The maternal mortality ratio is unacceptably high in Africa. Forty per cent of all pregnancy-related deaths worldwide occur in Africa. On average, over 7 women die per 1,000 live births. About 22,000 African women die each year from unsafe abortion, reflecting a high unmet need for contraception. Contraceptive use among women in union varies from 50 per cent in the southern sub-region to less than 10 per cent in middle and western Africa" UNFPA

Early and unwanted childbearing, HIV and other sexually transmitted infections (STIs), and pregnancy-related illnesses and deaths account for a significant proportion of the burden of illness experienced by women in Africa. Gender-based violence is an influential factor negatively impacting on the sexual and reproductive health of one in every three women. Many are unable to control decisions to have sex or to negotiate safer sexual practices, placing them at great risk of disease and health complications.

According to UNAIDS, there is an estimated of 22.2 million people living with HIV in Sub-Saharan African in 2009, which represents 68% of the global HIV burden. Women are at higher risk than men to be infected by HIV, their vulnerability remains particulary high in the Sub-Saharan Africa and 76% of all HIV women in the world live in this region.

In almost all countries in the Sub-Saharan Africa region, the majority of people living with HIV are women, especially girls and women aged between 15-24. Not only are women more likely to become infected, they are more severely affected. Their income is likely to fall if an adult man loses his job and dies. Since formal support to women are very limited, they may have to give up some income-genrating activities or sacrifice school to take care of the sick relatives.

For more information on HIV/AIDS and Reproductive health, please visit the following websites:

Source:  The Guardian
Despite staff being much better trained in abortion procedure, Dr Swebby Macha says many girls are still given incorrect information, which leads them to resort to dangerous methods.

Source: The Guardian
In Zambia, the taboo surrounding abortion leads to thousands of women dying every year as they try to terminate pregnancies.

Source: PlusNews
Sex workers in Rwanda say the criminalization of their activities, combined with their general isolation from society, means they are often excluded from HIV prevention, treatment and care opportunities. 

Source: All Africa
Government plans to construct mother's shelters in most rural health centres as a means of combating maternal mortality rates in the country.Community Development, Mother and Child Health Deputy Minister Jean Kapata said the construction of mother's shelters

Source: IRIN
Mortality rates in Guinea have dropped significantly over the past two decades, but efforts to speed up progress on the Millennium Development Goal (MDG) to reduce maternal mortality by three-quarters by 2015 through a ban on childbirth fees, including for Caesarean sections, are stalling due to poor planning and lack of resources, say critics.

No sustainable costing plan has been put in place to cover the fees. A health insurance scheme has been set up, but functions on a very small scale.

“You can’t just say something is free - you have to plan. Making maternal delivery free burdens health structures, which have not been given enough new money to cover it… for the most part delivery is free now, but the money will soon run out and they will have to find new sources,” the National director of community health and disease prevention, Hawa Touré, told IRIN.

In Guinea, 680 women die out of 100,000 live births, down from 1,200 in 1990, according to the UN.

Health not prioritized

In 2010 just 2.5 percent of the annual national budget was allocated to the Ministry of Health, according to the Health and Public Hygiene Minister, Naman Kéita. This rose to between 4 and 5 percent in 2011 - a marked improvement - but still far lower than the goal of 15 percent set in the Abuja Declaration.

As a result, the bulk of the health budget is covered by donors such as the Global Fund, GAVI, which promotes vaccination, the World Bank and the World Health Organization; and individual donors such as France, Japan and Spain.

Abolishing user fees works when there is a plan in place to boost the number of medical staff and equipment available to address expected higher demand; and a financial strategy to cover the care costs, according to lessons learned from similar schemes in Sierra Leone, Burundi and Mozambique.

Fatou Sikhé Camara, Director General of Guinea’s largest public hospital, Donka, in the capital Conakry, told IRIN the government had given the hospital a subsidy to cover costs, but she could not specify the amount, or how it had been used.

