Most people see the birth of a child as something to celebrate. But during a meeting with village leaders in Mali, Canadian Steve Mason learned that the arrival of a newborn in this poor African country can also be a time to mourn.
The community had always accepted that some women would die in childbirth, recalls Mr. Mason, regional CEO for West Africa at the Aga Khan Foundation, a non-profit international agency supporting social development programs in Asia and Africa. He says it was part of the culture that expectant mothers would make plans for their families in case they didn’t survive.
But Mr. Mason sees hope for these women.
“Maternal, newborn and child health is the cornerstone [of our health programming] because if that component is not addressed then there are massive repercussions,” says Mr. Mason. By heading a program focusing on the health of these vulnerable women and children, the Aga Khan Foundation aims to reverse the sobering statistics facing pregnant women and their unborn children in Mali – and in other parts of the developing world as well.
Nine mothers die for every 1,000 live births in Mali, according to the World Health Organization – deaths that can be attributed largely to lack of access to health services. It isn’t just mothers who are at risk; almost 100 of every 1,000 babies born in Mali will die before their first birthday.
The urgent problem of maternal, neonatal and child mortality isn’t unique to Mali. Globally, WHO estimates about 1,000 women die each day from causes related to pregnancy and childbirth. WHO’s data on children is even more staggering: each year, 7.6 million children die before the age of five, with about 40 per cent of these deaths occurring in the first four weeks of life.
Rates of maternal, neonatal and child mortality are particularly high in rural communities of the developing world. For this reason, the Aga Khan Foundation Canada established a new $12-million Mother Care and Child Survival (MCCS) program with the support of the Canadian International Development Agency (CIDA). The program focuses on remote areas in three of the world’s poorest countries: the Mopti region of Mali, Cabo Delgado in Mozambique and the province of Gilgit-Baltistan in Pakistan.
Undertaken through the Government of Canada’s $2.85-billion Muskoka Initiative to address maternal, newborn and child health needs, the program aligns with the United Nations Millennium Development Goals. The goals include dramatic reductions not only in maternal and child deaths but also in incidences of malaria, HIV/AIDS and hunger – factors that are critical to the health of women and children in developing countries.
Over the next three years, the MCCS program is expected to reach over 300,000 women and close to 200,000 children in Mali, Mozambique and Pakistan. Through the program, field staff work with local health systems to expand access to health care, improve access to health-related communication technologies, and develop community knowledge and capacity that can help women and their families make better health care decisions.
In Mali, Mr. Mason and his team developed a system to bring services to the women, instead of forcing women to travel to larger population centres. Working with communities, they created “rural maternities” – tiny huts where local women are trained in all aspects of childbirth and delivery.
“They are responsible for identifying pregnant women, taking them through all the steps before they give birth, delivering the child and then looking after the health and well-being of the mother and newborn,” says Mr. Mason.
These local women are drawn from the community itself and are paid by the community and local overnment for their work, creating an element of sustainability, says Mr. Mason.
In addition to training new birth attendants, Mr. Mason says that the program also retrains traditional birth attendants, who have historically been a “much maligned” group because some of their birthing practices have been counterproductive to women’s and children’s health.
“I think our approach of retraining traditional birth attendants and putting them in support of these new midwives has given them a new pride and a new role in the community,” says Mr. Mason, regional CEO for West Africa, Aga Khan Foundation
The year before this project launched, 20 women in the three targeted Mopti communities had died in childbirth. In the three years following the creation of the rural maternities, not a single woman died while giving birth.
This novel approach is now being replicated in more than 100 other rural communities in Mali, all located more than five kilometres from the nearest health facilities.
There is a fundamental reason to emphasize maternal, neonatal and child health: these are intrinsic human rights for every woman, girl and child. But the health of individual women and children can also make a difference in their families and communities.
In many cultures, women not only tend to the children and the household, they’re also significant contributors to the family’s finances – and are sometimes the sole breadwinner – through micro-businesses or farming.
Healthy women who survive childbirth can be a strong driver in the development of their families and communities.
The same goes for children. As Mr. Mason says, the first five years of a child’s life are critical to their development over time.
“It’s of utmost importance that young children are in good health and have access to early childhood opportunities,” says Mr. Mason. “The children are the next generation. They’re the people who are going to take the country forward.”
This report was produced by RandallAnthony Communications Inc. (www.randallanthony.com) in conjunction with the advertising department of The Globe and Mail. Richard Deacon, National Business Development Manager, firstname.lastname@example.org.
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