POVERTY: SOMALIA: Mortality rates among world's highest in Somaliland

HARGEISA, 2 February 2012 (IRIN) - The self-declared Republic of Somaliland is grappling with high child and maternal mortality rates, malnutrition and inadequate medical personnel, health officials told IRIN.
"Somaliland has one of the worst maternal mortality ratios in the world, estimated to be between 10,443 and 14,004 per 100,000 live births," said Ettie Higgins, head of the UN Children's Fund (UNICEF) field office in Hargeisa, capital of Somaliland.
"The infant mortality rate is 73/1,000 while the under-five mortality [rate] is about 117/1,000. Fully immunized children represent a mere 5 percent. Environmental sanitation is highly challenged," she said.
"There are a little over 100 doctors in the country, both in the public and private sectors, and about the same number of registered midwives," Higgins explained.
"Maternal mortality is the leading cause of death among women of reproductive age; it is caused mainly by haemorrhage, puerperal sepsis, eclampsia and obstructed labour," Higgins said, adding that women in Somaliland had a one in 15 risk of dying of maternal-related causes.

Child mortality
Abdillahi Abdi Yusuf, head of Somaliland's National Health Management and Information System (NHMIS) in the Ministry of Health, said acute respiratory infections accounted for 40 percent of child mortality in Somaliland, while acute watery diarrhoea and malnutrition accounted for another 40 percent.
"Diseases that can be prevented through vaccination, such as polio, diphtheria, tetanus, TB, measles and whooping cough cause 20 percent of children's mortality in Somaliland," Yusuf said.
According to NHMIS statistics, in 2011 "acute respiratory infections [excluding pneumonia] were the highest [cause of] morbidity in Somaliland's public health centres".
Other leading causes included "anaemia, urinary tract infections, watery diarrhoea, pneumonia, skin diseases, eye infections, trauma and burns, sexually transmitted infections and bloody diarrhoea".
According to a UNICEF/Ministry of Health Multi-Indicator Cluster Survey (MICS), diarrhoea is the second-highest cause of morbidity and mortality in Somaliland due to poor sanitation and low rate of access to safe water supplies.
"In Somaliland, only 42 percent of the population have access to latrines and 41 percent have access to safe water supplies," the survey said.
Yasin Nur Tani, a private doctor in Hargeisa, told IRIN: "I used to receive about 20 patients daily, complaining of different ailments; the most common disease is upper respiratory tract infections in all ages while skin disease is second and diarrhoea comes third.
These are then followed by acute gastritis, intestinal parasites, gynaecological and obstetric diseases and other non-communicable diseases including hypertension and diabetes."
Somaliland health authorities, in collaboration with international aid workers, conduct a weekly surveillance of communicable diseases and take action as soon as possible.
"The Ministry's focus on the communicable diseases control programme identifies the control and the prevention of those diseases contributing to the highest burden of disease in the country; these include malaria, tuberculosis, diarrhoeal diseases, HIV/AIDS, meningitis and vaccine preventable diseases," a report [ http://www.emro.who.int/somalia/pdf/Epidemic%20Control-Disease%20tools-EN.pdf ] by the Health Ministry states.
 http://www.irinnews.org/report.aspx?reportID=94782

POVERTY: Community Transportation System to Save Maternal Lives

Bill Brieger : 27 Jun 2011

Guest contribution from: Ahmed Mohammed Ahmed, Community Mobilization Specialist, Targeted States High Impact Project (TSHIP), Bauchi State, Nigeria

TSHIP aims to improve maternal and child health in Nigeria by strengthening health services and enhancing community participation. An example of the latter follows.

Five Ward Development Committees [WDCs] in Pali and Kungibar Districts of Alkaleri Local Government Area in Bauchi State have initiated a community approach to emergency transportation for pregnant women and children. This is at the background to recent 2OO8 NDHS survey which showed high rates of maternal and child mortalities in the North-East part of Nigeria.



The initiative which saw a strong commitment on the parts of different community and ward structures like the National Union of Road Transport Workers [NURTW], Okada Riders Association (motorcycle taxi drivers), Health Providers, Traditional and Religious leaders, was witnessed by other stakeholders such as Alkaleri LGA whose Chairman was represented at the occasion by the Director PHC.

