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Maternal MortalityMaternal mortality refers to the death of a woman due to causes related to or aggravated by her pregnancy and 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. Maternal Mortality in Sub-Saharan Africa is a prevalent issue.

Health Inequality in Maternal Healthcare

Almost all maternal deaths can be prevented, yet in 2017, Sub-Saharan Africans suffered from the highest maternal mortality (MMR). The ratio was 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 1000 deaths per 100,000 live births, considered a too high rate, are in Sub-Saharan Africa. South Sudan has 1150, Chad has 1140 and Sierra Leone has 1120. In comparison, the 2017 MMR in North America and Western Europe is 18 and 5.

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 to access services and resources available to protect mothers in the developed world.

The Importance of Access

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

Adolescent Pregnancy

Additionally, improving sexual health education is the key to eliminating adolescent pregnancies. These pregnancies account for a significant portion of maternal mortality in Sub-Saharan Africa. Teenage girls, especially those under 15, have a higher risk of maternal mortality than older women. For example, in 2014, there were 224 adolescents per 1,000 cases of pregnancy in the Democratic Republic of Congo. This is the highest teenage pregnancy rate globally, followed by Liberia, which has 221, and Niger, which has 204. Improvements in sexual health education would inform young girls of contraceptive options, family planning methods and safe abortion facilities.

Progress Tracker

Furthermore, 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. This percentage is 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. Rwanda is at 79%, Mongolia is at 71%, Eritrea is at 63%, Zambia is at 60% and Cabo Verde is at 51%.

Overall, 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. It aims at ending all preventable deaths of women, children and adolescents. UN’s Sustainable Development Goal target 3.1, also launched in 2015, aims at reducing global MMR to less than 70 per 100,000 live births by 2030. The current MMR in Africa is still seven times less than the target. Nevertheless, promising results from past and current campaigns indicate that a better future is within reach.

– Alice Nguyen
Photo: Flickr

Domestic Violence in Morocco
In Morocco, more than 50% of women have experienced violence. Among these women, only about 28% have sought help from others regarding their abusive environment. There is a new law put in place to criminalize violent actions against women. However, the government still needs to address several issues to protect women effectively from domestic violence in Morocco.

Laws to Protect Women Against Domestic Violence

The new law passed in 2018 outlaws some form of violent actions against partners and allows authorities to step into domestic affairs if it is necessary. This law spreads awareness and provides prevention measures. Abused women can file cases to charge abusive partners or family members. However, the law does not clarify what domestic violence is nor does it explicitly make marital rape a crime. Moreover, the law does not financially support victims or survivors of violence or any shelters for those who need housing after escaping from an abusive environment. The law requires police to be able to help abused women. However, they did not record statements of victims and made them go back to their partners in some cases. The law failed to create a system that checks if the authorities carry out their duties to protect the rights of abused women.

Vulnerable Women and Poverty

Poor women do not have access to education. As a result, they have to be financially dependent on their partners because they cannot find a job. These women tend to receive violence from their partner more passively than those who have jobs. Lack of education and jobs makes women vulnerable to abusive relationships because they feel no power to defend their rights and interests. Because of a lack of access to stable housing after escaping from an abusive situation, women are often forced to return to their abusive partners. Victims file criminal cases against their partners, but most of them drop cases because of the pressure from family or financial reasons. In the interview by UNFPA, Khadija tells her struggle about being financially dependent on her family after getting divorced from the abusive husband. She struggled with finding a job because of a lack of education.

Nongovernmental Organizations Help Abused Women

Several institutions and shelters exist in Morocco to help survivors of domestic violence. The Multi-sectoral Joint Programme is carried out by 13 national groups and more than 50 nongovernmental organizations. It provides legal and economic support for abused women. By 2010, they had 52 counseling centers in Morocco. Additionally, Fais entendre ta voix (Make Your Voice Heard) is a group working to empower women in Morocco. It offers legal help for women to defend themselves.

Effects of COVID-19 on the Victims

The COVID-19 lockdown prohibits individuals from going out without authorization. As a result, abused women cannot seek help. They have no choice but to stay at home where they face abuse. The number of calls to the hotline from abused women is about twice to three times more than before. After the efforts made by advocates, the authority made it possible to file domestic violence cases through phone calls and the Internet. This makes it easier for women who cannot go out to file cases. Poverty also plays a significant role in preventing abused women from seeking help because they do not have access to phones or technology. Therefore, the new tool to file complaints by phone and online help some victims. However, the COVID-19 lockdown still leaves impoverished women vulnerable.

