Every minute, somewhere in the world, a woman dies of complications in pregnancy or childbirth. That means a total of around half a million maternal deaths each year.
Childbirth remains a leading killer across much of the developing world, according to the UN Development Program’s data from 2005. Complications during pregnancy and childbirth are a leading cause of death and disability among women of reproductive age in developing countries.
The Middle East[Unfortunately, due to website restrictions, this data is not interactive. If you want to access the data interactively, please click here.]
If we only include Middle Eastern countries in the data, like the bar chart below, we can gain a more in depth picture of the countries in the Arab region.
Afghanistan has one of the highest maternal mortality rates in the world. An Afghan woman dies every two hours from pregnancy-related causes. With 1,800 mothers dying out of every 100,000 births, the rate in Afghanistan is comparable to those in sub-Saharan Africa according to a UN study conducted in 2008. More recently, the health ministry in Afghanistan carried out The Afghanistan Mortality Survey (AMS) 2010 which is the most comprehensive of its kind ever carried out in the country. This study, which was sponsored by a number of organisations including UNICEF and the World Health Organisation, indicated that there was a decrease in maternal mortality rates and the new research puts maternal mortality rates below 500 deaths per 100,000 live births.
However, officials say that it is difficult to compare the latest data with previous surveys which were based on geographically limited and less representative samples. The Afghan government has pledged to lower maternal mortality by 20 percent by 2020.
But cultural and religious taboos, as well as catastrophic shortages of qualified health personnel, have made this difficult. Dr Sarah Pickworth is based in the mountainous Province of Ghor and involved in training midwives said:
“There are a host of hidden cultural challenges. For example many women bleed to death before they can receive permission from their husband or mother-in-law to get medical help. ‘Most deaths are preventable. It’s down to lack of awareness coupled with unskilled care, and dangerous cultural practices such as cutting the umbilical cord with the edge of a shoe, from a well-meaning villager or mother-in-law.”
Charities, such as Afghan Save the Children, have been working to train midwives to cope with child birth and deal with regular illnesses such as diarrhoea or pneumonia. Through them, around 20,000 community health workers and 2,500 midwives have been trained since 2003 which is having a positive impact in the country.
Rest of MENA
If we remove Afghanistan from the data, as it’s extremely high death rates distorts the picture for the rest of the Middle East, we can see the remaining countries in the region in the pie chart here.
In Iraq, the maternal mortality rate is 300 deaths for every 100,000 births. Egypt’s maternal mortality rate is 82 for every 100,000, both these statistics can be attributed to similar reasons for the countries across the Middle East; low average age of marriage, illiteracy, lack of prenatal care and poor health information systems.
However, after Afghanistan, Yemen has the next highest maternal mortality rate in the Middle East. Yemen is the poorest country in the Arab world with limited opportunities and resources, and has high unemployment and widespread corruption and rampant human rights abuses. Although Yemen has three women ministers in the current transitional unity government, 3 members in parliament, 1 in the lower house and 2 in the upper house, and there was one woman ambassador out of 57 posts, yet it continues to occupy the last place in the region as well as in the overall rankings of 135 countries for six consecutive years.
Yemen has one of the highest maternal mortality rates in the world, seven women die every day due to complications during childbirth. The United Nations Development Program (UNDP) cites child marriage as a factor that contributes to Yemen’s lack of progress in meeting at least two goals: gender equality and reduced maternal mortality. There is an urgency to address this issue, to improve women’s health and reduce Yemen’s maternal mortality rate. Almost all these deaths could be prevented if easy access to quality health services during pregnancy and childbirth are secured.
Yemeni Women have inspired the rest of the world in their role in the Arab Spring and Tawakkul Karman became the first Arab woman to receive the Nobel Peace Prize last year for her part in the revolution. But it seems women’s groups have a long way to go before maternal mortality rates decreas. The Yemeni government issued the Law of Free Delivery in 1998 to help reduce the high mortality rate in Yemen, but the benefits are not extended to Yemenis in rural areas and public clinics.
But these decrees cannot be carried out if there is no support for clinics and hospitals and many critics say that these facilities need to be funded before decrees are written.
In spite of the law providing free deliveries, only 14 percent of women giving birth knew the law existed, according to a study by Oxfam in 2007. The study also revealed that implementation of the decree was limited to main hospitals, and not carried out in rural areas and public clinics.
In February 2012, as part of the Responsive Governance Project, USAID conducted an advocacy training workshop on “Free Delivery, Family Planning and Emergency Obstetric Care” for 90 representatives from the Ministry of Health, National Safe Motherhood Alliance (NSMA) and the Yemen Family Care Association (YFCA). The workshop consisted of discussions on how to advocate for the implementation of the free delivery law, as well as family planning and emergency obstetric care policies to promote maternal health in Yemen.
There are many organisations across the globe that are working to reduce maternal mortality rates across the globe. It will be interesting to see if the Arab Spring and the spread of democracy across the region will have a positive impact on reducing maternal mortality rates.