The event was marked with a short drama presentation highlighting the objective of the Emergency Transport Team [ETT], which is to provide free transport service to pregnant women and children under 5 from all the communities within the five wards. Mobile phone numbers of the executive committee members and that of other drivers and motorcycle drivers in the scheme were provided at the inauguration for ease of contact. (see transportation committee members at left)

In his brief speech at the occasion, the visiting Chairman of Bara WDC in Kirfi, Malam Haruna Katukan Bara, says ‘I am here to learn about this unique experience and also help my ward in replicating it.’ He also urge community members to support the good works of the WDCs towards the development of humanity.

Finally, one of the community’s traditional birth attendants (right) thanked the committee for taking action to save the lives of pregnant women in the wards.

http://www.malariafreefuture.org/blog/?p=1228

POVERTY: SOUTH AFRICA: Midwife shortage impacts maternal health

DURBAN, 27 June 2011 (IRIN)

 Photo: Anthony Kaminju/IRIN
Midwives can improve outcomes for mothers and babies
At Prince Mshiyeni Memorial Hospital (PMMH) in Umlazi, the largest township outside the South African port city of Durban, using midwives to provide maternity services has positively impacted maternal care in the area, but a national shortage of these specialist health personnel has made it difficult to replicate the model elsewhere.
“Midwives are integral to ensuring that we take quality care of our mothers and babies,” Rachel Gumbi, the hospital’s CEO, told IRIN. “The success story of this hospital is because of the teamwork between doctors and midwives.”
The maternity ward at PMMH is one of the busiest in the country, with more than 1,200 deliveries a month, but the staff of 123 midwives and 15 doctors have managed to reduce both infant and maternal mortality rates.
Although 40 percent of the women visiting the hospital’s antenatal clinic are HIV positive, the midwives play a key role in ensuring that 95 percent of those in need of antiretroviral (ARV) medication receive it, and that the rate of mother-to-child transmission of HIV is below 3 percent.
The midwives are involved in every aspect of a pregnant woman's health, from pregnancy screening to post-delivery care and the provision of family planning and pap-smears to detect cervical cancer.
They receive ongoing training through monthly meetings where they discuss difficult cases, and information-sharing sessions that ensure they are up-to-date on the latest policies and protocols. An outreach mentorship programme is also in place for midwives in outlying clinics who may need to refresh their skills.
Such success stories are relatively rare in South Africa. Rather than making progress towards the Millennium Development Goal of reducing maternal mortality by 75 percent by 2015, the number of deaths resulting from pregnancy or childbirth has doubled in the past 20 years.
For every 100,000 babies born, up to 625 mothers die due to childbirth complications. Mortality in children under five has also risen steadily and remains stubbornly high at 104 deaths per 1,000 live births, according to government figures.
Loveday Penn-Kekana, a maternal health researcher at the Centre for Health Policy, University of the Witwatersrand in Johannesburg, believes South Africa’s poor maternal health outcomes are linked to the lack of midwifery services.
“In order for us to address South Africa's maternal health we need to invest in more and better trained midwives,” she said. “Doctors only come into maternity wards from time to time, but it is the midwives who are running the entire service and they are overworked.”
For us to address South Africa's maternal health we need to invest in more and better trained midwives
Midwives are classified as nurses in South Africa so there are no figures on their numbers, but it is clear that there are too few. Low enrolment at nursing colleges is part of the problem but many midwives have also left the public sector to work for higher salaries overseas or in managerial positions because of the limited opportunities for career development and advancement in the clinical area.

No more home deliveries
Although pregnant women in South Africa are entitled to free healthcare, Penn-Kekana noted that some face difficulties accessing services because they lack money for transport. The Department of Health has initiated the use of maternal ambulances to transport pregnant mothers to health facilities but challenges remain in rural areas where there are no roads.
“I have no job and it is expensive for me to get to the hospital,” said a woman at PMMH who was expecting her seventh child. “I am happy with the service, but it is sometimes very difficult for me to get to my appointments here… because I have no money.”
In the past, midwives helped women give birth at home, but there are no longer enough of them for this to be possible. “It makes more sense for the few trained midwives to be stationed at facilities so that they can see more women than for them to be scattered across areas,” said Meisie Lerutla, National Programme Officer for Sexual and Reproductive Rights at the United Nations Population Fund in South Africa.
Deliwe Nyathikazi, President of the Society of Midwives of South Africa, noted: "The biggest challenges for us as midwives in South Africa is that there are not enough of us to provide the best care possible. Because people are first trained as a nurse and then given midwifery skills, midwifery is not prioritized.”
A plan by South Africa’s Health Minister, Dr Aaron Motsoaledi, to reopen unused nursing colleges across the country and increase the number of nurses should also result in more midwives being trained.
Lerutla pointed out that “Once we have increased the number of midwives in South Africa dramatically, the practice of midwife-assisted births at home for women in remote areas can be revisited.”