The new law passed in 2018 is a big step to help vulnerable women in Morocco. Financial support and education for women can help to empower women more. Being financially dependent on husbands or partners makes it difficult for women to seek help or escape from an abusive partner. In the survey, more than 60% of men showed the possession of beliefs that women need to endure violence to keep family together. This shows the need to change social beliefs as well.

Sayaka Ojima
Photo: Pixabay

Maternal healthcare in Algeria
Algeria, a large country in North Africa, bordering the Mediterranean Sea. The country is known for its rich history and culture, as well as its scorching temperatures. Like many nations in Africa, Algeria struggles to combat maternal mortality – a long-standing, persistent issue for many women in the country. However, in the last several years, Algeria has taken numerous steps to expand maternal healthcare and reduce pregnancy and labor complications. Here are four facts about maternal healthcare in Algeria.

4 Facts About Maternal Healthcare in Algeria

  1. According to recent updates on the maternal mortality ratio in Algeria — it has gradually dropped from 179 deaths per 100,000 live births in 1998 to 112 deaths per 100,000 live births in 2017. Much of the success in lowering the number of deaths is attributed to a multitude of factors such as increased medical training, investments in healthcare and specific government initiatives aimed at reducing maternal deaths. During the years 2009–2017, Algeria trained about 900 professionals from university hospitals such as, Benni Messous, Kouba, Oran and Bab El Oued on multidisciplinary management of pregnancy.
  2. Within the last couple of years, Algeria has managed to make major investments in healthcare. Algeria managed to increase expenditures in healthcare as a share of GDP from 3.6 % in 2003 to 6.4 % in 2017 — growing at an average annual rate of 4.57%. This is an impressive number when compared with Algeria’s neighboring countries. Moreover, these investments have also helped to establish successful disease detection programs and allowed for improved medical facilities.
  3. In 2015, the Ministry of Health in Algeria began to work in collaboration with UNICEF in an attempt to implement a neonatal and maternal mortality reduction plan. This plan was implemented with the intention of reducing as many preventable, maternal deaths as possible, with a target of 50 deaths per 100,000 live births by 2019. Additionally, in 2016 the Ministry of Health put forward an emergency maternal mortality rate (MMR) reduction plan. “The goals set by the plan relate to strengthening family planning, improving the quality of healthcare during pregnancy, birth and postpartum.”
  4. In order to continue the reduction of the maternal mortality rate, the Health Ministry of Algeria held a survey to consolidate the maternal death rate with the technical and financial collaboration of the three U.N. agencies: (UNFPA, UNICEF and the WHO). The objectives of this survey were to reach a consensus on connections between frequent causes of maternal death, update the maternal death rate and cultivate reliable data “for the readjustment of national programs on maternal health and the reduction of preventable maternal deaths for the implementation of Algeria’s ICPD commitments.”

A Leader in Maternal Healthcare

Much work remains in order for Algeria to be able to effectively put an end to preventable, maternal deaths. However, the measures put into practice within the last several years have already proven to be a success. Thanks to these policies, Algeria has become known as a leader in maternal healthcare in North Africa and the country continues to build a strong momentum and infrastructure to fight this problem.

Shreeya Sharma
Photo: Flickr

10 Facts About Life Expectancy in Guinea-Bissau
Guinea-Bissau, a small country in Western Africa, has a low life expectancy of 57.67 years.  However, life expectancy in Guinea-Bissau of both men and women increased by seven years over the last 17 years. In 2001, life expectancy in Guinea-Bissau was 50.368. Currently, men in Guinea-Bissau have a life expectancy of 55.6 while women have a life expectancy of 59.62. The increase in life expectancy in Guinea-Bissau is due to improvement in health care services, education, preventive measures and a reduction in child mortality.

