27th June, 2008
AMREF is in the process of consolidating its positioning as a provider of community-led solutions and as a reference point for strategies to improve maternal, newborn and child health in Africa. A meeting held last month in Rome, Italy, sought to translate AMREF’s strategy of working in ‘Partnership with Communities for Better Health’ into action plans targeting mothers, children under 5, pre-adolescents, adolescents and youth, and women and men of reproductive age.
“This first meeting focussed on neo-natal (neonates are children under 28 days old) and maternal health because it is one of the most pressing health issues in the developing world today,” explained Dr John Nduba, AMREF’s Technical Director for Sexual Reproductive and Child Health. “AMREF does not view women just as reproducers, but as people who have a right to sexual and reproductive health, particularly in Africa, where about 280,000 women die every year from pregnancy and childbirth-related problems. Besides, we are talking about a problem that affects half the human race.”
Maternal mortality rates in Africa are, indeed, alarming. In Sudan for instance, over 2,000 die in pregnancy and at childbirth for every 100,000 deliveries. On the lower end of the scale are countries like Kenya, where 400 die in every 100,000 deliveries, but even this is still unacceptably high. An African woman in Sub-Saharan Africa has a lifetime risk of one in 16 of dying from pregnancy-related causes, and this may be as high as 1 in 6 in the poorest communities. In contrast, the risk of maternal death is only one in 30,000 in Northern Europe (Lancet 2006: 368; 1189-200)
“This is one of the most glaring inequities in health today,” said Dr Nduba. “Moreover, for each woman who dies, several others suffer severe effects like birth injuries and long-term disability such as Vesico Vaginal Fistula – a tearing of the membrane between the vagina and the urinary tract as a result of obstructed labour. Many newborns (as many as 20 per cent) do not survive the birth ordeal that their mothers go through. That is why AMREF believes that to improve health in Africa, we must focus on this important cause of ill health and death of African women and their newborn children.”
The meeting was attended by AMREF Deputy Director General Dr Florence Muli-Musiime, Director for Community Partnering Dr Daraus Bukenya, Dr John Nduba and Communications Manager Bob Kioko. Heads of programmes from Kenya, Tanzania, Ethiopia, South Africa and Uganda were also present, as were their counterparts from AMREF in Canada, the UK, Netherlands, Spain, and the United States of America. Italy’s executive director Francesco Aureli hosted the meeting and seven staff from the AMREF in Italy office attended.
The World Health Organisation’s global Partnership for Maternal, Neo-natal and Child Health was represented at the one-week forum by Dr Mario Marialdi and Dr Marta Seone. The PMNCH is interested in working with AMREF in developing strategies to address maternal, neonatal and child health issues in Africa.
The next meeting will address the health of children and adolescents, Dr Nduba said. About 10 million children under five die every year, with Africa accounting for 55 per cent of these. Sadly, nearly 40 per cent of the deaths of African children result directly and indirectly from under-nutrition.
“The level of hunger in Africa is absolutely shameful! And this is becoming a greater and more relevant concern with increasing food shortages and rising prices. If we want to effectively address the high child mortality rates, we must address nutrition,” said Dr Nduba.
Nevertheless, the major cause of death among children in Africa remains infectious and communicable diseases driven by poor sanitation and lack of access to clean water, poor access to immunisation and other preventive services, high prevalence of malaria, and weak services that do no respond adequately to childhood illnesses.
“We in AMREF see this as a major health systems weakness because the systems do not address the basic causes of ill health. There is very little investment in prevention even though we know that a simple mosquito net will protect a mother and her child from malaria, and that a cup of clean water makes all the difference in eliminating diarrhoea,” said Dr Nduba.
He added: “There are simple solutions to most child health challenges, and AMREF intends to accelerate the uptake of the already well known effective ways of applying these solutions, and making them widely available through global advocacy on the role of communities and health systems. This way, we will play our part in improving the health of mothers, newborns and children, and consequently of African communities.