This building has two outside taps to serve six floors containing 700 tenants



http://www.irinnews.org/report.aspx?reportID=93071

POVERTY: Better midwifery could save millions of lives

DURBAN, 20 June 2011 (IRIN)

 Photo: MSF
The world is short of about 350,000 skilled midwives

 Up to 3.6 million maternal and child deaths could be avoided each year if midwifery services were upgraded, according to a new report released by the United Nations Population Fund (UNFPA) and partners at a conference in Durban, South Africa.
"Public health advisors and practitioners are not relying on the key health professional that can improve maternal mortality - the midwife," said Vincent Fauveau, Senior Maternal Health Advisor with UNFPA, who led the drafting of the report.
Of the nearly 1,000 women who die every day as a result of complications during pregnancy and childbirth, 99 percent live in developing countries, mainly in sub-Saharan Africa. A woman in Sweden has a roughly 1 in 11,000 chance of dying from pregnancy-related causes, while a woman in Niger faces a 1 in 16 chance during her lifetime.
The first State of the World's Midwifery report released on 20 June at the International Confederation of Midwives (ICM) 29th Congress, said most of these deaths, as well as many of the severe illnesses and disabilities caused by childbirth, could be prevented by a proficient, motivated and supported midwifery workforce.
The report focuses on the 58 countries with the highest rates of maternal, foetal and newborn mortality. These countries account for 91 percent of the global burden of maternal mortality, but have less than 17 percent of the world's skilled birth attendants.
The fifth Millennium Development Goal (MDG), which focuses on reducing maternal health, had seen the least progress, Fauveau told IRIN. Nearly half of all deliveries occur at home without a skilled birth attendant. To meet the MDG 5 target of 95 percent of all births being assisted by a skilled birth attendant, some countries will need to increase the number of midwives by six to 15 times.
"It is not unusual to find one midwife managing 200 women in one facility. We must prioritize investment in midwives to deliver life-saving care in the communities where mothers are needlessly lost," said Lennie Kamwendo, a midwife and Chairperson of the White Ribbon Alliance for Safe Motherhood in Malawi.
Ahead of the congress, more than 2,000 midwives marched in Durban in solidarity with midwives across the world to urgently call for more midwives to save mothers and their babies. The report highlights the uneven distribution of midwives, with rural areas losing out to urban areas, and the fact that not all midwives are adequately trained.
The International Confederation of Midwives (ICM), a global umbrella body and host of the Durban conference, has launched new standards and regulations for midwifery but Fauveau said these will only be successful if "countries revise their educational curriculum".
Many women also struggle to access midwifery services, especially in rural areas, because of the distance they must travel to reach health facilities or because they cannot afford the transport costs and fees.
"We must advocate for free health services for all pregnant women in all countries. Women often do not have the funds to pay to get into the health facility during childbirth or pregnancy, so they die at home," said ICM President Bridget Lynch. Fauveau added that "a complication with childbirth is one of the most common ways to bring a family to poverty."
The report calls for governments to recognize midwifery as a distinct profession, and to increase investment in the number of schools, trainers and tutors for midwives, with adequate budget allocations for midwifery services included in national health plans.
"Midwives do far more than deliver babies," said Bunmi Makinwa, Africa Regional director of UNFPA. "They are the first to identify and treat HIV, tuberculosis and malaria, and sexually transmitted diseases. They also provide counselling to expecting women, and family planning advice. Midwives play a critical role."
http://www.irinnews.org/report.aspx?reportID=93028

POVERTY: Stillbirths could be halved

DAKAR, 27 April 2011 (IRIN)

 Photo: MSF
A midwife listens to the foetal heartbeat of an expectant mother in Afghanistan (file photo)

 Preventing stillbirths can cost just US$2.32 per mother if governments, the private sector and international institutions adopt a package of 10 health interventions, rather than allowing stillbirths to be an almost invisible problem.
If ten recommended interventions were 99 percent implemented in 68 priority [low and middle-income] countries, the number of stillbirths could be halved, said Professor Zulfiqar Ahmed Bhutta of the Aga Khan University Medical Centre in Karachi, Pakistan, author of one of a series of papers on stillbirth published in The Lancet medical journal papers.
Even if the interventions were 60% covered, stillbirths could be reduced by one-quarter. Some 2.64 million foetuses die after the 28th week of pregnancy, mostly in low- and middle-income countries.
Interventions include: basic and comprehensive emergency obstetric care; skilled care at birth; detection and management of foetal growth restriction; detection and management of hypertension in pregnancy; elective induction in post-term pregnancies; insecticide-treated bed nets and intermittent prophylaxis to prevent malaria; detection and treatment of syphilis; folic acid supplementation; and management of diabetes in pregnancy.