10 Facts About Life Expectancy in Guinea-Bissau

  1. Child Mortality: The infant mortality rate in Guinea-Bissau continues to decrease. Child mortality was 125 for every 1,000 children in 2008 and that number decreased to 81.5 for every 1,000 children in 2018. Guinea-Bissau’s investments to provide mothers with children under the age of 5 with better access to health care contributed to the reduced child mortality rate. In addition, a U.N. report determined that an increase in vaccinations was extremely effective in reducing the child mortality rate. This was possible because of collaboration from organizations like the United Nations Children’s Fund, the World Health Organization and GAVI. However, there is still more that people can do to improve life expectancy in Guinea-Bissau, such as training more medical professionals to help with childbirth. In 2014, only 45 percent of childbirth had trained professionals available. The leading causes of death for children under 5 are communicable diseases, particularly malaria, diarrheal diseases and respiratory illnesses.
  2. The Leading Causes of Death: The leading causes of death in Guinea-Bissau in 2012 were lower respiratory infections including whooping cough and infection of the lung alveoli, along with HIV/AIDs, malaria and diarrheal diseases. Although malaria-related death is common, that number is declining due to both government and donor efforts from organizations like the Global Fund. These efforts include providing insecticide-treated bed nets and increasing education about malaria.
  3. Spending on Health Care: In Guinea-Bissau, both the government and individuals spend little money on health care. In 2016, the per capita average that people spent on health care was $39 while the government spent 6 percent of its GDP on health care. A U.N. report stated that in 2001, the African government pledged to increase health care expenditures to 15 percent. However, Guinea-Bissau has not yet reached that goal. In addition, the most vulnerable population that suffers from preventable illness and diseases, women and children, receive less than 1 percent of health care funds.
  4. Politics: One of the reasons the government faces difficulty in increasing health care funding is because of instability in Guinea-Bissau’s politics. Since Guinea-Bissau’s independence in 1974, the country has had four successful coups and 16 failed coups. The instability causes constant changes in government officials who are responsible for policies.
  5. National Institute of Public Health: In 2011, the creation of the Instituto Nacional de Saúde Pública (INASA) or the National Institute of Public Health helped bring different components of Guinea-Bissau health care together in order to provide adequate services. INASA works with both international donors, institution and the government to help with disease surveillance and preparation for health emergencies. The responsibility of INASA is to help create health policy in the country as well as to help place health care workers and officials throughout the country.
  6. Lack of Trained Medical Personnel: Guinea-Bissau does not have enough health care workers. It has 1.7 doctors for every 10,000 people, 1.4 midwives and nurses for every 1,000 people, three pediatricians and four obstetricians. For example, in 2014, Guinea-Bissau lost some of its health care workers due to brain drain (trained medical personal moving to other countries). In addition, the lack of adequate pay and failure by the government to pay its medical workers on time have led to strikes. According to a U.N. report, Guinea-Bissau would need to create incentives in order to better retain its health care workers.
  7. Training of Health Care Workers: Training health care workers in Guinea-Bissau is difficult because the country relies on international help from countries like Cuba. One of the main problems is that the training material is in Spanish instead of Portuguese. In addition, some of the reading materials are in e-book formats and students may not have access to computers to read the content. Furthermore, during medical training, there are not enough specialists to oversee or conduct the necessary training. There is hope, however, as the United Nations Population Fund (UNFPA) is helping provide some advanced training for medical professionals who require it.
  8. Vaccine Coverage: Although the lack of political instability has limited government spending in health care, Guinea-Bissau’s coverage rate is 80 percent due to help from the World Health Organization (WHO) and other non-government agencies. Children receive rotavirus and pneumococcal vaccines to help with respiratory and diarrheal illnesses.
  9. Accessibility to Health Care Facilities: In Guinea-Bissau, it can be difficult to visit a medical facility because of the lack of adequate roads. Although there are motorized boat ambulances, it can still be difficult to get to a medical facility in some regions in Guinea-Bissau. However, there are plans to build surgical centers in places like the Bijagos region to provide better access to health care.
  10. Community Health Programs and Workers: Community health programs and outreach have been effective in helping with the Guinea-Bissau health care system. These programs that community health workers (CHW) administer provide a community-based approach in helping with the health needs in Guinea-Bissau. Programs include spreading knowledge of childhood nutrition, malaria prevention, pneumonia and household hygiene, and providing several health services. There are around 4,000 community health workers and they are each responsible for visiting 50 households every month. During their visits, community health workers encourage families to adopt the 16 key family practices that can help reduce the number of diseases children may experience. These family practices include the promotion of mosquito nets and six months of breastfeeding, and handwashing, etc.  Community health workers also play a vital role in helping with literacy because of the high illiteracy rate in the country.

Although Guinea-Bissau’s life expectancy is low, there is hope that it will continue to increase due to continuous investment by international donors and non-government organizations. One of the best ways that Guinea-Bissau can provide better health care for its citizens is to strive to be more politically stable.

