2. The Stall in Maternal Mortality Reduction in Africa - Sharing Experience from Ghana IPHU Workshop: November 11 2007 john mahama & nicolas mensah

3. Outline Introduction Why maternal health Stall in MM in Africa When do these deaths occur Conclusion

4. Definition Maternal death: The death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes (ICD-10).

5. Why maternal health A woman’s health is critical to the well- being of her family and to the economy of her community and her country. When a mother dies or is in ill health, children are more likely to be stunted and to receive less schooling and healthcare. A child whose mother has died is up to four times more likely to die than a child who has not lost a mother.

6. The total value of women’s unpaid house and farm work adds one-third to the world’s GNP. Where women lack education, economic opportunities, and power over the decisions that govern their lives, the health of mothers is poor.

7. Maternal mortality Every minute of every day, a woman dies needlessly during pregnancy or childbirth, most in the developing world. South Asia and sub-Saharan Africa have the poorest maternal health. Sub-Saharan Africa alone accounts for 51% of the world’s maternal deaths.

8. Lancet Series, 2007

9. The three delays –Delay in seeking care –Delay in arriving at an emergency care facility –Delay in receiving care from providers –4 th Delay (???)

10. When do these deaths occur? Lancet Series, 2007

11. 10 GHANA IMMPACT, 2003

12. 11 ACCESS TO SKILLED ATTENDANTS IN GHANA CONTEXT  High MMR, 214 – 800 deaths per 100,000 LB  Utilisation of skilled attendants relatively low – 43.6% (DHS, 2003)  Utilisation of skilled attendance lowest among the poor

13. While an annual decline of 5.5% in MMR between 1990 and 2015 is required to achieve MDG 5, data from WHO, UNICEF, UNFPA & World Bank show an annual decline of less than 1%. While gains are being made in middle-income countries, the annual decline in MMR between 1990 and 2005 in SSA was only 0.1% (WHO, 2007). Progress towards MDG 5

14. Conclusion Maternal health is ultimately related to whether societies invest in and realize the potential of women—not only as mothers but as critical contributors to sustaining families and transforming nations.

15. THANKS