Identifying solutions
Stillbirths have largely been neglected in policy prioritizing for a variety of reasons. “There was little in terms of verified data for stillbirths and even less for its categories - whether intrapartum [during childbirth] or antepartum [before childbirth] - and risk factors, and little confidence that interventions could make a difference,” said Bhutta.
The Lancet series hopes to change this perception by re-framing stillbirths so that they are not seen as an unexplained event that occurs in the womb, but as something that is potentially preventable if appropriate care is given during pregnancy and birth.
Bhutta suggested in his paper that cheaper solutions, such as improving antenatal care, preventing malaria, detecting and treating syphilis, be adopted immediately, while more expensive interventions, such as training health workers, and procuring equipment for emergency births, could be built up gradually.
Other interventions would require improved long-term funding allocations, including addressing hypertension, diabetes, post-term pregnancy (which lasts longer than usual) and monitoring foetal growth problems.
Providing skilled attendants at birth would reduce intrapartum stillbirths by about 23 percent, said Dr Joy Lawn, of NGO Save the Children, making it the most effective single intervention. Almost half the women in low- and middle-income countries give birth at home, without any skilled assistance.
Voucher schemes or conditional cash transfers could be used to encourage women to have their babies in a facility, since in settings where the highest infant mortality occurs, only half of all births take place in facilities.

Maternal mortality
In high-income countries, where most women receive fairly good quality care while giving birth, the proportion of stillbirths is less than 10 percent of all births.
Sub-Saharan Africa, which has a scarcity of skilled birth attendants, has been making swifter progress than Asia in encouraging women to give birth in a facility. “One year ago, the international community became acutely nervous about the lack of progress on reducing maternal mortality,” Lawn said.
A year later, maternal mortality in sub-Saharan Africa had fallen by 2.6 percent. “This marks significant progress… For stillbirths, a lot of the focus in high-income countries has been because parents have called for it. Setting a global policy goal is one good way of getting it on the agenda.”
One-third of African countries could meet the Millennium Development Goal to reduce childhood mortality (Goal Four) and to improve maternal health (Goal Five), which would also reduce stillbirths.
Some investments in reducing maternal mortality are already having a positive effect on the number of stillbirths, but these results are not given due significance. “Governments could argue for more investment if they counted stillbirths in the work they’re already doing,” Lawn told IRIN.
Saving mothers’ lives costs $23,000 per death averted, but if stillbirths and neonatal deaths are included, the figure drops to $2,700 per life saved. “Our single message is, ‘Care at birth may be more expensive, but it gives you the biggest bang for your same buck if you count it properly’
http://www.irinnews.org/report.aspx?reportid=92590

POVERTY: MDGs: Make the most of the next five years

 Photo: UN/Eric Kanalstein: Maternal mortality is the MDG with the lowest success rate