– Joshua Meribole
Photo: Flickr

 

Maternity Crisis in Sierra Leone
There is a maternity crisis in Sierra Leone. The country has the highest maternal death rate in the world, with one in 17 women dying from pregnancy or birth complications. This number could be even higher, as Sierra Leone’s 2017 Maternal Death and Surveillance Report estimated that seven in 10 maternal deaths go unreported. Below are seven facts about the maternity crisis in Sierra Leone.

Top 7 Facts About the Maternity Crisis in Sierra Leone

  1. The Majority of Maternal Deaths are Preventable: The top causes of maternal death in Sierra Leone are bleeding, pregnancy-induced hypertension, infection and unsafe abortions, all of which are preventable through adequate medical treatment, according to the World Health Organization. Bleeding is a particularly difficult problem for under-served rural areas where mothers do not have access to health care facilities. Another issue facing mothers is infrastructure. People poorly maintain many roads between towns and clinics and these make for a difficult journey for sick and laboring women. Again, road maintenance is a simple problem that can help reduce maternal death in Sierra Leone.
  2. The Majority of Mothers are Under 20: One hundred and twenty-five out of 1,000 mothers in Sierra Leone are under age 20 according to a 2017 United Nations Population Fund (UNFPA) study. Maternity in Sierra Leone is particularly dangerous for adolescent mothers and 20 percent of maternal deaths in Sierra Leone were among teenagers. Beyond maternal death, pregnant teenagers in Sierra Leone lose out on life prospects – a 2015 law banned pregnant girls from attending school, and parents describe teenage pregnancy as the “ultimate shame” for a family.
  3. The 2014-2015 Ebola Crisis Halted Progress: Before 2014, Sierra Leone was making progress in reducing maternal death – from 2000 to 2015, maternal deaths dropped by 4.4 percent. However, the Ebola epidemic caused an immediate increase in maternal death through 2015. Sierra Leone planned to meet many Millennium Development Goals by 2015, but the May 2014 Ebola outbreak reversed progress, particularly in maternal health. Not only did Ebola put a strain on general health care in Sierra Leone, but it also dramatically reduced the number of health care workers in the country. A 2016 World Bank report estimated that maternal death could increase by 74 percent due to the extreme shortage of health care workers in the country.
  4. Programs for Maternity Care Still Need Funding: There is a dearth of doctors in Sierra Leone. For example, in the district of Bonthe, there are nine doctors for 220,000 patients and only 44 percent of births receive support from a nurse or midwife. Unfortunately, between the civil war from 1991 to 2001 and the 2014 to 2015 Ebola outbreak Sierra Leone, the burgeoning health care system in Sierra Leone lost momentum. The E.U., the U.N. and UNICEF have all devoted funds to maternity in Sierra Leone in addition to Partners in Health and other nonprofit organizations. Donations are critical to moving forward with maternal health.
  5. Sierra Leone’s Government has Committed Itself: President Julius Maada Bio announced in October 2019 that Sierra Leone increased its health budget from 8.9 percent to 11.5 percent of the country’s national budget to help combat dangerous maternity in Sierra Leone. On October 18, 2019, Sierra Leone opened a $1.6 billion maternity facility in Freetown to better serve the country’s largest city. Sierra Leone also launched a free health initiative in 2010 to help improve pre- and post-partum care. The government’s goal for maternity in Sierra Leone is to meet Millennium Development Goals by 2030, reducing the global maternal mortality ratio to less than 70 per 100,000 live births.
  6. Nonprofits are Deeply Involved: Multiple nonprofit organizations, including UNICEF, Partners in Health and the Borgen Project have covered issues with maternity in Sierra Leone. Partners in Health has been particularly successful, building a maternal waiting home and opening a health clinic in Kono in 2018. UNICEF provided safer water for mothers to help with illness and sanitation. These nonprofits prove that the crisis is not insurmountable.
  7. Celebrities are also Getting Involved: In October 2019, vlogbrothers, run by Hank and John Green, pledged $6.5 million to Partners in Health as part of his family’s initiative to bring awareness to maternity in Sierra Leone. John Green discussed how he traveled to Sierra Leone and saw first-hand the lack of hospital electricity, medical equipment and transport. He praised the efforts of the Partners in Health in developing a large-scale hospital system and making systematic changes and he asked anyone who can donate to do so. Currently, the vlogbrothers have a goal of $240,000 per month in donations – so far, they have approximately $194,000. The vlogbrothers are also providing updates on their donations and work with Partners in Health in Sierra Leone.

