* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.
101 years into celebrating International Women’s Day many women around the world still suffer gross inequalities and struggle for basic human rights. One of the gravest global inequalities can be seen in women’s access to maternal health care. 99% of maternal deaths occur in developing countries and Myanmar, also known as Burma, is no exception in high maternal mortality ratios.
The country is splashed across every travel magazine as this year’s hottest destination. Carefully concealed behind the glossy images and the sleek tours there is, however, a very different story. Myanmar, one of the poorest countries in the world, ranks 149 out of 187 in the Human Development Index[1]. Indigenous and remote regions have suffered decades of conflict and in those areas, many still live without the most basic amenities. Shan State Special Region Four in Shan state, which is bordering with China and Laos, is still recovering from conflict, but for the last 6 years it also has been making the journey towards safer motherhood for all women.
When Health Poverty Action started working in the area in 2006, 98% of women gave birth at home and most of these births took place without the presence of a trained health worker. Instead, women relied on traditional birth attendants, who often didn’t wash their hands, couldn’t identify high-risk pregnancies and used shards of bamboo to cut the umbilical cord, tying it with a piece of string. It’s hardly surprising that, given these conditions, many women – and their children – died unnecessarily.
Health Poverty Action believes that safe pregnancy and childbirth is a fundamental human right. The processes and knowledge to reduce maternal deaths are readily available elsewhere. In the last 6 years, the organisation has been working to address the barriers to maternal health faced by women in this fragile state – some have been removed, but others still remain. For example, local health service providers in Shan state received training to raise awareness about safe childbirth and improve health systems. In such an isolated region, with poor transport links, it focuses on building the capacity of local people to provide village level services. It also improves the ability of clinics to provide them with support, supervision and supplies, and to deal with the more difficult cases.
The organisation has trained over 200 Traditional Birth Attendants (TBAs). These trained TBAs can now provide basic antenatal checks, identify risks before and during labour and refer high risk women to a clinic, and provide clean delivery for women who deliver at home. Now 83% of women in Shan state deliver with a trained traditional birth attendant and women are becoming more aware of maternal services available to them. As well as clean delivery, trained TBAs are able to challenge harmful traditional practises and help women to receive the treatment and referral they need. TBAs will usually accompany women to a clinic and advocate with families to allow this to happen. In villages without TBAs, women are more vulnerable – if their husband does not consent, they will usually not receive treatment.
Trained TBAs are most effective if they are part of the public health system, with links to clinics which function well. Lack of funding for national health systems had left many health outposts with severe shortages of medically trained staff, medical equipment and essential drugs. Health Poverty Action has worked with the local authority to upgrade these clinics, but with region-wide unreliable electricity supplies, problems with water supplies and difficulties in obtaining anaesthetics, there are still more barriers to be overcome to provide the best possible care at clinic level.
International Women’s Day serves to celebrate women – but it also marks the stark inequalities which still persist around the world. Health Poverty Action is committed to giving every mother the right to safe motherhood – a right that extends to women who live in the world’s most isolated regions.
Source URL: http://www.healthpovertyaction.org/news/blog-championing-safer-motherhood-in-myanmar
