Statement of Thoraya Ahmed Obaid UNFPA Executive Director

Good afternoon,

It is my pleasure to be here with you today. It is a pleasure for UNFPA, the United Nations Population Fund, to host this event in collaboration with the World Health Organization (WHO). I am pleased to be joined by Manuela Colombini, who represents Joy Phumaphi, Assistant Director-General of Family and Community Health at WHO and will deliver a message on behalf of Ms. Phumaphi.

Before I go further, I would like to thank our speakers for taking the time to join us today. We are very lucky to have with us today the first ladies of Mali and Burkina Faso, whom I will introduce shortly, and also Gertrude Mongella, whom many of you know as Mama Beijing. I am quite certain that their experiences and insights will illuminate our discussions this afternoon.

We are here today because Safeguarding Maternal Health, Women’s Empowerment and Reproductive Health for Achieving the Millennium Development Goals is a very important and timely topic. We all know that a healthy mother is key to the health and well being of her children and family, and to a healthy community and nation.

We also know that greater progress must be made to improve maternal health and reduce maternal death, as a human rights and development priority.

There is no other health indicator, which shows such a glaring gap between rich and poor, both between countries and within them, as maternal death. For half a million poor women each year, what should be a time of joy is turned instead into a time of tragedy and deep sorrow.

Of the estimated 529,000 maternal deaths each year, the vast majority—95 per cent—occur in Africa and Asia. In her lifetime, a woman in sub-Saharan Africa faces a 1 in 16 risk of dying during pregnancy or childbirth compared to a 1 in 3,800 risk for a woman in the developed world.

In many settings, available safe motherhood services either cannot meet demand or are not accessible to women because of distance or cost. Another hindrance is the low social and economic status of women. Too often, women are put at the bottom of the list of priorities and this has tragic consequences, with far-reaching implications.

The good news is that we know the causes of these deaths and the way to prevent them. During the past 10 years, we have come a long way in better understanding what needs to be done. There is a need for women’s empowerment and reproductive health and rights. We need universal access to reproductive health care, including family planning. This is particularly important for addressing the needs of 1.3 billion young people about to embark on their reproductive lives. Currently, 200 million women have an unmet need for safe and effective family planning services.

Nearly two thirds of maternal deaths worldwide are due to five direct causes: heavy bleeding, obstructed labour, high blood pressure, infections and complications of unsafe abortion.

All five of these life-threatening complications can be treated by a professional health worker. Being prepared to address complications is the key to saving the lives of mothers and newborn children. This is why skilled attendance is crucial. Yet today, even though progress has been made, only 58 per cent of women in the developing world have access to skilled attendants. And as a result, women are paying with their lives. The least progress in skilled attendance is in sub-Saharan Africa.

In the developed countries, the picture is different. Because they receive prompt and effective treatment, women in the United States, Europe, Australia, Canada or Japan rarely die or experience permanent disabilities from pregnancy-related problems. Maternal deaths are 90 per cent preventable.

The Way Forward

UNFPA advocates an approach to maternal health that is based on human rights and gender and cultural sensitivity.

Such an approach calls on governments to invest in universal access to reproductive health and rights. It calls for the integration of HIV/AIDS and reproductive health services for comprehensive services that meet real needs. And finally, it calls on governments to foster women’s empowerment, male responsibility and gender equality and to promote and protect the human rights of women and girls.

To move forward, we need to move from lines in speeches to lines in budgets for reproductive health services. And this requires increased political will and pro-poor policies and programmes, so that services are affordable and accessible to the poorest and most isolated women. We need to improve health systems and the quality of care.

We need to engage communities more fully, including men. Maternal death reduction depends in part on supportive families and communities. Transforming gender relations requires a change in values and relations in the whole community – by men as well as women.

We are making progress and some countries have been successful in reducing maternal death. Over the past decade, deaths have been reduced significantly in countries as diverse as Bangladesh, China, Egypt, Honduras, Indonesia, Jamaica, Jordan, Mexico, Mongolia, Sri Lanka and Tunisia.

These successes build on programmes to improve the quality of care, especially to ensure access to skilled attendants at birth and to effectively manage obstetric complications. Attention was also focused on mobilizing community support for women during pregnancy and childbirth and addressing reproductive health needs, including family planning.

In closing, I would like to stress that success is within reach and is, in fact, happening in many places. To build on this momentum, we need the political will to replicate and scale up what we know works, in order to reach the poorest women. What we really need now is a political campaign to consolidate progress. And you in this audience, in your various capacities, are well placed to move this campaign forward. We need to make the health, well-being and autonomy of women a top priority. For over half a million women this year alone, it is a matter of life or death.