News Analysis: Developing Asia still grapples with high maternal mortality rate

MANILA, Philippines (Xinhua) – Ensuring women’s access to family planning education and services will slash high maternal mortality incidence and sustain the gains achieved in promoting maternal health in developing Asia, health experts said.

Thein Thein Htay, deputy director general for public health in Myanmar, reported that from 1990 to 2008, Southeast Asian countries have made substantial reductions in maternal mortality. But Htay notes that results are uneven between countries.

Htay, who was recently in Manila to attend a regional conference on reproductive health, reported that while Brunei, Singapore, Malaysia, and Thailand succeeded in slashing mortality rate, such positive trend was not sustained by other countries in the region including the Philippines, Indonesia, Myanmar and Cambodia.

Htay said greater intervention is needed to decrease in the number of mothers who die from unsafe abortion, hypertensive diseases, and postpartum haemorrhage as well as on neonates who fail to survive due to pneumonia, sepsis, and birth asphyxia.

Meanwhile, a separate report presented by Tara Chetty, program director of the Fiji Women’s Rights Movements, enumerated several factors that harm women’s reproductive health in the Oceania region.

These factors include low government spending on health, lack of access to comprehensive sexuality education, high rates of gender-based violence, inavailability of safe and legal abortion and the conservative interpretation of cultural traditions and practices.

“We’re (Pacific islanders) not really conservative as we’d like to portray ourselves to be. We’re just conservative in realizing other people’s rights, especially that of young people who are supposed to know their place and to not to push the envelope.” Chetty said.

Htay and Chetty’s reports only covered the Southeast Asian regions. But latest data from the UN showed these reports actually reflects the situation of maternal health in developing Asia as a whole.

The United Nations Economic and Social Commission for Asia and the Pacific (UNESCAP) reported that with regards to health related Millennium Development Goals (MDGs), the region is off-track on maternal mortality and universal access to reproductive health.

UNESCAP said that there have been some improvements in women’s health, especially in East Asia, where women live longer than the world average. In South Asia, however, women have low life expectancy owing to high maternal mortality rate – around 217 mothers die for every 100,000 live births.

In a separate report, the United Nation Development Program (UNDP) said most countries in Asia-Pacific are not likely to attain the MDG target of reducing the maternal mortality rate by three quarters in 2015. Only Bhutan, Iran, Maldives, Nepal and Vietnam have achieved the target so far while five other countries (Bangladesh, Cambodia, China, Laos and Timor-Leste) are likely to meet the target by 2015.

In terms of access to sexual and reproductive health care services, the UNDP said that between 1990 and 2008, the proportion of women of reproductive age who are using (or whose partner is using) a contraceptive method rose from 58 to 67 percent.

There is however a wide disparity in contraceptive prevalence rates between sub-regions. While Southeast Asia enjoys a high 60 percent prevalence rate, the Pacific had the lowest rate in the region of 38 percent.

Lack of access to health services – such as access to the services of skilled doctors/midwives and contraceptives that will prevent unwanted pregnancies – is one of the key reasons behind the high maternal mortality rate.

UNESCAP said inadequate public health funding also contributed to this, noting that governments which spent more on health succeeded in bringing down maternal mortality rates.

UNESCAP said maternal health is also related to women empowerment, noting that “literate, well-informed and empowered are in a much stronger position to decide on their number of children and care for them.”

Suchitra Dalvie, one of Asia’s foremost experts in women’s health, stressed it’s important to educate more women about their choices and respect the decisions they made about their reproductive health.

“It’s interesting to see how the decision (to give birth) is usually taken out from the hands of women,” she said.

Dalvie notes that one of the main causes of maternal deaths is complications due to unsafe abortions. And yet, even in countries where abortion is legal, women die from unsafe abortion either because they are not aware of their options or were denied of this service.

“Even in countries where abortion is not restricted, it ( complications due to unsafe abortions) can still become a problem because women don’t have access to abortion services or the doctors won’t give this service,” Dalvie said. –(philstar.com)