While we have made great strides in saving the lives of pregnant women and children, for too many women childbirth is a journey of fear, for their own survival and that of their newborn. This week, Canadians have the opportunity at the United Nations General Assembly to call for a change. We will be calling for maternal, newborn and child health to be at the heart of the international agenda. We will be calling the world to deliver on our promises and make women, newborns and children count.
The United Nations General Assembly is a pivotal moment to inspire and mobilize the world to follow Canada’s lead in improving maternal, newborn and child health globally. At the 2010 G8 Summit, Canada galvanized world leaders around saving the lives of mothers, newborns and children, and in May 2014 we did it again by contributing an additional $3.5 billion to accelerate progress. Because of this leadership, more lives are being saved than ever before.
Canada can be proud of what we have contributed. Our Partners are working in over 1,000 of the poorest regions in the world. Dozens of organizations have joined forces, along with the Canadian government, to save lives through improved facilities, better trained healthcare worker training and improving access to vaccines, medicines and nutrition.
The progress we have seen is tremendous. In 2013, 600,000 fewer children died than in 2010. 90 million children’s lives have been saved in the past two decades. Since the launch of the Millennium Development Goals (MDGs), the number of preventable maternal deaths has significantly decreased.
While we have made great strides, for too many women childbirth is still a journey of fear, for their own survival and that of their newborn. 287,000 women are still dying due to complications during pregnancy and childbirth. 6.3 million children still die before their fifth birthday from preventable causes like malnutrition, diarrhea or pneumonia, especially newborns in their first month of life.
Canada has shown a landmark commitment, and at the United Nations General Assembly, we are calling on global leaders to do more. Global players need to commit new funds that are dedicated to improving maternal, newborn and child health. The financial investments that we make reflect the value that we place on mothers, newborns and children. We must accelerate our efforts and scale-up cost-effective, proven solutions. We must allocate these funds with an equity approach so that progress, which has been uneven across and within countries, reaches the most vulnerable women and children.
No woman should die giving life. No newborn should lose a fair start at life, and no child should die of preventable causes. Yet these tragedies continue to be daily occurrences in many countries around the world, typically uncounted except by their grieving families.
An estimated one-third of the world’s annual births and two-thirds of annual deaths are not legally recognized,with three-quarters of all uncounted people being in sub-Saharan Africa and Southeast Asia. Hospital reporting of deaths is often poor and no cause is attributed to most deaths outside hospitals.
Mothers and children need to be counted first in order to effectively plan for and deliver health care services. As Canadians we care about social justice and human rights. If a woman is not registered at birth as a person, she is less likely to attend school and more likely to be coerced into sex or marriage at a very young age. She is more likely to give birth at a time when her risk of dying is five to nine times higher, and when outcomes for her children are less successful.
Accountability must underpin every investment that is made. While there is often conversation about accountability, we need to see this dialogue quickly manifest in meaningful action. Within these investments that we make, it is critical that we spend dollars wisely and track impact. Unless every life is counted, we cannot know what is working and what is not working. This information is important so that we invest in the most effective and sustainable solutions.
Prime Minister Stephen Harper will be on the world stage at the United Nations General Assembly next week, calling on world leaders to join Canadians in this effort. The future of health for women and children depends on partnerships at all levels, starting with global leaders and reaching to include communities in improving their future. It is worth celebrating that we have started to end the preventable deaths of mothers, newborns and children. But our work must continue, to affect a truly lasting impact. It is time to count what matters, deliver on our promises and end preventable deaths of mothers, newborns and children within a generation.
Dorothy Shaw, MBChB, FRCSC, is Chair of the Canadian Network for Maternal, Newborn and Child Health.
September 22, 2014
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