The World Health Organization (WHO) has issued a call for the world to “Act now for safe and respectful childbirth,” as it leads the global commemoration of the World Patient Safety Day 2021. This call is a welcome step to raise global awareness on maternal and newborn safety, particularly during childbirth.
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17 September has been marked as World Patient Safety Day since 2019. Earlier in May that year, the 72nd World Health Assembly adopted the "Global action on patient safety" resolution. The day brings together patients, families, caregivers, communities, health and care leaders, and policymakers to show commitment to patient safety. It is thus a day for global solidarity on issues of concern to all who receive health and care.
This year's theme, "safe maternal and newborn care," draws attention to the questionable state of continued maternal and newborn mortality and morbidity. According to the WHO, approximately 810 women die every day from preventable causes related to pregnancy and childbirth. Further, 6,700 newborns also die every day.
Maternal and newborn mortality
According to the World Health Organization (WHO)
die every day
die every day
of all maternal deaths
occur in low- and lower-middle-income countries
A major reason for this awful situation is the exposure of women and newborns to unsafe care, particularly in less developed countries. 94% of all maternal deaths occur in low- and lower-middle-income countries. In 2017, the maternal mortality ratio in high-income countries was 11 per 100,000 births, while in low-income countries, this was a staggering 462 per 100,000 births.
There were 196,000 maternal deaths in sub-Saharan Africa alone in 2017. This figure represents two-thirds of all maternal deaths in the world that year
There were 196,000 maternal deaths in sub-Saharan Africa alone. This figure represents two-thirds of all maternal deaths in the world that year. In Southern Asia, there were 58,000 recorded maternal deaths in the same period. This represents almost one-fifth of the global figure. The two regions thus accounted for 86% of the estimated global maternal deaths in 2017.
These figures mask differences between countries and, even more importantly, differences between social classes and other marginalized groups. The most affected people are the poor who live in rural areas and pauperized urban centers. They lack access to quality maternal and child healthcare because public health systems are underfunded and understaffed.
Migrants, refugees, and internally displaced people also live precariously, a situation worsened in some cases by xenophobic dispositions of government officials. Violent conflicts have also exacerbated the problem in countries like South Sudan, Haiti, Afghanistan, Iraq, the Democratic Republic of Congo, and the northeastern region of Nigeria.
The present state of maternal and child mortality is unacceptable. The need to act now and make childbirth safe and respectful for all cannot be overemphasized. But if the root cause of the problem is not tackled, gains that would be made would at best be minimal.
Governments as duty bearers bear responsibility for addressing the problem. Calls to "stakeholders" do wittingly or unwittingly steer clear of this critical point. These "stakeholders" tend to cover seemingly do-good foundations, voluntary associations, and the wolf of businesses often cloaked in the sheep clothing of these bodies.
These bodies are not accountable to the people, and in the case of businesses, have profit-seeking interests as well. But what is needed is the funding and democratic governance of public maternal and child health programs. '
Low-income countries lack resources not simply because they are poor. Many are resource-rich, but they are being bled financially. For example, $427 billion is lost globally to tax havens annually. This amount is enough to pay the salaries of 34 million nurses and midwives, who could contribute significantly to arresting maternal and child mortality. International financial institutions' conditionalities also restrict the fiscal policy space of poorer countries, limiting the funding they could make available for public health, including maternal and child healthcare.
It is thus high time for the international community to stop financial practices that make it impossible for governments in low-income countries to have enough resources dedicated to maternal and child public healthcare delivery. Trade unions and civil society must also demand that governments commit much-needed funding for public healthcare to make safe and respectful childbirth the norm everywhere, as should be the case in today’s world.