Motherhood should not be a gamble. Families around the world deserve to look forward to pregnancy and birth and not feel distressed. Multiple organizations are pushing for progress, but more is necessary. Support in any form, from awareness to donations, can only help the crisis of maternity in Sierra Leone.

Melanie Rasmussen
Photo: Flickr

end female genital mutilationThe international agencies UNICEF and UNFPA are now in their second year of Phase III of their joint campaign to end female genital mutilation (FGM). While this human rights violation receives less coverage than many other plights affecting the world’s poor, the world’s leaders have come together in recent years to agree on the need to end female genital mutilation. Complete elimination of FGM is recognized as part of the Sustainable Development Goals the global community hopes to reach by 2030.

The Issue at a Glance

The UNFPA defines FGM as “any procedure involving partial or total removal of the external female genitalia or other injury to the female genitals for non-medical reasons.” Affecting 200 million women and girls today in 30 countries, FGM can take the form of a clitoridectomy, infibulation—a way of surgically sealing the vaginal opening—excision, or other damage to the genital area.

While FGM is most prevalent in Africa, it is widely practiced in parts of Asia and the Middle East as well. Egypt and Somalia have among the highest rates in the world, where over 90 percent of girls undergo FGM. In Indonesia and some Asian countries, FGM is so standardized that hospitals expect to perform it on all newborn girls.

Why FGM Should Be Stopped

Part of what makes FGM a human rights violation is that this treatment is typically done to girls under 15 who are not old enough to offer informed consent. Many agree to FGM after hearing myths of what will happen if they forgo the treatment, and the youngest never agree at all—their parents decide.

Not only does FGM violate a women’s right to make informed decisions about what happens to her body, which has physical and psychological repercussions, but it has a negative impact medically 100 percent of the time. Even when done by medical professionals with sterile tools and cutting-edge technology, FGM is a dangerous medical procedure that has no health benefits and frequently leads to a multitude of health issues later in life, including urinary problems, painful copulation and complications during childbirth, as affirmed by the World Health Organization. In short, girls are put through a painful procedure that has negative side effects down the road because of a cultural bias that women can’t be trusted to manage their sexual decisions.

How UNICEF-UNFPA’s Program Works to End Female Genital Mutilation

The reason FGM exists in the first place and has been so difficult for aid organizations to combat is that it is ingrained as a cultural norm. Girls grow up knowing that they will undergo this procedure and that their daughters will too—breaking that cycle appears inconceivable. Unfortunately, the reasons girls are guided to FGM are entirely myth-based and built on a sexist desire to limit female’s use of their sexuality. Girls are told that unless they undergo FGM, they will be dirty, impure or ineligible for marriage by either a religious sect or often by their community. This means that the work UNFPA and UNICEF does to fight involves looking for ways to change the social expectations around FGM.

Some of the specific ways UNFPA and UNICEF’s Joint Program is ending FGM include working with social groups and media to spread awareness of the health and human rights concerns associated with FGM and “to change perceptions of girls who remain uncut.” The agencies have also worked with government leaders to design policies that prohibit FGM to discourage the procedure for legal reasons and with religious leaders to “de-link FGM from religion.” As a result of their work, 31 million people have publicly declared abandonment of FGM. The focus has been on collective abandonment, since when only one or two individuals in a community give up the practice, they face being ostracized by their peers.

UNFPA and UNICEF, along with countless other international agencies, have worked to end FGM one girl at a time. Unfortunately, the procedure is still all too prevalent in large regions of the world. Removing taboos that FGM is too religious or too intimate of a topic to discuss will be necessary for the fight against FGM, and so women may be freed from this violation of their bodies.

– Olivia Heale
Photo: Flickr

Maternal Mortality Rate in GuatemalaAs of 2015, the maternal mortality rate in Guatemala was 88, and three-quarters of these maternal deaths occurred in women of indigenous ancestry. The maternal mortality rate among indigenous women is thought to be more than 200. Since midwives or comadronas primarily care for pregnant indigenous women in Guatemala, investments from the World Bank and UNFPA have been focused on training midwives and connecting them with hospital services when necessary. More than six million indigenous people inhabit Guatemala and comprise a large portion–estimated at 45 to 60 percent–of the population. Further, 21.8 percent of the indigenous population live in extreme poverty compared to only 7.4 percent of the non-indigenous population.

