Improve Maternal Health (MDG 5)

Overview

Major progress has been achieved in reducing maternal mortality. By 2010, the number of women dying from pregnancy and childbirth-related complications in developing countries had declined by almost half since 1990, dropping from more than 543,000 deaths to 290,000 deaths. Despite these achievements, however, the 75 percent decrease needed to meet MDG 5 by 2015 appears unlikely.

According to the United Nations, every two minutes, a woman dies of pregnancy-related complications, the four most common causes being: severe bleeding after childbirth, infections, high blood pressure during pregnancy, and unsafe abortion. Most of these deaths (99 percent) occur in developing countries and most could have been prevented.

Disparity and inequity in access to health services underlies this global trend. One in every 39 women in sub-Saharan Africa risks dying of preventable or treatable complications of pregnancy during her lifetime compared to one in 3,800 in developed countries. Ten countries account for 60 percent of global maternal deaths: Afghanistan, Bangladesh, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, Pakistan, Sudan and Tanzania.

The proportion of women in developing countries who received skilled assistance during delivery rose from 55 percent in 1990 to 66 percent in 2010. Progress was made in all regions but was especially dramatic in Northern Africa and South-Eastern Asia, with increases of 84 percent and 74 percent, respectively.

Canada's Contribution

CIDA, through its Children and Youth Strategy (PDF, 255 KB, 8 pages), supports improved maternal health by:

• Facilitating access to family planning, counselling, and commodities
• Supporting appropriate and timely antenatal, obstetric, and post-partum care for mothers and newborns
• Strengthening health systems as a whole to provide quality health care to mothers and children

Canada has also committed $450 million over 10 years through the Africa Health Systems Initiative, to address the critical shortage of human resources in the health field.

At the 2010 G8 meeting, hosted by Prime Minister Stephen Harper, leaders endorsed the Muskoka Initiative on Maternal, Newborn and Child Health—initiative that garnered commitments of US$7.3 billion in new global funding over five years; This included $1.1 billion from Canada, over and above Canada's existing $1.75 billion commitment. Canada's support, through CIDA, focuses on strengthening health systems, reducing the burden of disease and improving nutrition.

Contributions from CIDA and its Partners

Increased access to sexual and reproductive health services: CIDA's $2,590,146 contribution to the Society of Obstetricians and Gynaecologists of Canada (SOGC) (2006-2012) improved care for safe motherhood, newborn health, and prevention of HIV/AIDS in four countries (Haiti, Burkina Faso, Uganda, and Guatemala). In Haiti, for example, the project established a maternity unit that provided prenatal and postnatal services to 22,966 women and skilled care at delivery to 6,055 women and their newborns. Similarly, in Uganda, the project helped provide skilled care at delivery to more than 24,200 women and their newborns, as well as emergency obstetrical care to 3,911 women.

In Afghanistan, CIDA helped UNICEF establish the first maternal waiting home in Kandahar, a facility that improves access for pregnant women to skilled care during birth, as well as quality emergency obstetric care. Outreach activities have reached 15 of 17 districts in the province, providing vaccinations, de-worming tablets, insecticide-treated mosquito nets, and micronutrients. Among other achievements, 264 health workers from Kandahar and Uruzgan provinces were trained to identify the links between illnesses among children and combine treatment of these diseases where appropriate. In addition, 34 health providers were trained in basic emergency obstetric and neonatal care in the two provinces.

Stronger access to family planning: Canada's support to the United Nations Population Fund helps ensure universal access to reproductive health, family planning, and sexual health. Between 2005 and 2009, a project in Nigeria improved reproductive health by increasing access to safe motherhood kits, contraception, and other reproductive health services. Among results achieved, 510 health care workers were trained to use a management system that tracks reproductive health materials—a huge increase from the 44 workers trained in the year before the project began.

Access to skilled health care professionals during birth: In Haiti, CIDA has provided $20 million for free prenatal care. Since the program began in 2008, more than 70,000 women and their newborns have had access to skilled care during pregnancy, childbirth, and the postnatal period. In participating institutions, the maternal mortality rate per 100,000 live births is about 135—a significant difference from the 630 deaths nationally.

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