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A pregnant Angolan mother is seen with one of her five children on the southern edge of Luanda in August, 2009. (LOUISE REDVERS/AFP/Getty Images)
A pregnant Angolan mother is seen with one of her five children on the southern edge of Luanda in August, 2009. (LOUISE REDVERS/AFP/Getty Images)

Globe editorial

When it comes to maternal health, let Africans decide Add to ...

If Canadians of all political persuasions really want to help women in Africa, they should abandon posturing over funding abortion overseas, and instead lobby G8 countries to fund a new facility, focused on maternal and child health, at the Global Fund to Fight AIDS, Tuberculosis and Malaria.

This nimble model can be used for maternal health. The Fund finances US$19.3-billion and, critically, it invests on-the-ground experts in each recipient country with the authority to decide spending priorities.

Independent auditors and technical review panels scrutinize aid programs to ensure they reach specific goals. The public can track the progress of all grants via theglobalfund.org. Donors maintain influence through their work, sitting on a rotating board of directors, but the programs are country-driven.

Poor women in Africa die in childbirth at shocking rates. In some countries, one woman in 22 will die as a result of pregnancy or childbirth. Deaths are on the rise in sub-Saharan Africa, including Mozambique, Namibia, Chad and Nigeria.

That so many African women continue to die reflects their disempowerment and their lack of freedom - economically, politically and biologically. Many pregnant women can't get to a clinic, can't afford care, or must resort to under-resourced hospitals that lack blood and basic supplies. The lack of the most basic medical care during childbirth means women die of completely preventable or treatable complications such as hemorrhage, infection, blood-pressure disorders, obstructed labour and sepsis (infection of the genital tract or surrounding areas following childbirth).

The recent political debate on maternal mortality has focused on unsafe abortions, but this is a distraction. Unsafe abortions do account for some of these pregnancy-related deaths and the reality of abortion services in Africa is a horror. But given that abortion is highly restricted for 90 per cent of Africans, and wholly illegal in 14 countries, the G8 would accomplish little by focusing on the issue. The bigger task - and one where the G8 can actually make a difference - is empowering women to have more control over their sexual lives, by increasing access to family planning and ensuring that pregnant women have access to care when they are ready to deliver.

Recipients of aid must design their own solutions and take their social context into account, and donors, who have reneged in the past, must be kept accountable for their promises. That's why work on a new facility at the Global Fund should be the main focus of maternal health activists, as it could deliver large sums of money to Africans to turn the situation around.

Indeed, the debate around abortion could put the broad, bi-partisan coalition on development and global health that has come together over the last decade at risk. Is this really what Canadians want?

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