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Women in eastern and southern Africa continue to die during pregnancy and childbirth from preventable causes, Dr Brian Chiromba, WHO representative in Rwanda, told a high-level meeting to track progress in ending preventable maternal and newborn deaths. prevent.

Effective interventions are needed “to ensure quality care for mothers and newborns, starting with pre-pregnancy, antenatal, labor and delivery, and the postpartum and neonatal periods,” he said.

In the Eastern and Southern African region, significant progress has been made in improving the survival and health of pregnant women and newborns. For example, the maternal mortality ratio (MMR, or the number of maternal deaths per 100,000 live births) fell by 49 percent between 2000 and 2017. However, the MMR remains well above the global average and the current rate of decline is insufficient. to achieve the 2030 SDG goals.

The United Nations Inter-Agency Maternal Mortality Assessment Group (MMEIG) estimated in 2017 that around 77,000 women lose their lives in the region each year during pregnancy and childbirth. For a 15-year-old girl, the lifetime chance of dying from maternal causes is 1 in 58, compared with 1 in 11,200 in Western Europe.

While the global neonatal mortality rate was 17 deaths per 1,000, in sub-Saharan Africa the rate was 27 per 1,000, according to the Child Mortality Trends 2021 report. Of the 54 countries that failed to meet the SDG target of less than 12 deaths per 1,000 births, 40 are in sub-Saharan Africa.

“The global health agenda has shifted from a focus on reducing mortality to ensuring that all women, newborns, children and adolescents not only survive, but thrive and realize their rights to the highest attainable standards of health and well-being,” Dr Chiromba . said.

This paradigm shift requires greater investment in integrated initiatives alongside quality comprehensive reproductive, maternal, newborn, child and adolescent health (RMNCAH) interventions that focus on health promotion, disease prevention and treatment.

Progress tracking

To support the implementation of evidence-based recommendations for maternal and newborn health, the United Nations Interagency Group for Eastern and Southern Africa (UNICEF/WHO/UNFPA) organized a regional meeting this month in Kigali, Rwanda.

The meeting, led by the H6 Eastern and Southern Africa Coordinating Group (mainly UNICEF, WHO and UNFPA), aimed to follow up on the implementation of the Every Newborn Action Plan (ENAP) and the Program to End Preventable Maternal Mortality (EPMM).

Many countries have developed RMNCAH policies and implemented them at all levels of the health system in line with the Global Strategy for Women’s, Children’s and Adolescents’ Health 2016-2030. and set goals to achieve the SDGs.

Launched in 2014, the global ENAP program provides a strategic action roadmap to end preventable neonatal deaths and stillbirths, and to help reduce complications during pregnancy and childbirth.

Countries shared their successes and challenges in universal health coverage, emergency obstetric care, midwifery and newborn health as they work to accelerate progress towards the SDG targets. Opportunities were identified for scaling up high-impact interventions in primary care, from South-South cooperation to leveraging innovation. This included the use of new digital technologies such as portable ultrasound, e-learning and mentoring platforms, safe delivery programs and clinical decision support platforms.

Improving Midwifery in East and Southern Africa

Midwives are key to reducing maternal and newborn deaths and improving their health and well-being. While the region has seen improvements in higher education and career development for midwives, shortages of midwives remain. In addition, some countries lag behind in institutionalizing continuing professional development and relicensing midwives.

These important points were discussed during a follow-up meeting held by UNFPA on the World Midwifery Report 2021 for Eastern and Southern Africa, which was attended by representatives from ministries of health and midwifery associations, as well as UNFPA midwifery experts.

The countries’ experience in creating a favorable environment and equipping midwives with the skills and knowledge necessary to ensure a healthy pregnancy and safe childbirth were exchanged. Action plans to improve the state of midwifery in their countries were developed, with UNFPA playing a key role in providing technical support to implement these plans over the next two years. Plans included increasing the number of qualified midwives with the knowledge and skills needed to reduce maternal mortality and accelerate progress towards the SDGs.

Distributed by APO Group on behalf of UNFPA – Eastern and Southern Africa.

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