Expectant Mother Shefali Rani Das is seven months pregnant. She has given birth to six children – all at home and without a doctor. Three of them have survived, and three of them died shortly after birth. She is worried for her unborn baby. She is pictured here with her daughter Suborna, four, sitting on the bed where she has given birth six times before, and where she will give birth to her next child. Shefali says: "I cannot see a doctor because they are far away amd we can not afford it. And I know that is why the children die. What can we do if we can’t afford it? Photo: Colin Crowley/Save the Children
This blog was originally published by the EveryOne Campaign. Written by Jasmine Whitbread.
This year’s 15th anniversary of our State of the World’s Mother’s Report shines a spotlight on the needs of mothers and children in places affected by humanitarian crises who are struggling to survive – mostly from preventable causes – due to crumbling health systems or the lack of access to a skilled health worker.
Countries affected by conflict, often combined with natural disasters, are those where mothers fare the worst. More than half of all maternal and child deaths occur in fragile settings affected by conflict. A child in Sierra Leone has one chance in five of not reaching his or her fifth birthday, and one Chadian woman in 15 is likely to die because of a pregnancy-related cause.
The impact that conflict and natural disasters have on fragile health systems is immense, and is a major block to achieving our shared goal of achieving Millennium Development Goal 4 to reduce preventable child deaths by two thirds by 2015. Of the 178 countries ranked, seven countries, including the DRC, Niger, Mali, and Guinea-Bissau are all still in the bottom ten and have placed last on the index since it was launched in 2000. Six of these have a history of conflict and all, except Guinea-Bissau, have suffered recurring natural disasters over the same period.
Worldwide, women and children are often much more likely than men to die in a disaster, whether man-made or natural. And each year, thousands more mothers and children die in conflict-settings than fighters die in battle.
However, there are some hopeful examples emerging. It was only three years ago that a war-torn Afghanistan ranked last of our Mother’s Index. Since then, with the support of the international community, it’s made great improvements to its health infrastructure by training more health workers, providing better immunization coverage, and raising girls’ education levels resulting in substantial improvements in the rates of maternal and child deaths. Investing in girls and women will help ensure mothers have the vital support they need to care for their children after violence has broken out.
Last year Save the Children responded to 119 humanitarian crises in 48 different countries. With record numbers of people displaced by war and conflict, and increasingly severe natural disasters causing total destruction, it’s clear we need to do more to protect mothers and children who are often the poorest and weakest segments of their societies. We urgently need to increase access to healthcare in places where state capacity is weak and conflict and insecurity is widespread.
Save the Children is calling upon governments, the international community and civil society to:
- Ensure that every mother and newborn living in crisis has access to high quality health care:
- Invest much more in women and girls and ensure their protection; Build stronger institutions and promote early action, social protection, disaster risk reduction and strong health systems that provide universal health coverage and provide for the most vulnerable;
- Design emergency interventions with a longer-term view and the specific needs of mothers and newborns in mind;
- Ensure political engagement and adequate financing, coordination and research around maternal and newborn health in crisis settings.
All children have the right to survive, no matter where they are born. On the Syrian border I visited the infant and young child feeding centre, and met mothers who had given birth in the camp. Our teams continue to work to help mothers initiate and continue breastfeeding, supporting them to keep their babies healthy by providing access to vaccines, health services and high protein biscuits for nursing mothers. It’s now up to the international community to ensure communities like these are given the tools and infrastructure to be truly resilient in the face of future disasters.
The majority of maternal and child deaths are increasingly concentrated in conflict-affected and fragile states but many of these deaths are avoidable. Meeting the health and nutritional needs of mothers, newborns and children is central to finishing the urgent task of achieving MDG4 and with the right commitments, plans and investments before, during, and after a crisis has hit, we can be the generation that sees an end to these preventable deaths.