JOHANNESBURG, 20 January 2011 (IRIN) - A decade after world leaders adopted the eight Millennium Development Goals (MDGs), there is no consensus on what impact they have had on global poverty.
The academics, policy-makers, civil society activists and development workers who gathered in Johannesburg on 16-19 January for a summit on global poverty agreed that the MDGs have made a difference, but have fallen far short of the ambitious targets on poverty, education, health, gender equality and global partnership that 189 countries committed to achieving by 2015.
An estimated one billion people around the world regularly go to bed hungry and between 1.5 and two billion are thought to be living in poverty. HIV continues to claim thousands of lives every day and there has been little improvement in infant and maternal mortality rates. Meanwhile, inequality within and among countries has widened and foreign aid levels have declined during the past two years of the global financial crisis.
That is the glass-half-empty view of the MDGs. However, David Hulme, executive director of the University of Manchester’s Brooks World Poverty Institute, which organized the summit, takes a glass-half-full view. He argues that if countries and the international community accelerated their efforts on development over the next five years, the glass could reach three-quarters-full by 2015.
“The idea of the MDGs as a failure is definitely wrong, there has been progress,” he told journalists on 19 January.
Globally, there have been gains in terms of poverty reduction, life expectancy and education over the past decade, although it is unclear whether those gains can be attributed to the MDGs or to massive economic growth in countries like China and India.
However, a number of promises made by developed and developing countries to reduce poverty have not been kept and the mechanisms for holding leaders accountable are weak. Hulme and several other speakers commented on the over-emphasis on the role of aid as a driver of development.
“The focus ... needs to be on national development goals and supporting governments to reduce poverty, not just through funding but through knowledge exchange,” Hulme told participants.
Sakiko Fukudo-Parr of the New School University in New York described the MDGs as a valuable instrument for drawing attention to priorities, but cautioned that the eight goals ignored many pressing developmental priorities such as the need for structural transformation, job creation and to narrow the growing equality gap.
Another speaker, Sophie Harman of City University in London, agreed that while goal setting was important, “some things you just can’t measure”. The goal of gender equality, for example, could not be achieved by simply counting the number of female appointments in an organization.
With just four years to go, Hulme said it was time to begin discussions about what form a new set of goals might take. “The MDGs were a bare minimum,” he said. “We need another vehicle for the next decade with grander ambitions.”
In a statement, delegates called for the process of defining post-2015 goals to be led by the UN but to include participation from civil society, governments and the poor themselves. Fukudo-Parr said the new goals would need to reflect global concerns that have emerged over the last decade such as climate change, and correct elements missing from the previous goals, for example, mechanisms for holding governments to account.
Speaking to IRIN on the sidelines of the summit, Hulme said the MDGs had not fundamentally changed the way people thought of poverty as an inevitable feature of the world and that a global call to action was needed to change such thinking. “Philanthropy will help,” he said, “but national governments have to do it.”
http://www.irinnews.org/report.aspx?ReportID=91681

MALNUTRITION: Nepal: Nutrition programme revamp on the cards

 2010-12-31 The Himalayan Times
KATHMANDU: The Ministry of Health and Population is set to upgrade nutrition programmes. This comes at a time when malnutrition is emerging as a major obstacle to realisation of Millennium Development Goals (MDGs).
Secretary at the ministry, Dr Sudha Sharma, said the programme will address the nutrition needs of both mother and child from the time of conception. However, it will focus more on nutrition during the first 1000 days – 280 pre-delivery and 730 days after birth.
Although a global wave of 1000-day nutrition campaigns is fast emerging, Nepal is yet to introduce similar programmes. The programmes being implemented in Nepal follow similar patterns, said Sharma. She further added that scaling up proven life-saving interventions to improve maternal and child nutrition during 1000 days can help reduce both maternal and child mortality rates. At present, the ministry is upgrading the micro-nutrient programme with special focus on Karnali region, establishment of malnutrition rehabilitation centres in remote districts, improvement of wheat and salt programme and distribution of iron, zinc and folic acid.
While malnutrition reduction rate is 0.6 per cent, almost half of the children under five in the country are stunted, more than 38 per cent are underweight and 13 per cent are wasting as a result of malnutrition, according to National Demographic Health Survey -2006.
The highest prevalence of underweight children was recorded in the hills of far and mid-west and central regions. Figures for central and far western Tarai show that 20 per cent of the children are wasting away. Humla has the highest prevalence of stunted growth where 72 per cent children are estimated to be short for their age.
As children develop their intelligence during the first 1000 days, this period is considered crucial, said Dr Sharma. According to her, malnutrition – one of the world’s most serious and least addressed problems – is behind 3.5 million deaths each year.
Infant mortality and maternal mortality are directly associated with micro-nutrient deficiency.
http://www.thehimalayantimes.com/fullNews.php?headline=Nutrition+programme+revamp+on+the+cards&NewsID=271284

POVERTY: A perilous journey: the mortal danger of poverty

Jun 24th 2010

OUTSIDE the main hospital in San Cristóbal de las Casas, women in traditional multicoloured garb queue up to see a doctor. Many are pregnant or carry infants on their backs. One expectant mother says she fears there will not be a bed for her when she enters labour—all too common in the overcrowded hospital. Tales of deaths from hypertension, haemorrhage or infection during or after giving birth are common in the second city of the state of Chiapas. In a nearby village, one doctor recalls a woman whose journey took so long that she died on the street outside his clinic.
Maternal mortality in Mexico has fallen by 36% since 1990, but it is still higher than in other Latin American countries. The problem is far worse among Indians and in the poorer south. Mothers in Chiapas, Oaxaca and Guerrero states die in childbirth 70% more often than the national average, and indigenous women are three times less likely to survive birth than non-indigenous women. Most of these deaths are preventable.