Improving Mortality through Training

In 2006, UNFPA, a U.N. agency focused on sexual and reproductive health, began to offer obstetrical emergency training to local comadronas and family planning methods. The agency also teaches the importance of a skilled attendant being present during births in order to improve the maternal mortality rate in Guatemala. Estimates suggest that a well-trained midwifery service “could avert roughly two-thirds of all maternal and newborn deaths.” Statistics show that from 2009 to 2016, UNFPA has trained more than 35,000 midwives.

The Department of Sololá in the western highlands of Guatemala is home to more than 300,000 people, most of whom are indigenous Maya. Only one in four rural births occurs in a hospital, compared with over two-thirds of urban births. In Sololá, comadronas attend more than 63 percent of births mainly outside of a hospital. Some estimates put this figure at more than 90 percent.

The Improving Maternal and Neo-Natal Health Initiative has a three-pronged approach and funding from the World Bank’s Youth Innovation Fund in 2017. The initiative has established a visually-based curriculum to help comadronas recognize dangers and risks during delivery, two-week long training workshops conducted in local healthcare posts, and endowment of “safe birthing kits” for all comadronas containing tools such as latex gloves and gauze pads. Unlike previous initiatives, these trainings have been conducted in local languages rather than solely Spanish. Rosa, a comadrona in the city of Santiago, said this simple change made her “feel more respected” and gave her an increased desire to participate because she felt empowered to save “more lives in her community.”

In collaboration with the Ministry of Public Health and the government of Guatemala, the Maternal Child Survival Program (MCSP), an international program with national and subnational branches, implemented a Midwifery Training Program in February 2018 to improve the maternal mortality rate in Guatemala. Their model uses a competency-based skills training approach. Working with the University of San Martin Porres, MCSP established a coursework protocol for certification.

Discrimination Against Indigenous Peoples

Maternal mortality rates among indigenous populations in Guatemala face particular hurdles. In addition to access to care and infrastructure challenges, indigenous populations face heavy discrimination. They are often evicted from their ancestral lands only to face abuse within the criminal justice system. One young indigenous man reported abuse at the hands of a local gang to police. He believed that “the police don’t listen to us as indigenous people–they do not care about us.” A U.N. Special Rapporteur on the rights of indigenous peoples, Victoria Tauli-Corpuz, says she is very worried about “the grave situation of indigenous peoples” in Guatemala.

Guatemala has made consistent strides in reducing the national maternal mortality rate from more than 200 in 1990 to less than 100 today. However, the maternal mortality rate among indigenous populations remains high. Indigenous populations should be heartened by these improvements, but their unique struggles must not be lost in the larger narrative of maternal mortality in Guatemala.

– Sarah Boyer
Photo: Flickr

Female genital mutilation in Egypt

Female genital mutilation has impacted at least 200 million women and girls worldwide, though the exact number is unknown. The practice is most common in western, central and northern Africa, though it also occurs in a few countries in the Middle East and Southeast Asia. Egypt has one of the highest rates of female genital mutilation in the world, with 87 percent of women between the ages of 15 and 49 having undergone the procedure as of 2016. Some progress has been made over the past few decades, thanks to efforts by the Egyptian government and international organizations, but the cultural preference for female genital mutilation in Egypt prevails, and there is much work that needs to be done.

Egypt has the fourth highest rate of female genital mutilation, tied with Sudan. Only Somalia, Guinea and Djibouti are higher, all with at least 90 percent of women between the ages of 15 and 49 having undergone female genital mutilation. In Somalia, the procedure is nearly universal, at 98 percent.

According to the World Health Organization, there are four main types of female genital mutilation, otherwise known as FGM. These types vary based on what parts of the female genitalia are removed or altered. In Egypt, the most common procedure is Type 1, which includes the partial or full removal of the clitoris.

FGM is condemned internationally for a number of reasons. It has no health benefits, can lead to infections, severe bleeding, infertility and other serious medical problems, is a violation of the rights of women and can result in psychological trauma.

Prevailing Cultural Beliefs

Female genital mutilation in Egypt was banned in 2008 and criminalized in 2016; however, these laws have had little impact on the prevalence of the practice. FGM is seen as an important rite of passage within many communities. It’s viewed as a way to promote female chastity and purity, and many view it as essential for a young woman to get married. According to some Egyptian villagers, husbands will require their brides to undergo the procedure before the wedding ceremony.

