When the 189 UN Member States adopted the Millennium Declaration in 2000, they committed their respective governments to drastically cut the incidence of poverty by half and make the world a better place for everybody to live not later than 2015. The commitments in the declaration are espoused in a set of eight goals with achievable targets, commonly referred to as the Millennium Development Goals (MDGs). The goals broadly cover areas on reduction of poverty; education; health especially for children and women; HIV and AIDS; environment and promotion of global partnerships conducive for a just world.

The MDGs generally target issues that are most basic to any meaningful form of human development. Four of the goals are directly related to the well being of women. While goal three addresses gender equity; goal four on child health, five on maternal health and six on reversal of HIV/AIDS which addresses important aspects related to the health of women. This is testimony to the importance to which the world leadership attaches to women advancement in general and their health in particular.

In the second half to 2015, different countries, regions and continents have recorded mixed results on each goal as at mid-pint in 2007. It has been generally established that of the six continents, Africa is the only one that seems way off track towards achievement of all the MDGs. However, Africa has recorded remarkable gains on promoting women leadership with the continent having one elected woman president, several women vice presidents and many cabinet ministers in various African governments.

There are variations on the gains on each goal at country level but generally the continent needs to do a lot more if it is to achieve the MDGs.

State of Goal 5 in Africa

Northern Africa is generally the region in the continent that has been making impressive gains towards achievement of all the MDGs except on goal four on reducing child mortality. The Sub Saharan Africa (SSA) on the other hand has been making slow pace which does not measure to the required speed if the region is to achieve any of the MDGs by 2015.

During the Millennium Declaration in 2000, the maternal mortality ratio in the world was put at 450 deaths per 100,000 live births in developing regions. It was highest in Sub Saharan Africa at 920 while in North Africa it stands at 183. The target on MDG 5 is to reduce maternal mortality by two thirds by 2015. But beyond the mid point to 2015, maternal health still remains a big regional and global concern, with the odds that today a Sub Saharan African Woman will die from complications arising from pregnancy and childbirth during her life at 1 in 16, compared to 1 in 3,800 in the developed world.

The vast majority of these deaths are avoidable through skilled care in delivery and access to emergency obstetric care. For every woman who dies because of obstetric complications, 30-50 others suffer morbidity and disability. MDG 5 on maternal health rightly focuses attention to address this unacceptable situation.

It is widely agreed that the high maternal mortality ratio in many Sub Saharan African counties reflects the status of women in these societies, as it illustrates how acceptable a society finds such avoidable deaths. While trends in the use of antenatal care in developing countries during 1990s show significant progress, in Sub Saharan Africa, by contrast, use of antenatal care has hardly changed over the decades. Achievement of MDG 5 is therefore inextricably intertwined with meeting MDG 3 – to promote gender equality and women and empower women.

Most maternal deaths are preventable. For instance, deaths caused by infections or hemorrhage during delivery can be prevented with drugs or blood transfusion. Women in need of emergency obstetric services can be saved if they have access to transportation that can get them quickly to the nearest facility. Unfortunately this does not seem a priority especially in Sub Saharan Africa as is testified by the unacceptably high maternal mortality in the region.

Further, it should not be overlooked that MDG 5 calls for improvements in maternal health, not only reductions in maternal mortality. This is an important distinction to note. Improvements of maternal health, though important in themselves, will not necessarily be accompanied by reductions in maternal mortality.

Redress Measures

Consequently, strategies needed to reduce maternal mortality – increased access to, use and quality care during pregnancy and childbirth – need to be complemented by efforts to address maternal health more broadly, and by efforts to strengthen the position of women in society through education and a commitment to gender equity. To promote maternal health in the spirit of the Millennium Declaration, it is imperative that governments in Africa, especially in Sub Sahara Africa to urgently address the following:

• Provide all women the opportunity to access high quality delivery care. Such care has three essential elements: skilled attendant at delivery; access to emergency obstetric care in case of a complication; and a referral system to ensure that those women who do experience complications can reach life saving emergency obstetric care in time.
• Provide all women with family planning information and services to safeguard women’s health during their productive years.
• Ensure gender equality, social justice and stop all forms of violence against women and uphold women’s rights including their political participation and access to resources.
• Emphasize, in their health policies, preventive health, reproductive health and actively combat HIV/AIDS pandemic and diseases associated with poverty.

There is therefore need to mount pressure on the governments in this region to effect policies that support programmes aimed at improving the women health and delivery on all the MDGs.

In celebrating the International Women’s Day various anti-poverty campaigners have organized a number of events these include:

A press conference in Johannesburg this Friday, March 7th, Ana Agostino and Kumi Naidoo will be joined by the South African Commissioner for Human Rights, Jody Kollapen, and leaders from local women’s rights NGOs. Foreign and local media will hear about our demands and our plans to Take Action during the rest of 2008.

In Nigeria there will be a lecture in Taraba state to which they have invited key dignitaries to hear their policy demands.

In Kenya, the GCAP National coalition has sent a petition to the Permanent Secretary in the Ministry of finance to develop a gender sensitive budget.