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Reproductive health in the African region: what has been done to improve the situation?

Article Excerpt
Africa accounts for about one tenth of the world's population and 20 per cent of global births; yet, nearly half of the mothers who die during pregnancy and childbirth are from this region. The World Health Organization (WHO) estimates that poor reproductive health accounts for up to 18 per cent of the global burden of disease, and 32 per cent of the total burden of disease for women of reproductive age. One of the underlying causes of this situation is the lack of access to key intervention for improving reproductive health, such as family planning. Despite well-known benefits of family planning, there are unmet needs: contraceptive use among married women in sub-Saharan Africa is very low, estimated at 13 per cent, and the total fertility rate is 5.5 children per woman. Consequently, the adult lifetime risk of maternal death is highest in Africa (1 in 26), while developed countries had the smallest lifetime risk (1 in 7,300).

Maternal mortality estimates for 2005 indicate that the decline between 1990 and 2005 in sub-Saharan Africa was on average less than 1 per cent a year and that to achieve Millennium Development Goal (MDG) 5--improve maternal health--a decrease of at least 5.5 per cent per year is needed. More than half of the estimated 536,000 maternal deaths worldwide occurred in sub-Saharan Africa, and 13 out of 14 countries with maternal mortality rates of at least 1,000 are in the region. (1) The main causes of death are severe bleeding (haemorrhage), infection (sepsis), eclampsia, obstructed labour and unsafe abortion (see Figure 1). However, an increasing number of mothers in the region die from indirect causes, such as HIV/AIDS, tuberculosis, malaria and...