It is not only men, however, who support the procedure. While opinions about FGM vary among women, many women do adhere to this cultural tradition and support it being done to their children and grandchildren. According to UNICEF data, only 38 percent of Egyptian women who know about FGM think the practice should end. Egyptian woman Mona Mohamed remembers being tied down to get the procedure when she was ten, her mother and grandmother each holding one of her arms.

Slow Progress

In 2000, for married women, the rate of female genital mutilation in Egypt was 97 percent. Between then and 2014, there was little progress, as the 2014 health survey found that 92 percent of women between the ages of 15 and 49 had gone through FGM. There has been more significant progress between 2014 and 2018, however, as the rate has been reduced to 87 percent.

While this represents a higher rate of reduction, if progress continues at this rate, it will take more than 34 years to end the practice entirely. Success in ending FGM relies on working at a community level to change cultural perceptions.

Efforts by International Organizations

In 2008, UNICEF and UNFPA created a joint program targeting FGM in the countries where it is the most prevalent. Their program focuses on law reform, research, training medical personnel and fieldworkers, and engaging directly with religious leaders and local communities.

Both Muslim and Christian communities are known to support female genital mutilation in Egypt, so the program works with leaders from both religions to educate them on the realities of FGM. If religious leaders come to agree with international views on FGM, the program then provides resources to help them spread this knowledge in their communities through sermons and family counseling.

To better reach girls and women, the program also launched a national television campaign. By far their most innovative solution for community outreach, however, is an interactive street theatre show on female genital mutilation. The play provides a depiction of FGM and its impact on girls, and afterward, the audience is encouraged to be involved in an open community discussion.

Despite being a culturally-driven practice, FGM is often performed by licensed doctors. The 2014 health survey found that 72 percent of FGM procedures in Egypt was done by a doctor. As a result, it is important to also focus efforts on medical professionals. Beginning in 2013, UNFPA held workshops for the medical staff at hospitals to disseminate accurate knowledge about FGM and provide doctors and nurses with the resources they need to counsel their patients and argue against FGM.

Additionally, UNFPA is working on a legal front to address the lack of legal repercussions for those who perform FGM, in spite of it being criminalized. This involves working with law enforcement personnel and prosecutors to ensure that individuals aren’t able to exploit legal loopholes to avoid conviction.

Hopefully, the efforts of UNFPA, UNICEF and other international and regional partners will continue to have an impact on the prevalence of female genital mutilation in Egypt, protecting the human rights of thousands of women and girls.

– Sara Olk
Photo: Pixabay

Life Expectancy in Laos

The both ethnically and linguistically diverse country of Laos is a landlocked, independent republic in Southeast Asia. It is home to about 7 million people, representing just 0.9 percent of the world’s total population. The average life expectancy in Laos is currently 65.8, but the number has gone up in recent years. The information below will provide 10 facts about life expectancy in Laos and what action is being taken to improve it.