One of the first obstacles for a pregnant woman is transport. To reach a doctor you need to get a car, a driver, petrol, and someone to take care of the other children. The roads to the nearest town hospital are often slow and dangerous. As a result, many women—including one-third of Indian mothers—give birth without any medical help at all.
Another set of problems awaits at the hospital. Laboratory tests and medical supplies are often too costly for the poorest Mexicans. The quality of care is low: 40% of urban maternal deaths are caused by using the wrong medicine, by botched surgery or by other forms of malpractice.

Lastly, there are cultural and social difficulties. Many women are scared to go to a male obstetrician, which is frowned upon in areas with a macho, conservative culture. Those who do may have trouble communicating, since many indigenous women speak poor Spanish. Doctors sometimes make matters worse by denigrating rural patients, discouraging them from seeking medical help.

More spending on midwives and contraceptives would help save mothers’ lives. New money is on the way: the Spanish government and the charities of billionaires Bill Gates and Carlos Slim announced plans this month to spend $150m on health care for the poor in Central America and southern Mexico. But the best way to reduce maternal mortality is via investment in infrastructure, health and education—all of which would help the south catch up in general.

http://www.economist.com/node/16439044?story_id=16439044

POVERTY: AFRICA: "Encouraging" drop in maternal deaths

NAIROBI, 16 September 2010 (IRIN) - The proportion of women in sub-Saharan Africa who died because of pregnancy fell by more than a quarter between 1990 and 2008, according to estimates released on 15 September. In 1990, the maternal mortality ratio (MMR - expressed in deaths per 100,000 live births) was 870 in sub-Saharan Africa, the worst rate of any region in the world. In 2008, it was 640, according to data published jointly by the World Health Organization (WHO), UN Children's Fund (UNICEF), the UN Population Fund (UNFPA) and the World Bank. Globally, the ratio fell by 34 percent, from 400 to 260, states the report, Trends in Maternal Mortality, noting that this represented an annual decline of 2.3 percent. This is less than half the reduction needed to achieve the fifth Millennium Development Goal (MDG), which concerns maternal health. "There was a 26 percent reduction in maternal death rates in sub-Saharan Africa and this data is encouraging," Thoraya Ahmed Obaid, executive director of UNFPA, told IRIN. "We welcome and are thrilled by the decline, which shows that interventions are working. There are increasing efforts in countries to train more midwives, provide family planning, and strengthen hospitals and health centres to provide care to pregnant women. But we need to do more and increase community engagement. There are still 1,000 women [across the world] who die every day in childbirth, and more than 200 million women with an unmet need for family planning," Obaid said. Data were collected in 172 countries, but only 63 provided complete information from civil registration systems and good attribution of causes of death for the estimates. "Maternal deaths are more often misclassified than other [deaths], not only because they are easily confused with deaths due to other causes, but also because health institutions may prefer to attribute them to other causes, due to the stigma of inadequate treatment associated with maternal death," Lale Say, monitoring and evaluation officer with the Department of Reproductive Health and Research at the WHO, told IRIN. "Even in the best civil registration systems in the world, it has been found that maternal death can be substantially under-reported," Say added. Http://www.irinnews.org/report.aspx?ReportID=90490