Asha Camara, 21, said she stayed overnight at the hospital but had not paid to give birth. “I paid for food - not much else,” she told IRIN on leaving Donka with her newborn baby.

“Too medicalised”

The scheme would have more impact on maternal mortality if ante-natal and post-natal care visits were also covered, said Julien Harneis head of the UN Children’s Fund (UNICEF) in Guinea. “The approach is too medicalised - covering ante-natal consultations would identify at-risk women and highlight in advance those who require more assistance.”

Ifonou Estelle Montserey, who is eight months pregnant, waited for her prescription on a bench outside the ante-natal unit at Donka Hospital. She showed IRIN separate bills of US$10 for her monthly scan and a $3 consultation fee. “Last month I paid $7.40 [for the scan]. Nothing is consistent here… and nothing is free in Guinea.”

The effect of the fee abolishment is as yet unknown: a countrywide district health survey addressing maternal mortality rates, among other issues, is underway and the results will be published in 2012.

But a prominent development specialist told IRIN she expected the strategy to have little added impact, given the way it’s been delivered. “On the plus side, it’s good that the government proposed it, but they now need to finance it,” she said.

Minister Kéita told IRIN he hopes the health budget will be increased in 2012, and if it is the government will set aside funds to finance the plan. “Maternal mortality is one of our priority areas. But we lack resources. We need more personnel, more money, and more equipment to make this work.”

Recruitment drive

The number of medical staff per capita remains very low in Guinea: 401 midwives are thought to be practicing in the country, according to the UN Population Fund. To reach the MDG target of 95 percent of births covered by a skilled birth attendant, a further 2,294 personnel are needed.

Kéita said the government had launched a drive to recruit some 1,800 midwives and nurses earlier this year, the first such campaign in five years. According to UNFPA there is just one private school with a three-year midwifery programme.

Funding is often drained through widespread corruption according to medical staff at Donka.

“Maternal mortality needs more work, here,” said Harneis. “Progress on reducing maternal mortality is taking too long. Donors and the government need to come up with a joint vision to fight it… we are not where we need to be.”

Acknowledging the challenge, he noted that “You can’t vaccinate against all the risks associated with pregnancy - while polio or measles can be tackled with once-a-year campaigns, the response to maternal mortality is oriented around the quality of the healthcare structure, which in Guinea is consistently poor.”

 

Ifonou Estelle Montserey: “Nothing in Guinea is free”.

Source: The Mail & Guardian 
For 15 years Thato Serite has made her living as a prostitute along Botswana's busiest highway, hired by truckers plying the main route to South Africa.

Source:AWID
(WNN) Deauville, FRANCE : “I came here to stand up for the voiceless mothers of Africa,” says thirty-one-year-old Ugandan nurse midwife and woman’s advocate Esther Madudu at Global Meeting 2011 of the Women’s Forum for Economy and Society in Deauville, France. She begins with murmured conversations dying down to hear her speak. “When people ask me: ‘What can we do to help you do your job?’ I answer: I need more of me. Every year, more than 200,000 women in Sub-Saharan Africa die during pregnancy or childbirth, just because medical care was too expensive or difficult to reach.”

Source: All Africa
The director of the National Institute to Fight against HIV/AIDS, Dulcelina Serrano Monday in Luanda said that women register a greater number of HIV infection than men especially in rural areas.

Source: All Africa
Of the more than 34 million people living with HIV worldwide, half are women and three quarters of the world's HIV positive women live in the Sub-Saharan Africa.

Source: Times of Zambia
OF the more than 34 million people living with HIV worldwide, half are women and three quarters of the world’s HIV positive women live in the Sub-Saharan Africa.

Source: The Observer
Reports from the World Health Organization (WHO) estimate that over half a million women die in pregnancy or childbirth every year and a 1.4 million barely survive life-threatening complications in developing countries.

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