Top 10 Facts About Life Expectancy in Laos

  1. Currently, the life expectancy of the total population in Laos is 65 years. Men in Laos have a lower life expectancy than the average rate at 62.9 years, and women’s life expectancy is approximately 67 years.
  2. The maternal death rate in Laos is one of the highest in the Western Pacific Region. According to the Laos Maternal Death Review, 54 percent of maternal deaths were caused by complications from postpartum hemorrhage. In 1990, 905 women per 100,000 live births had died. Given this statistic, the primary focus of the ministry and WHO has been developing a voucher program that ensures free delivery of pre and postnatal care for women.
  3. In conjunction with WHO, the ministry is providing free health services to women and children in 83 districts in 13 provinces. As of 2015, the mortality rate has dropped to 197 deaths for every 100,000 live births. This drop can also be largely attributed to the work being done by the UNFPA, which is providing counseling on family planning and training midwives to match international standards.
  4. Assisted childbirth was almost unheard of in 2007, and death during childbirth was considered common if not likely. Since 1995, the Ministry of Health has begun to recognize the importance of having trained and skilled professionals present during birth and is working to decrease the number of home births in the country. As of 2015, the maternal mortality rate had decreased 75 percent. Only eight other countries had been able to accomplish that goal.
  5. As of 2017, heart disease and stroke accounted for 22 percent of deaths in Laos. Since 2007, the number of deaths from stroke has risen 5.6 percent, and deaths from heart disease have risen 3.3 percent. Most cardiovascular and respiratory problems stem from smoking and high rates of air pollution.
  6. In March of 2019, the Pollution Control Department reported that there had been a large number of wildfires in Laos and neighboring countries. Forest fires in Thailand had caused air pollution levels to become hazardous. Currently, air pollution levels are more than 20 times the safety limit. Residents have been advised to wear safety masks to prevent smoke inhalation, and officials are working to bring down toxicity levels by spraying water into the polluted air.
  7. Malnutrition has also been a persistent problem in Laos and can lead to cognitive difficulties, delayed development and high mortality rate. In 2015, 17 percent of the population was considered malnourished. Additionally, 45 percent of deaths of children under five are linked to undernutrition. Food security, diet diversity and water and sanitation all contribute extensively to the malnutrition issues. Fortunately, UNICEF has been able to advocate for nutritional programs and interventions with the hope of lowering the mortality rate.
  8. In September of 2018, Ministries of Planning and Investment, Agriculture, Public Works, Transport and Health teamed up with the World Bank to tackle the malnutrition problem in Laos. These organizations have developed a program that is focused on the critical development that occurs in the first 1,000 days of a child’s life. The ministries and World Bank intend to establish welfare programs, diversify food production and improve hygiene and sanitation by ensuring clean water is accessible in rural sectors of Laos.
  9. Drinking water in Laos is often contaminated with dangerous chemicals and waste, particularly in rural areas and schools. Only 66 percent of the nearly 9,000 primary schools in Laos have functional water supply systems and latrine facilities, causing widespread health complications. UNICEF has been working with the Ministry of Education and Sports to implement a program called WASH, which improves water, sanitation and hygiene in conjunction with one another. Through the program, UNICEF is implementing effective hygiene practices, providing access to safe water and ending the practice of open defecation in rural communities.
  10. Government health expenditures have gone up more than 2 percent in the last four years in an effort to provide universal health coverage by 2025. The nation continues to work towards protection from infectious disease, and while the progress has been slow, with continued government funding health coverage is likely to expand.

Many of Laos’ SDG’s are still far from being accomplished, but the 2018 country profile from the WHO suggests that improvements have been made that will eventually lead to an overall increase in life expectancy. These 10 facts about life expectancy in Laos provide insight into what steps toward improvements have already been made and what still needs to be accomplished. The hope is that Laos will continue to increase its overall life expectancy, reaching an average age of 70 by the year 2030.

Anna Lagattuta

Photo: Everystock

A Look at the Life of Dr. Osotimehin
On June 4, 2017, Dr. Babatunde Osotimehin, died in his West Harrison, New York home at the age of 68. He led the United Nations Population Agency.

Dr. Osotimehin amassed renown for his work with women’s sexual health and reproductive rights around the world. Additionally, he promotes the UN goals of “preventing maternal deaths in childbirth, meeting all demands for family planning, and eliminating harmful practices against women and girls.” Here is a look back at the rich life of Dr. Babatunde Osotimehin.

Osotimehin was born on Feb. 6, 1949 in Ogun State, Nigeria. He received a doctorate in medicine from the University of Birmingham in the United Kingdom in 1979. He became the Nigerian Minister of Health in 2008. In addition, his achievements include an award for the Nigerian national honor and Officer of the Order of the Niger. He also reaffirmed the government’s commitment to eliminate polio and other childhood diseases.

In 2011, Osotimehin assumed the position of the Executive Director of the UN Population Fund. This fund plays a significant role in providing health care and training to midwives to help women fleeing conflict in war-torn countries.

The UN Population Fund (UNFPA) funds programs that help mothers deliver babies during disasters. Additionally, it prevents violence against women and girls, and argue against female genital mutilation. Unfortunately, the UNFPA has been hit with a series of blows by the Trump Administration, including a $33 million funding cut.

“The world has lost a great champion of health and wellbeing for all,” the UN said in their press release of Dr. Osotimehin’s death. Nonetheless, the “UNFPA is dedicated to continuing Dr. Osotimehin’s grand vision for women and young people and will continue to stand up for the human rights and dignity of everyone, particularly the most vulnerable adolescent girls,” the statement added.

Dr. Osotimehin dedicated his life to helping women and girls around the world. Consequently, countless individuals will dearly miss him.

Kelsey Jackson

Photo: Flickr