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17:38 24 June 2013

OPINION: Investing in women's health - the key to Africa's economic development

By Babatunde Osotimehin
TOKYO, June 24, Kyodo

In countries where women have adequate access to reproductive health services -- such as family planning, skilled attendance at birth and emergency obstetric and neonatal care -- maternal and newborn deaths are rare. But this is a luxury in many African countries.

Africa has the highest maternal mortality ratio in the world, with 57 percent of all maternal deaths occurring on the continent.

There has been some progress in the past couple of years, with the maternal mortality ratio for sub-Saharan Africa falling by 41 percent between 1990 and 2010. A total of 189,000 of the 358,000 maternal deaths that occur every year worldwide still take place in Africa.

For any pregnant woman in sub-Saharan Africa, the lifetime risk of dying from pregnancy-related complications is one in 39, compared to the industrialized world, where it is one in 4,700.

Although the global under-five mortality rate has fallen by one third since 1990, Africa continues to suffer from the highest rates of child mortality, with one in eight children dying before the age of five -- nearly 20 times the average of one in 167 for more developed regions. An estimated 30 percent of these under-five deaths occur among newborns, and some 60 percent occur within the first year of life.

In addition, the region has the world's highest fertility, with a regional total fertility rate of about 5.1 lifetime births per woman. Contraceptive prevalence rates for modern methods in most of the region remain low.

In both Middle and Western Africa, less than 10 percent of women use any modern method, and in East and Southern Africa the figures are 27 percent and 58 percent respectively.

The region's unmet need for family planning among married women is the highest in the world. More than two thirds of women of reproductive age are currently not using modern contraceptives.

About 39 percent of pregnancies are unwanted. The low use of family planning leads to many births that are timed badly or unwanted and contributes to the world's highest level of maternal mortality.

The current situation of poor maternal health and low use of family planning has major consequences for the continent. For example, when a mother dies or an orphaned child does not get the food or education he or she needs, or a girl experiences a life without opportunities, the consequences extend beyond the existence of these individuals.

They diminish society as a whole and lessen the chance for peace, prosperity and stability. This is why it is important to invest in women's health.

Several studies and experts have argued that investing in women's health is a key to economic development on the continent. Access to reproductive health, in particular family planning and maternal health services, helps women and girls avoid unwanted or early pregnancies and unsafe abortions, as well as pregnancy-related disabilities.

This means that women stay healthier and are more productive. They have more opportunities for education, training and employment, which in turn benefits their families, their communities and ultimately their nations. Investment in reproductive health is cost effective.

Each dollar invested in contraceptive services saves up to $4 in health expenditure and as much as $31 in other social services such as education, housing and sanitation. It is also estimated that family planning alone could reduce maternal mortality by as much as 40 percent.

The economic benefit of family planning is also well documented. Studies have shown that if all births were spaced at least two years apart, the number of deaths among children younger than five years would decline by 13 percent. The number would decline by 25 percent if there was a three-year gap between births.

The Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA) is a major effort to address maternal health in Africa. Initiated by the African Union and supported by UNFPA and other partners, the campaign aims to mobilize the commitment and support of leaders and to mobilize communities to renew and intensify their efforts to reduce maternal mortality. So far, 38 countries have launched CARMMA.

But despite these outstanding achievements, and successes in many other countries, Africa has not kept up with the pace of improvements on other continents.

This is evidenced in the statistic of over 450 women and girls who die in Africa every day from complications in pregnancy or childbirth.

If the continent is to continue the remarkable economic and social progress achieved over the past decade, then reducing child and maternal deaths and enhancing choice and access to all in family planning must be a top priority.

(This OP-ED piece was contributed by Babatunde Osotimehin, executive director of UNFPA, or the United Nations Population Fund. He became the fourth UNFPA executive director in January 2011. He holds the rank of Under-Secretary-General of the United Nations.)

==Kyodo

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