Campaign on Accelerated Reduction of Maternal Mortality in Africa
The health of mothers is improving
Maternal mortality in Africa has dropped by a massive 41 per cent in 20 years, from 920 deaths per 100,000 live births in 1990 to 500 deaths per 100,000 births in 2010. Yet this rate is still unacceptably high when compared to figures for the rest of the world. Globally, an estimated 287,000 women die each year from pregnancy and delivery-related complications and more than half of these – a disproportionally high number – occur in Africa (165,000 or 57.5 per cent).
A woman in Africa has a one-in-39 lifetime risk of dying from pregnancy and delivery-related complications compared to 1 in 4000 in developed countries. Over one million children are left motherless and vulnerable due to these deaths - and children who have lost their mothers are 10 times more likely to die prematurely than those who have not.
The high maternal death rate is affected by the high number of child marriages on the continent, with most girls being pressured to begin child bearing soon after marriage, long before they are physically or emotionally ready to be a parent. The younger the woman, the greater the risk: young women aged 15-20 years are twice as likely to die in childbirth as those in their twenties.
The high death rate is unacceptable as most of the deaths can be avoided. A concerted push is needed as few countries in Africa are on track to reach the Millennium Development Goal 5 (MDG 5) target of reducing maternal deaths by 75 per cent by 2015.
What UNPFA is doing about high maternal mortality
The African Union Commission initiated the Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA) in recognition of the daunting challenge of reducing maternal mortality in most African countries by 75 per cent compared to figures for 1990, by 2015, as recommended in Millennium Development Goal 5. The campaign is supported by UNFPA, the WHO and UNICEF.
CARMMA was officially launched in May 2009 with the aim of intensifying the implementation of the Maputo Plan of Action for the reduction of maternal mortality in the Africa region.
What is UNFPA doing to reduce the unacceptably high death rate of women from childbearing? Watch this video of Dr. Akinyele Eric Dairo, Senior Programme Officer, speaking from Tunisia.
Each country takes control
CARMMA uses policy discussions, advocacy and community social mobilization to enlist political commitment. It aims to increase resources and bring about societal change in support of maternal health. It is a country-driven undertaking. All African countries are to launch CARMMA and have a follow-up implementation plan, as well as to monitor progress.
The achievements to date
As of September 2014, 44 countries had launched CARMMA, and tremendous progress has been made due to rising political commitment. Half of the African Union's member states have:
- strengthened their health systems;
developed a monitoring and evaluation system;
- integrated HIV, reproductive health and family planning services.
Countries that have launched CARMMA
2009: Mozambique, Malawi, Rwanda, Nigeria, Swaziland, Ghana, Namibia and Chad.
2010 : Ethiopia, Sierra Leone, Central Africa Republic, Uganda, Cameroon, Mauritania, Lesotho, Zambia, Zimbabwe, Guinea Bissau, Senegal, Gambia, Eritrea, Angola, Togo, Benin, Congo Brazzaville and Kenya.
2011 : Botswana, Liberia, Democratic Republic of Congo, Gabon, Tanzania, Equatorial Guinea, Burundi, Burkina Faso, Tunisia and Niger.
2012: South Africa
2013: Guinea Conakry and Comoros
Experiences of national launches
Driving the launches are senior political leaders (Presidents, Vice President, First Ladies and Ministers), joining hands with the UN (WHO, UNICEF, FAO, UNAIDS, UNIFEM, WFP and UNFPA), the World Bank, bilateral donors (USAID DFID), academia and civil society (IPPF, White Ribbon Alliance etc.) to mobilize the country and commit to specific actions to reduce maternal mortality in their countries.
Other major stakeholders in national launches have been parliamentarians, community and religious leaders and institutions, professional associations such as Nurses and Midwives Associations and Medical Associations, artists, the media and the private sector. In some countries, the launch of CARMMA has been used to mobilize additional domestic resources for Maternal and Newborn Health.
In many of the countries, the national champions of CARMMA or the national authorities have committed to follow-up activities to intensify the reduction of maternal mortality in their countries, such as:
• Decision to launch CARMMA in all Districts or States – e.g. Malawi, Chad, Zambia, Rwanda, Sierra Leone and Nigeria;
• Adoption of District Hospitals for health system strengthening in partnership with private sector – e.g. Malawi;
• Instituted Maternal Mortality monitoring indicators – e.g. Swaziland;
• Decision to use the launch of CARMMA to coincide with the Campaign to End Violence Against Women, and also to mobilize funding for Maternal Mortality Reduction through pledges – e.g. Chad;
• Decision to provide free medical services for pregnant mothers and infants – e.g Sierra Leone.