Improving maternal health

A mother with her newborn in a mother-child facility in Burundi.

Every day some 800 women die of the consequences of pregnancy and childbirth in de­vel­op­ing coun­tries on account of a lack of adequate medical care. In some coun­tries, especially in sub-Saharan Africa and South Asia, one mother dies for roughly every 100 births. The World Health Organization has termed this loss of life an "invisible epidemic". It is unnecessary. Most of these deaths are avoidable even in de­vel­op­ing coun­tries.

The lack of health education and of medical care for expectant mothers are two of the main reasons why pregnancy is a life-threatening condition in many coun­tries. In the regions where maternal mortality is highest, about half of all women give birth without the help of a qualified midwife or a doctor. Many women have only little say in matters of sexuality and family planning. Roughly one woman in five who has her child in a de­vel­op­ing coun­try will not have attended a single antenatal check-up during the pregnancy.

Alongside skilled care during pregnancy and childbirth, preventing unwanted pregnancies and reducing the number of unsafe abortions are im­por­tant factors in reducing maternal mortality.

Germany’s commitment

Within the scope of in­ter­national de­vel­op­ment co­op­er­a­tion, Germany supports the United Nations Population Fund (UNFPA) through voluntary contributions to the UNFPA budget and through the financial resources it provides for special programmes on reproductive health. The German gov­ern­ment also supports the In­ter­national Planned Parenthood Federation (IPPF).

The BMZ promotes more than 50 projects globally in the field of sexual and reproductive health in the form of appropriate activities and interventions.

At the G8 summit in 2010 Germany pledged to support the Muskoka Initiative on Maternal, Newborn and Child Health (MNCH). In the period up to 2015 the German gov­ern­ment will provide an additional 400 million euros to finance pertinent measures. In 2011 BMZ launched its own Initiative on Rights-based Family Planning and Maternal Health as a contribution to realising the G8’s Muskoka Initiative and in order to support the global strategy Every Woman, Every Child under the aegis of the United Nations Secretary-General. The BMZ Initiative pursues three goals:

  1. To improve knowledge and acceptance of modern family planning methods;
  2. To expand access to modern family planning methods and services;
  3. To increase the number of births attended by health professionals.

The following examples give a brief insight into the wide spectrum of Germany’s commitment:

Cameroon – young mothers promote sex education and work to counter violence

Family in Buea, Cameroon. Copyright: Thomas Imo/photothek.netIn Cameroon, a girl’s aunt is traditionally her closest confidante and advisor in sexual matters. The "tantines" (little aunts) project builds on this tradition.

By mid-2013 the project had trained more than 17,000 unmarried women who had become pregnant as teenagers on many aspects of sexual and reproductive health. The newly trained young mothers called themselves "tantines" and founded local associations in which they supported one another and took on the work otherwise performed by aunts.

The "tantines" are reaching a large number of young people in their own villages and districts. They offer sex education as part of school instruction and advise young people outside schools.

Cameroon now has more than 330 local "tantine" associations with a total of at least 36,000 members. Advisory services outside schools reach another 1.2 mil­lion people every year.

Kenya – safe motherhood for the poorest women

In Kenya a voucher system has been introduced with German support to give disadvantaged women access to reproductive health care. As of a predetermined level of pov­er­ty, women may buy subsidised vouchers. This entitles them to certain services in health facilities participating in the scheme. The voucher system covers antenatal care, family planning advice and care for victims of sexual violence.

The programme was first launched at six locations in Kenya and has since been expanded to the new county borders (four counties each with 20 districts and two slum districts in Nairobi). These areas are home to a total of over 600,000 poor women of childbearing age. Since the programme started tens of thou­sands of children have been born safely, attended by health professionals, at the 155 accredited public and private health facilities – another 2,500 children join them every month.

The voucher programme serves as the basis for the planned introduction of a health insurance scheme for poor people.

BMZ glossary

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