women. However, Bengali women have long borne the brunt of their country’s struggles while still relentlessly pushing for change. Hopefully, their resilience will ultimately shine through.

 – Jack Silvers
Photo: Flickr