Despite the 44% decrease in maternal mortality internationally from 1995 to 2015, mother mortality still remains high. However, 99% of the maternal deaths occur in developing nations due to the lack of access to adequate health services.
More than half of deaths occur in the region of sub-Saharan Africa and ? is located in South Asia. 75% of other mortality occurs due to complications, such as severe bleeding, infections, high blood pressure and unsafe abortion. The 15% of maternal mortality is associated with diseases such as AIDS or malaria during the period of pregnancy.
Even though the United States is a well-developed nation, it has a continuously increasing mother mortality rate. Worldwide, only about 30 people live through a near death experience during the birth of their child. The country of Fiji has continuously been putting their efforts into improving healthcare deliveries and maternal outcomes by committing themselves into achieving the Millennium Development Goals. The percentage of mother mortality decreased dramatically in the mid-1970s, but soon rose again in the 1980s. However, the rate has remained unchanged over the years with small decreases and increases in mother mortality percentages. Since 1990, Fiji has offered high coverage usage to its citizens and established an improved health system based on primary care concept. However, the country is struggling with funding medical workers and raising awareness of primary health care to the communities. Over 70% of direct mother mortality in Fiji occured due to abortive results, hypertensive disorders and obstetric haemorrhage.
Also, the maternal deaths that were indirect occured due to cardiac diseases. In 2009, the United Nations Population Fund conducted a study where they discovered that all of four Fiji’s health facilities met the international standards on emergency newborn care. II. United Nations InvolvementIn 2015 at the United Nations General Assembly, UN Secretary-General Ban Ki-moon developed the Global Strategy for Women’s, Children’s and Adolescents’ Health, 2016-2030. This strategy was a set of guidelines to follow for the post-2015 agenda in order to find preventable ways to reduce mother mortality and help those thrive healthy in environments. Millenium Development Goals and the International Conference on Population and Development aimed to reduce the percentage of mother mortality by 75% before 2016. Additionally, by 2030, the Sustainable Development Goals (Global Goals) want the maternal mortality ratio to reduce to 70 deaths for every 100,000 births.
The World Health Organization has continuously been working with partners in order to address the inadequate and unequal access to health care facilities and is working on strengthening these health systems in order to ensure high quality data and accountability. WHO led the 2010 Global Strategy and the Every Woman Every Child movement that aims to help women and children meet the adequate standard of health. Additionally, the United Nations Population Fund has aimed on increasing the capacity of maternal care through the strengthening of resources and training medical workers on the proper way to treat pregnant women. The UNFPA also emphasizes the prevention of fistula by assisting repair programmes and doubling the number of repairs supported in five years.
The non-government organization, Every Mother Counts, dedicate to ensuring safe pregnancy and births, through education and avocation. This program has impacted about 600,000 people. In Nazdeek, the NGO trained lawyers and community advocates to document violations of mother mortality against the government in order to ensure that they receive adequate care in the future.III. Country Policy and SolutionsOver 400 million people do not have access to adequate health care and it is necessary to provide pregnant women assistant to maternity providers. Therefore, Fiji proposes the Department of Health and Family Welfare of the Government of Gujarat which was funded through the Chiranjeevi Scheme. This project targets women who are classified below the poverty line in order to help provide them access to private maternal health and doctors during their pregnancy without paying healthcare fees. Additionally, the program has provided vouchers to families for free pre-delivery visits to doctors and transportation.
It has identified specific private providers to help decrease maternal mortality and reimbursed them. Results have shown that in Gujarat, India, there were only six maternal deaths reported and 80% of deliveries of women were accommodated. The scheme originally began as a small project within a region but soon expanded into the national government and might be used internationally. This project has not decreased the cost of public healthcare use and there was not a decline in using government facilities. Worldwide, women do not have knowledge on how to have a healthy and safe birth.
Therefore, Fiji would like to propose the Participatory Women’s Birthing Groups which originally began in Makwanpur District in Nepal in 2001. It was modeled after a community-based education approach and was supported by the Infant Research Activities and UNICEF. In this village development committees, there is a local female leader, trained on perinatal health service, who meets in a specific village monthly over a time span of ten months. During this time, she educates villagers on childbirth by using methods like picture card games to discuss maternal treatments and ways to prevent injuries.
Additionally, within these participatory women’s birthing groups, they develop local strategies to offer transportation, home visits, and clean delivery kits to pregnant women. In the beginning of the program, already 37% of women were attending the meeting. However, it not only affected those who attended but the knowledge spread to those throughout the community. This project addresses communities personally in order to make a difference in their actions to result in a safe, successful birth.