• More than 350,000 women die annually from complications during pregnancy or childbirth, almost all of them — 99 per cent — in developing countries.
• The maternal mortality rate is declining only slowly, even though the vast majority of deaths are avoidable.
  
• In sub-Saharan Africa, a woman’s maternal mortality risk is 1 in 30, compared to 1 in 5,600 in developed regions.
• Every year, more than 1 million children are left motherless. Children who have lost their mothers are up to 10 times more likely to die prematurely than those who have not.
  The United Nations (UN) has two targets to meet this goal:
• Reduce by three quarters the maternal mortality ratio
  
• Achieve universal access to reproductive health
  So, what does the UN have to say about progress? Here are some comments directly from the UN:
  
• Most maternal deaths could be avoided
  
• Giving birth is especially risky in Southern Asia and sub-Saharan Africa, where most women deliver without skilled care
  
• The rural-urban gap in skilled care during childbirth has narrowed
• More women are receiving antenatal care
• Inequalities in care during pregnancy are striking
• Only one in three rural women in developing regions receive the recommended care during pregnancy
• Progress has stalled in reducing the number of teenage pregnancies, putting more young mothers at risk
• Poverty and lack of education perpetuate high adolescent birth rates
• Progress in expanding the use of contraceptives by women has slowed
• Use of contraception is lowest among the poorest women and those with no education
• Inadequate funding for family planning is a major failure in fulfilling commitments to improving women’s reproductive health

Inequalities in care during pregnancy are striking. That is a strong choice of words from the UN. That is a concern.

Maternal mortality is declining, but more needs to be done. This report from the UN gives a good visual description of where the gap lies through use of comparative graphs. Take a look.
 

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Investing in Reproductive Health and Rights to Achieve MDG5 and Accelerate Sustainable Development
Statement to the World Bank by Purnima Mane, UNFPA Deputy Executive Director

Your Excellencies,
Colleagues,
Ladies and Gentlemen,
It is with great pleasure that I join you today to talk about how investing in MDG 5 saves money.
UNFPA is proud to co-host this meeting with the Government of the Netherlands and the World Bank, as a follow-up to the high-level meeting on maternal health that took place last year in Addis Ababa.
I would like to thank you for taking the time to join us for this breakfast.

Why are we here/expected outcomes
We are here to answer the Addis Urgent Call to Action for Maternal Health. We are here to find ways to better support women so they can enjoy healthy pregnancies and safe deliveries.

These issues are key to the right to development and to rights of women, men, young people and children to a better quality of life.

We are here to explain how investments in reproductive health and rights are crucial not just for the achievement of MDG5 to improve maternal health but also for the other MDGs – to eliminate extreme poverty and hunger, ensure universal education, reduce child mortality, curb the spread of HIV and AIDS, promote gender equality, and ensure sustainable development.

And we are here to call on you as Ministers of Finance to do what needs to be done and use your power to invest in women’s health because it is smart economics. Together we can ensure that this message reverberates throughout the 10-year review of the Millennium Development Goals leading up to the high-level meeting at the United Nations in September.

Link between Poverty, Reproductive Health and Rights
Today poor sexual and reproductive health is a leading cause of death and disability in the developing world. It limits life expectancy, hinders educational attainment, diminishes personal capability and productivity, adds to the costs of health care at the tertiary level and thus impacts directly on economic growth and poverty reduction.

Every year, about half a million women die during childbirth, over 95 percent in Africa and Asia. A mother’s death lowers family income and productivity, affecting the entire community. It is estimated that pregnancy-related death among women and newborns results in a combined $15 billion loss in productivity each year in the developing world.

While devastating, these global statistics do not fully convey the tragedy that a family encounters when a mother dies during childbirth. This tragedy can be easily averted. We know how to prevent these needless deaths. Effective interventions exist. And this is what makes these deaths doubly tragic.
The vast majority of maternal deaths could be averted if every woman had access to reproductive health services, especially family planning, skilled attendance at birth and emergency obstetric care.

One in four women who want to avoid or space a pregnancy are not using an effective method of contraception. This means that 215 million women have an unmet need for family planning. And we know that effectively addressing this current unmet need would prevent 150,000 maternal deaths and 640,000 newborn deaths each year. The final speaker, Sharon Camp, will tell you more findings like this from our new joint report, Adding it Up.

