1 |1 | Making Pregnancy Safer UN Human Rights Council Session 14 4 th June 2010 Department of Making Pregnancy Safer Dr. Maurice Bucagu Sachiyo Yoshida Maternal mortality in Afghanistan

2 |2 | Making Pregnancy Safer UN Human Rights Council Session 14 4 th June 2010 Preventable maternal mortality and morbidity and human rights …the unacceptably high global rate of preventable maternal mortality and morbidity is a health, development and human rights challenge…” Resolution 11/8. UN Human Rights Council, 2009

3 |3 | Making Pregnancy Safer UN Human Rights Council Session 14 4 th June 2010 Fight for Life nistan.html

4 |4 | Making Pregnancy Safer UN Human Rights Council Session 14 4 th June 2010 Statistics from the ground reality Maternal mortality ratio 1800 per live birth (Source: Estimate developed by WHO, UNICEF, UNFPA and the World Bank) Life time risk of maternal deaths is 1 in 8. (Source: Estimate developed by WHO, UNICEF, UNFPA and the World Bank) Infant mortality 129 per 1000 live births. (Source: Afghanistan Health Survey 2006)

5 |5 | Making Pregnancy Safer UN Human Rights Council Session 14 4 th June 2010 Antenatal care coverage at least once by skilled provider Source: Afghanistan Health Survey 2006 NRVA: National Risk and Vulnerability Assessment AHS: Afghanistan Health Survey

6 |6 | Making Pregnancy Safer UN Human Rights Council Session 14 4 th June 2010 % of births assisted by skilled birth attendants Source: Afghanistan Health Survey 2006 NRVA: National Risk and Vulnerability Assessment AHS: Afghanistan Health Survey MICS: Multiple Indicator Cluster Survey

7 |7 | Making Pregnancy Safer UN Human Rights Council Session 14 4 th June 2010 % of births assisted by skilled birth attendants by wealth status Source: Afghanistan Health Survey 2006

8 |8 | Making Pregnancy Safer UN Human Rights Council Session 14 4 th June 2010 Place of delivery Source: Afghanistan Health Survey 2006

9 |9 | Making Pregnancy Safer UN Human Rights Council Session 14 4 th June 2010 Place of delivery by travel time to health facility using routine mode of transportation Source: Afghanistan Health Survey 2006

10 | Making Pregnancy Safer UN Human Rights Council Session 14 4 th June 2010 Family planning Source: Afghanistan Health Survey 2006

11 | Making Pregnancy Safer UN Human Rights Council Session 14 4 th June 2010 Conclusion (1) Like in all conflict situations, women and children bear the brunt of crisis (e.g. access to basic health services; maternity services). Women, particularly pregnant women, and their newborns are often overlooked or hard to reach. Pregnancy & childbirth do not wait for the stabilization period in case of crisis. Afghanistan: WHO priority country;

12 | Making Pregnancy Safer UN Human Rights Council Session 14 4 th June 2010 Conclusion (2) Key interventions for maternal and newborn survival: –Identify: pregnant women and newborns, –Identify: skilled personnel and available materials –Supply kits to: pregnant women (delivery kits); skilled staff (midwifery kits); health facilities with appropriate kits. –Establish a referral system for obstetric emergencies; –Ensure safe-blood transfusion; From crisis to developmental vision (MDGs 4&5): To reduce maternal mortality: –Skilled care at birth + Emergency Obstetric care + Newborn care + Family planning. –Adequate funding for maternal and child health programme

13 | Making Pregnancy Safer UN Human Rights Council Session 14 4 th June 2010 Thank you