MALNUTRITION: the key to maternal and child health

A medical aid group says if G8 leaders want to improve mother and child health, they must first solve the malnutrition problem.
Doctors Without Borders, also known as MSF, is calling for “fundamental changes” in addressing malnutrition, as well as “new sustainable funding resources.” The group says malnutrition affects 195 million people worldwide – most in sub-Saharan Africa - and is the “underlying cause of at least one-third of the 8 million annual deaths of children under age 5.”
Marilyn McHarg, General Director of MSF Canada, says, “There’s a real risk that the maternal-child health agenda will not move forward. We will not be able to improve the situation worldwide if we are not looking (at) and addressing malnutrition.”
She says it’s not necessarily the amount of food aid being provided that’s at issue, but rather the quality.
“We are very concerned about the fact that a lot of G8 countries are providing food that is sub-standard from the perspective that it is not addressing the nutritional needs of children worldwide…. It’s not enough to provide corn-soy blend or wheat. Foods that get used as porridge,” she says.
The MSF official says more “higher quality” foods are needed to ensure children’s survival, what she calls “comprehensive nutritional activities.”
She adds, “We see a very strong need for micro-nutrient supplements, for ready-to-use therapeutic foods like the peanut-paste mixtures that can exist. And this needs to be in combination with the other types of foods that are already accessible.”
MSF says it agrees with a World Bank estimate that it would cost (US) $12 billion per year to address malnutrition in the most affected countries. It calls donor funding during the global economic slowdown “insufficient, volatile and unpredictable.”
McHarg says, “It’s a matter of making sure there are sufficient funds for intervention over time.”
Sharply reducing hunger is one the Millennium Development Goals that come due in 2015. G8 and G20 leaders are expected to discuss the issue at their summits in Canada.
http://www1.voanews.com/english/news/asia/decapua-g8-msf-22jun10-96902634.html

POVERTY: Maternal death statistics

DAKAR, 4 May 2010 (IRIN) - Eight of the bottom 10-ranked countries in Save the Children's annual Mothers Index, which ranks the best and worst places to be a mother, are in sub-Saharan Africa, says the NGO. Afghanistan, Niger, Chad, Guinea-Bissau, Yemen, Democratic Republic of Congo, Mali, Sudan, Eritrea and Equatorial Guinea form the bottom 10; while Norway, Australia, Iceland and Sweden come top. One in seven women dies in pregnancy or childbirth in Niger and one in eight in Afghanistan and Sierra Leone; while the risk is one in 25,000 in Greece and one in 47,600 in Ireland. "The problems around maternal and newborn health have been raised for many years, but there still remains so much to be done," Houleyemata Diarra, Save the Children's newborn health regional adviser for Africa, told IRIN from Mali. "There are not enough skilled attendants at births, and governments are not taking into account where health workers are needed - in communities."

Malnutrition: multiplier effect

AFTER the global economy was jolted by the worst recession since World War II last year and the food and fuel crises in 2008, a report jointly published by the World Bank and International Monetary Fund (IMF) claimed that while developing countries are on track to achieve the Millennium Development Goal (MDG) on poverty, the goal to reduce hunger may not be met by 2015.
The “Global Monitoring Report 2010: The MDGs after the Crisis” projects that the number of extreme poor could reach around 920 million by 2015, which marks a significant decline from the 1.8 billion people living in extreme poverty in 1990.
However, the MDG target of halving the proportion of people who suffer from hunger by 2015 from the 1990 baseline “appears very unlikely to be met” due to the food- price crisis in 2008 and the global financial crisis.
“Both the 2008 food-price crisis and the financial crisis that hit that year have played a role in exacerbating hunger in the developing world. The critical MDG target of halving the proportion of people suffering from hunger from 1990 to 2015 appears very unlikely to be met as over a billion people struggle to meet basic food needs,” the World Bank and IMF said in a joint press statement.
The World Bank and IMF report stated that malnutrition among children and pregnant women have multiplier effects. About a third of diseases of children under five and 20-percent maternal deaths, the World Bank and IMF said, are caused by malnutrition.
World Bank projections said that for the period from 2009 to the end of 2015, around 1.2 million more deaths might occur among children under five due to crisis-related causes.
http://businessmirror.com.ph/index.php?option=com_content&view=article&id=24542:hunger-in-developing-countries-to-remain&catid=23:topnews&Itemid=58

Nigeria: Maternal mortality due malaria

The maternal mortality and child morbidity situation in Nigeria is abysmal and worrisome. In Africa, the country has the worst record; and globally, Nigeria’s record is only better than India’s. As a woman dies from childbirth, 30 others suffer long term chronic ill-health. The risk of a woman dying from childbirth is one out of eight in Nigeria, compared to one out of 61 for all developed countries and one out of 29, 800 for Sweden. Although abortion complications predispose women to infertility and ectopic pregnancy, which swell the rate of maternal mortality, malaria scourge has been found to be the greatest contributor to incidence of maternal mortality in Nigeria. Some other factors contributing to the country’s maternal mortality include lack of antenatal care, low proportion of women being attended to by skilled birth attendants, delay in the treatment of complications of pregnancy, poverty, harmful traditional practices and low status of women.
http://www.thisdayonline.com/nview.php?id=170938