In Africa, 41 thousand infants die annually before they're one month old. Most newborn and maternal deaths occur within days of childbirth, when there is usually no skilled care. The major causes of these deaths are infection, premature birth and asphyxia. One initiative designed to reduce infant and maternal mortality is Countdown to 2015, a partnership of UN agencies, governments and NGOs. They are trying to meet the UN Millennium Development Goals calling for cutting in half the number of deaths of pregnant women and infants over the next seven years. The Millennium goals also call for universal access to reproductive health services. Voice of America English to Africa reporter Unathi Kondile in Cape Town looks at some of the problems and successes of the effort to reduce child and maternal mortality.

Experts say progress is uneven as African countries try to improve health care for mothers and infants.

For countries experiencing conflict, it's hard to gather data on causes of death and the shortage of drugs and supplies that could help turn the situation around. Experts say hiring researchers could alleviate the problem. In Zimbabwe, which had excellent health care, economic problems have led to the departure of trained personnel from the country.

Purnima Mane is a top official of the United Nations Population Fund (UNFPA). She says, "Maternal health has always been a serious problem in a majority of countries and not enough progress is happening. But there are some countries that are surprisingly doing well. The picture in general is not too great but there are pockets of hope."

Several African countries are making gains. A number are already strengthening their primary care systems by increasing incentives for staff, including salary increases, and temporarily using international doctors while training domestic health care workers. Ghana has developed a team approach in which a paid primary care nurse supervises community health care workers providing care for mothers and newborns. In South Africa and Botswana, nearly all pregnant women have access to a midwife or a caesarean section.

Other African countries making progress are Eritirea, Malawi, Burkina Faso, Madagascar, Tanzania and Uganda. They have reduced child mortality rates to between 24 and 34 per 1000 live births.

Health experts are asking for greater political support.

Dr. Monir Islam is the director of the World Health Organisation's  Making Pregnancy Safer Department of Reproductive Health and Research.

He says, "We realize that as health care providers we have got limited power. Deciding about resources, money, investments don't depend on us. It depends on the political people – so we are saying now we really need to involve them. When we talk to parliamentarians, sometimes they get shocked because they didn't have that information [about maternal deaths]. Once they get the information, they can table the motions in parliaments and make sure that government acts more on maternal and newborn health."

Islam says the family also has a role to play in ensuring safe births:

“Pregnancy and childbirth should not be the responsibility of the mother – it should be the responsibility of the husband, the responsibility of the family, it should be the responsibility of the society or the area and it should be the responsibility of the nation. We cannot just put everything on the mother’s side.”

South Africa’s minister of health, Manto Tshabalala Msimang has said publicly that pregnancy and child bearing are supposed to be rewarding experiences that bring new life and hope for women, their families and communities.

Health experts say they can increase their chances toward reaching that goal by monitoring local access to health care services and asking their governments to renew their commitment to young families. They say communities can go a long way toward reaching that goal by monitoring local access to health care services and asking their governments to renew their commitment to young families.

“Pregnancy and childbirth should not be the responsibility of the mother – it should be the responsibility of the husband, the responsibility of the family, it should be the responsibility of the society or the area and it should be the responsibility of the nation. We cannot just put everything on the mother’s side.”

South Africa’s minister of health, Manto Tshabalala Msimang has said publicly that pregnancy and child bearing are supposed to be rewarding experiences that bring new life and hope for women, their families and communities.

Health experts say they can increase their chances toward reaching that goal by monitoring local access to health care services and asking their governments to renew their commitment to young families.

They say communities can go a long way toward reaching that goal by monitoring local access to health care services and asking their governments to renew their commitment to young families.

               

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