Each year more than 350,000 women die from preventable complications in pregnancy and childbirth.
Divya Bajpai, the Alliance’s senior advisor on sexual and reproductive health and rights explains. “Complications related to pregnancy and childbearing and HIV are the two most important causes of death in women of reproductive age. HIV alone accounts for more than 61,000 maternal deaths annually.
“HIV directly increases the risk of complications in pregnancy and delivery such as anaemia, haemorrhage and sepsis. To stop dying, women must have access to comprehensive packages of sexual and reproductive health information and services such as family planning, maternal and child health and treatment of HIV and other STIs.
“We must see greater integration of HIV and sexual and reproductive health services if we want to improve women’s health. It is not acceptable that women are dying of preventable causes in the 21st century,” says Divya.
Being a woman in South Sudan
As South Sudan’s people recently voted to separate from the North it will be interesting to see what this situation will bring for the women of the country. Currently, nowhere is the situation more challenging for women than South Sudan, one of the poorest countries in the world.
After four decades of armed conflict, health facilities are very poor and official data estimates the maternal mortality ratio to be at 2054 deaths per 100,000 live births. In the UK it is 8.2.
Women experience high levels of violence and abuse including sexual and domestic violence, emotional and psychological abuse, forced marriages, sex trafficking and sexual exploitation.
Florence Bayao is Country Director for Alliance South Sudan. “A baseline study recently conducted as part of a UK government DFID project has highlighted the low use of reproductive health services in South Sudan.
“Many health facilities lack basic equipment and most of the maternal and neonatal health workers lack the necessary skills to perform simple life saving and nursing procedures, particularly as over 80% of deliveries take place at home or under the supervision of village midwives or relatives,” explains Florence.
With less than 20 hospitals in the whole country if a woman does experience complications during pregnancy or childbirth there’s little that can be done about it.
Knowledge and awareness of HIV among women is very low. In the 2010 Household survey only 54% of women had ever heard about AIDS and of those who answered, 59% didn’t know that HIV could be prevented by using a condom.
The majority of women don’t have any knowledge that HIV can be transmitted from a mother to a child, which is the greatest source of HIV infection in children below 15. With no intervention 24-45% of babies born to HIV infected mothers will acquire the virus.
At the end of 2009 South Sudan had only 19 facilities providing Prevention of Mother To Child Transmission (PMTCT) services. There are huge practical challenges in delivering effective PMTCT services in South Sudan, not least addressing the acute shortages of HIV testing kits, antiretroviral prophylaxis for mother and exposed child, safe delivery services and infant feeding advice.
“We are working with DFID to raise awareness of the links between HIV and maternal mortality, and advocate for the development of national policies that establish community referral pathways for HIV positive women and their families,” says Florence.
“What is needed is for formal national PMTCT training packages to be in place so that we can scale up the programme and get more staff trained. Communities play a crucial role in increasing awareness, access and uptake of services and the Alliance will be working with communities to do this.
“Women are the backbone of many communities and it is they who can make a real difference to the wellbeing of people in those communities but we need to give them the health care they need and have a fundamental right to,” she adds.