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Last Updated: Friday, 2 January, 2004, 00:11 GMT
Call for action on maternity care
Woman with babies
Many women do not have access to good maternity care
Medical experts have called for urgent action to improve maternity care for women in developing countries.

The Lancet medical journal says reproductive health is one of the most neglected public health issues.

Half a million women die each year from pregnancy-related causes - 99% are from developing countries.

Writing in the journal, experts say the answer is to focus on the particular problems of women in local communities in the developing world.

Strengthening reproductive health and human rights is an urgent global need
The Lancet
There is a huge disparity between maternal death rates in developed and developing countries.

The risk of dying from maternal causes in western Europe is one in 4,000. In sub-Saharan Africa, it is one in 16.

Technology need

The Lancet, which includes papers written by reproductive health experts from around the world, says a quarter of maternal deaths worldwide are due to haemorrhage.

Another 15% are due to sepsis, 13% to abortion complications, 12% to eclampsia and 8% to obstructed labour.

Many of these causes could be tackled if countries had better equipment and technology to which all women who needed them could have access.

The Lancet also highlights long-term health problems women develop after childbirth such obstetric fistula, where holes form between the uterus and rectum or bladder due to obstructed labour.

Dr France Donnay, of the UN Population Fund in New York, said: "The advent of modern obstetric care has led to the eradication of obstetric fistula in nearly every industrialised country.

"However, in the developing world obstetric fistula continues to cause untold pain and suffering in millions of women.

"The very existence of this condition is the result of gross societal and institutional neglect of women that is, by any standard, an issue of rights and equity."

'Future of mankind'

Ten years ago, the International Conference on Population and Development (ICPD) set out an action plan for reproductive health.

But in an editorial, the Lancet says: "After a decade, an enormous amount of work remains.

"The solution is not another huge, expensive conference, but renewed commitment to the particular problems of individual women in particular communities.

"Strengthening reproductive health and human rights is an urgent global need, one on which the future of mankind may quite literally depend."

Writing in the journal, Adrienne Germain of the International Women's Health Coalition in New York, said: "2004 marks the 10th anniversary of ICPD, when the world's nations recognised reproductive health and rights, women's empowerment, and gender equality as important global goals.

"We hope that this series of articles highlights some of the challenges that remain, and serves as a reminder that these issues underlie many of the world's most pressing problems."


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