The point is that this lack of essential health services keeps women trapped in a vicious cycle of poverty that runs from one generation to the next.
It is this poverty trap that must be broken if we are to achieve the Millennium Development Goals. Investing in sexual and reproductive health can play a significant role in making this happen and that is why the second target under MDG5 is universal access to reproductive health.

Benefits of Investing in Reproductive Health and Rights
Good reproductive health enables couples and individuals to lead healthier, more productive lives, and in turn to make greater contributions to their household incomes and to national savings.The health benefits of these investments are well known, well documented and substantial.

They include the prevention of deaths due to pregnancy and childbirth, the prevention of HIV, the prevention or reduction of conditions such as obstetric fistula and other sexual and/or reproductive illnesses and disabilities; better nutritional status and decreased risk of anemia for women; and increased survival rates and better health of infants.

It is estimated that ensuring access to voluntary family planning could reduce maternal deaths by up to 40 per cent, and child deaths by as much as 20 per cent. The World Bank estimates that ensuring skilled care in delivery and particularly access to emergency obstetric care would reduce maternal deaths by about 74 per cent.

These are significant benefits. But as striking as these numbers are, the personal, social, environmental and economic benefits of reproductive health services may be even more important.

These benefits are extremely important for human welfare and economic development. They include improvements in women’s status and greater equality between women and men, slower population growth, as well as benefits at the individual, household and societal levels.

These investments in reproductive health in general, and particularly in family planning, bring government savings. That is why we say that family planning is not an item of expenditure; it is an investment that brings high returns.

A study in Mexico found that for every peso the Mexican social security system spent on family planning services between 1972 and 1984, it saved nine pesos in expenses for treating complications of unsafe abortion and providing maternal and infant care.

In Thailand, every dollar invested in the family planning programme saved the government more than $16.

Even more dramatic is the analysis in Egypt, which found that every dollar invested in family planning saved the government $31. This included savings on government expenditures on education, food, health, housing and water and sewage services.

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MATERNAL HEALTH

Every day around the world, nearly 1,000 women die due to complications with their pregnancies or childbirth.  Thousands and thousands of others experience serious injuries or suffer disabilities. It does not have to be like this. These deaths and injuries are preventable, and we know exactly what needs to be done to save the lives of these mothers, sisters, wives, aunts, and best friends.  
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It is not rocket science.  It is something people in the richer countries have taken for granted since our grand parents’ time - access to family planning, access to skilled birth attendance, access to emergency obstetric care, to blood, to antibiotics.  
 
In addition, we have to tackle some of the underlying causes like gender inequality, young people's lack of access to health services, adolescent pregnancy, child marriage, etc.
 
The global community called for intensified action on maternal health, when it set the Millennium Development Goals back in 2000. One of these goals, goal 5, specifically targets maternal and reproductive health. However, this exact goal is the one lacking most behind, here five years before the target date in 2015. It is not too late though, We can still make it, but it requires stepping up efforts.
 
It pays to invest in women's reproductive health and rights. Making sure that all women have access to reproductive health services, is not only the right thing to do; it is also smart economics.  Women deliver enormous social and economic benefits for their families, communities and nations.  When women are healthy and survive, children and others live and thrive.

Today we are on the verge of a tipping point, where with an increase in political will and financial commitments, dramatic progress is within reach. But we need to keep drawing public and political attention to the issue. We need your voice to make this a reality.  


MDG 5

In September 2000, building upon a decade of major United Nations conferences and summits, world leaders came together at the United Nations Headquarters in New York to adopt the United Nations Millennium Declaration, committing their nations to a new global partnership to reduce extreme poverty and setting out a series of time-bound targets - with a deadline of 2015 - that have become known as the Millennium Development Goals (MDGs).

The eight Millennium Development Goals – which range from halving extreme poverty to halting the spread of HIV/AIDS and providing universal primary education – form a blueprint agreed to by all the world’s countries and all the world’s leading development institutions. They have galvanized unprecedented efforts to meet the needs of the world’s poorest.

MDG Five – which focuses on improving maternal health by decreasing maternal mortality and achieving universal access to reproductive health services - is the only Millennium Development Goal which is lagging in progress. Given that an estimated 500,000 women die each year from pregnancy or childbearing complications suggests that mobilization of a wide spectrum of players is needed to reverse these trends.