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Strategising to accelerate the reduction of maternal mortality in the African Region

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Johannesburg – The African Region accounted for 66% of the 303,000 maternal deaths recorded globally in 2017.

To address this situation, WHO in collaboration with UNFPA, UNICEF and partners support Member States to ensure that all women and girls have access to quality and timely health services, particularly during pregnancy, childbirth, and after delivery, leaving no one behind.

Most maternal deaths in the Region are attributable to five main causes: haemorrhage, pregnancy-related hypertensive disorders, unsafe abortion, infection, and obstructed labour. Of these, complications of haemorrhage and hypertension account for almost 50% of deaths," said Dr. Owen Kaluwa, WHO Representative in South Africa.

Furthermore, unsafe abortion is responsible for 16% of all maternal deaths, with variations across countries depending on the level of restrictions on abortion.

One of the main roles of WHO/AFRO is to produce, disseminate and monitor the implementation of global guidelines and standards that are adapted to the regional context.

In this context, WHO/AFRO is developing the Regional Accelerated Plan of Action to end all preventable maternal mortality due to Postpartum Haemorrhage and Pre-eclampsia/Eclampsia. In addition, WHO/AFRO is updating the 2012 regional Agenda for Sexual and Reproductive Health and Rights (SRHR), a strategic document aimed to ensure universal access to proven effective and quality SRHR services using the most effective and appropriate delivery systems.

“One thing we need to look at is the skills of our health workers. People need to know how to repair a simple episiotomy wound and many other lacerations. We need to ensure that we have skilled and conscious clinicians." said Dr. Manala Makua, chief director of women’s, maternal and reproductive health at the National Department of Health South Africa

From April 27 to 29, 2022, a meeting was held in Johannesburg, where these three strategic documents were presented and discussed with representatives of 15 Member States, UNFPA, UNICEF, SIDA and SRHR partners namely professional associations, Population Council, Members of the WHO/AFRO regional Reproductive, Maternal, Newborn and Child Health Technical Advisory Group (RMNCAH-TAG).

The purpose of the meeting was to build consensus on the SRHR Agenda and the RAPA and discuss the effective implementation of the WHO Abortion Care guideline in countries in alignment with national law.

“It is my privilege to say that gradually we are seeing the global leaders’ committing and joining hands in responding to the agenda of SRHR. Make sure you utilize this opportunity to the maximum," said Dr. Manala Makua to the participants, insisting on innovating and thinking about ways to accelerate and rethink actions for African populations' Sexual and Reproductive Health and Rights.

Richard Delate, Programme Specialist SRH/HIV, United Nations Population Fund East, and Southern Africa Regional Office, also advised the participants.

“As we consider issues relating to sexual and reproductive health and rights over the next few days, let us also take into consideration that the gains we make are not only dependent on the health system but require that we foreground the rights dimension of sexual and reproductive health.” he said.

Dr. Christina Sadia, a member of the WHO/AFRO RMNCAH-TAG participated in the meeting.

“I think the structural barriers are contributing to a lot of issues that we are seeing. And, the disparities and equities issues need to be addressed. As we talk about leaving no one behind, we need to have a general whole so that our universal coverage and pushing up our accelerated implementation plans can then make a reality and hopefully, we can catch up to win the SDGs.” she said.

Dr. Lwazi Manzi, Head of Secretariat of the African Union (AU) Commission on Covid-19 was in attendance. She was really pleased to be part of the meeting.

“It is an immense privilege to participate in this timely conference that brings the issue of Sexual and Reproductive Health Services to the top of the regional agenda. Through his Covid-19 Championship, President Cyril Ramaphosa tabled a report to the AU on strategies to tackle the attrition of SRHR services during the Covid-19 pandemic. As secretariat, we are excited that we are not only aligned with partners like the WHO but that the Covid-19 commission is in a strategic position to keep the agenda alive at the highest level of the AU political structures. We look forward to continuing fostering respectful partnerships as we are called upon by Africa’s New Public Health Order.” she stated.

The recommendations of the meeting will help to tackle maternal mortality in the African Region so that no women should die while giving birth and no violence against women and girls should be tolerated on the continent.