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| Monday, 15 November 2004 |
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Asia's poor face uphill battle against infant, maternal deaths by P. Parameswaran WASHINGTON (AFP)
In a remote commune in Vietnam's Central Highland, the belief is that when childbirth begins, a woman must go to the forest by herself, deliver the baby and bring the child home. So, when a woman gave birth unattended to a baby girl in the forest but developed high fever because parts of her placenta remained embedded in the womb, her desperate parents had to summon a traditional healer. On hearing the woman's predicament, a young locally trained doctor offered to help. But 30-year-old physician Truong Cong Thang had to give a written undertaking to villagers that he would submit to any punishment if he could not save the woman's life - as it was forbidden under local laws for a stranger to see the body of a married woman. Not only did his gambit pay off but he convinced most of the pregnant women in the commune to visit his clinic for regular check-ups and also learn about family planning. Truong's story was among highlights in a World Bank report Thursday warning that developing countries are lagging behind in the race to sharply reduce the number of deaths among pregnant women and children under the age of five. The United Nations had set a global target to cut maternal mortality by three-quarters and child mortality by two-thirds by 2015. But a review by the World Bank showed that many developing nations were behind targets enshrined in the so-called Millennium Development Goals, or MDGs. In 2002, more than 11 million children died from preventable illnesses before reaching their fifth birthday, while as many as 500,000 women perished during pregnancy or childbirth, said the report "Rising to the Challenges: The Millennium Development Goals for Health." "Truong's example is to highlight that households are the key but underrated actors in the health sector and also the health divide between the rich and the poor in Asia ," said Mariam Claeson, a physician with the World Bank and co-author of the report. When pregnant women do not seek assistance during delivery or do not seek antenatal care during pregnancy, health providers have their hands tied, she said. She said countries such as Vietnam and China had done largely well nationally in stemming infant and maternal deaths "but when you look at the situation in the rural areas, you get a very different story." Some 130 per 100,000 mothers die after childbirth in Vietnam compared with the East Asia's rate of 115 per 100,000 maternal deaths, World Bank demographer Ed Bos said. But even as infant mortality in the region has come down from 56 per 1,000 births to 32 per 1,000 births over a decade in 2000, the region still lagged behind the Middle East and Latin America in terms of achieving the MDG goals, Claeson said. She said that among developing economies in East Asia, China, Malaysia, Indonesia and South Korea had made great strides in checking malnutrition among children while the Philippines, Laos, Cambodia, Myanmar and Mongolia fared poorly. World Bank President James Wolfensohn said "even with general economic growth and faster progress on the non-health MDGs, many regions will still miss many of the health MDG targets. "We need to look at measures such as committing increased resources to meeting the health-related MDGs," he said in a statement to mark the release of the bank report. Four of the MDGs set by the United Nations relate directly to health. The World Bank said progress on child survival had been insufficient "to leave any Bank region or any Sub-Saharan country (in Africa) on track to hit the target. "All but one Bank region (the Middle East and North Africa) will miss the maternal mortality rate, albeit by a smaller margin than for the child mortality target," the bank said, assessing the situation at "half time" in the 1990-2015 period for the MDGs. Only 16 percent of developing countries are on track to cut child mortality rates, while 17 percent should be able to make progress on the maternal mortality front, the bank said. "When these kinds of targets are set, it seems too soon to take urgent action, and then, after a few short years, it seems too late," said Lee Jong-wook, director general of the World Health Organization, which helped to write the report. "We still have time to (achieve) the targets for 2015, but to do so we have to act now." |
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