New alliance could keep mothers safer, healthier

Working together for a common goal.

A new alliance of organizations and concerned citizens could greatly improve the health of mothers in Yemen, said participants in a recent meeting at the Taj Sheba Hotel. The meeting was held by the United States Agency for International Development, the World Health Organization, and the Supreme Council for Motherhood and Childhood of Yemen, in order to discuss this proposed alliance.  Participants in the meeting came up with a preparatory committee of 23 members to establish the new alliance, perhaps within the next couple of months.  

The point of such an alliance is that when the health, religious, education, human rights, agriculture, nutrition, and transportation sectors all work together, they have more power to achieve a goal.  “There are benefits to working as an alliance, as it increases resources which can overcome the lack of resources of any single group, increase shared training/capacity-building opportunities, and it results in more creative solutions with sharing of ideas and experiences and cooperate in joint actions; a strong united voice (the whole is greater than the sum of the parts),” said Hamoda Hanafi, the Director of the Basic Health Services Project of the American Agency for Human Development. 

Safe motherhood means preventing maternal and infant death and disability through access to basic health care, according to the Global White Ribbon Alliance in 2000.  The White Ribbon Alliance for Safe Motherhood is a global movement to help save women’s and infants’ lives. “The WRA is dedicated to the memory of all women who have died in pregnancy and childbirth,” said Hanafi.  The global WRA was initiated in 1999 by NGOs, UN agencies and USAID, in response to the recommendations from the Safe Motherhood Initiative, and the recognition that a united, multi-sectoral effort is essential to save women’s and newborns’ lives.  Membership is open and broad-based to include multiple sectors: health, religious, education, human rights, agriculture, nutrition, transportation, etc.

The board members are from: Australia, Burkina Faso, Egypt, India, the UK and the US.  Worldwide, more than half a million women die during pregnancy and childbirth each year, and about 4 million children die within the first month of their lives each year. “At least two-thirds of these deaths could be prevented, because this is not a difficult thing and not one ministry’s responsibility but all of us are responsible for such a thing,” said Nafisah al-Jaefi, the Secretary-General of the SCMC. 

The Fifth Millennium developmental goal is to improve maternal health and reduce the maternal mortality rate by three-quarters from 1990 to 2015. Among the underlying factors that make motherhood so lethal in Yemen are: poor health and nutrition before pregnancy, inadequate, inaccessible or unaffordable health care, and inadequate care and hygiene during childbirth.  Socio-economic factors include women’s low educational levels, poverty, and women’s unequal access to resources.  About 42 percent of mothers’ morality in Yemen happens among women of between 15 and 49. 

“The data on mothers’ morality in Yemen is very limited since there are not national accurate statistics. Moreover, the medical system does not keep such statistics which happen in the health facilities,” said Dr. Arwa al-Rabie, the Deputy Minister for Primary Health Care Sector.  According to the data provided by the 2003 Family Health Survey, the rate of maternal mortality is estimated by the Ministry of Public Health and Population to be 365 women for every 100,000 live babies.  Thus, eight mothers die every day, and one woman out of 50 dies as a result of complications resulting from pregnancy or delivery.    

“Some studies estimate that there are double or three times the estimated numbers of women dying in childbirth in Yemen. For every woman, there are about 30 others who die because they suffer from various diseases,” said al-Rabie.  “When a mother dies, it is not only the tragic loss of a unique person and a valuable life, but her family and community also suffer. Her surviving children face higher risks of poverty, neglect and even death,” said al-Jaefi. 

According to the Yemeni 1997 Demographic Health Survey, about 25 percent of mothers, between 15 and 49, suffer from malnutrition and nine percent of them suffer from stunted growth. Moreover, about 53 percent of them suffer from bad health through pregnancy, 41 percent also suffer from dangerous complications through delivery, and 44 percent suffer from these complications after delivery.  It is possible to avoid about 70 percent of newborn babies’ mortality if the government pays great attention to mothers’ health. According to the 2003 Family Health Survey, the rate of newborn babies’ mortality amounts to about 37 percent for every 1,000 live births.

About 75 percent of nursing babies die for every 1,000, and about 102 children less than five years old, die for every 1000 ones. Moreover, about 32 percent of nursing babies suffer from a low weight.  According to the Census of 2004, about 869,155 babies are born annually. This means that about 130,389 women suffer from life-threatening complications. Between 2,695 and 7,040 women die annually, and some 32,420 newborn babies die annually.  According to the 2003 Family Health Survey, about 65 percent of mothers’ mortality takes place in homes; 9 percent of women die in the way to the hospital and 24 percent of them die in the health facilities. 

About 39 percent of women die in homes because there is not a close medical facility and about 15 percent of them die because they prefer to give birth at homes, avoiding the high fees paid in the health facilities to receive the necessary services. There are also about 9 percent of mothers who die because they refuse to be taken to hospitals. Approximately 3 percent of them die because their husbands refuse to take them to any health facility. And these numbers are probably underreported. “It is fair to say that a great development has been achieved in various fields in Yemen, but there are still a lot of things should be done,” said al-Rabie. 

Since the 90’s, public income has increased and life expectancy in Yemen overall has increased from 52 to 59 years old.  The rate of newborn babies’ mortality has decreased to 37 percent for every 1,000 live births and the rate of children’s mortality, fewer than five years old, has decreased to 102 for every 1,000 live births. The rate of school enrollment has also increased from 57 percent to 78 percent. “But Yemen is still one of the poorest countries in the world. It is ranked at148 one from 175 other countries, according to the United Nations Development Programme of 2003.

Moreover, Yemen is regarded as a country which needs great attention according to the Development Millennium Convention,” said al-Rabie.  Yemen’s population growth is high, increasing by 3 percent annually. It will amount to 38,000,000 in 2026. This means that the pressure will increase on the natural resources, especially water. About 75 percent of people are living in the rural areas; there are also a lot of difficulties with providing those people with the necessary services, especially those living in the mountains and remote areas. 

Children younger than 15 years old represent about 46 percent of the population, and need more services to support them with education, health services, clean water and jobs. “There are a number of ambitious developmental plans aim to improve the economical conditions of Yemen to be better in 2025,” said al-Rabie. “They also aim at decreasing the poor rates and achieving the Millennium goals in 2015.”

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