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The recent progress report on the Millennium Development Goals (MDGs) shows remarkable improvements in eradicating poverty; the number of people living in extreme poverty has fallen in every developing region.
Both MDG 1 to halve the number of people living in extreme poverty and MDG 7 to halve the number of people without access to safe drinking water have already been met three years before the deadline. However, progress on Goal 5 to improve maternal health and reduce maternal mortality by three quarters is lagging.
Despite the reduction in maternal deaths since 1990 and also since 2000, much of the progress has slowed significantly. UN Secretary General, Ban Ki Moon, affirms that with progress at its current rate, in 2015 “mothers will continue to die needlessly in childbirth”.
In low- and middle-income countries the maternal mortality ratio (MMR), the number of maternal deaths per 100,000 live births, sits at an average of 240 deaths per 100,000, a significantly higher figure when compared with 16 deaths in high-income countries.
Particularly in Sub-Saharan Africa the maternal mortality ratio of 500 deaths per 100,000 is far from the 2015 target, accounting for 56% of maternal deaths worldwide in 2010.
Factors which contribute to the improvement of maternal health, such as receiving ante-natal care, births attended by skilled attendants, and access to family planning were also monitored in the report, and displayed worrying signs of slowing progress.
Some regions have seen greater improvements, such as South East Asia, which is close to meeting its target. However, according to the report “inequality is detracting from these gains”, with many marginalised women still far from receiving the care they need during pregnancy and childbirth. The lack of ethnic and regional analysis and data only exacerbates the problem of the invisibility of any disparities between different groups of the population.
Many women in rural and remote areas, particularly those from indigenous communities and ethnic minorities, are still not receiving sufficient maternal health coverage. In Cambodia, only 38% of women in the rural provinces of Mondol Kiri and Ratanakiri receive skilled birth attendance. In contrast, 95% of births in urban areas of Cambodia are attended by a skilled health worker.
Factors such as ethnic discrimination, distance to health facilities, and availability of health workers can significantly affect a woman’s access to reproductive and maternal health care.
Health Poverty Action is currently running a petition, as part of its Mothers on the Margins campaign, aimed at ensuring that these barriers to health care are no longer an issue for women from indigenous and ethnic minorities in the Asia-Pacific Region.
Efforts by the World Health Organisation (WHO) to improve maternal health have led to progress, yet more needs to be done to ensure that these efforts are culturally inclusive.
National health systems should integrate the needs of ethnic minorities and indigenous peoples, and we call on the WHO Asia Pacific Region to develop guidelines for indigenous peoples to attain their right to health, including on culturally appropriate health care. For MDG 5 to be achieved, immediate action needs to be taken by governments, NGOs and Civil Society groups to ensure that every woman has fair and unprejudiced access to quality maternal health care.