Holding MP’s accountable to safe motherhood promises

Date: January 1, 1970
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Ahead of Malawi’s 19 May parliamentary and presidential elections, the White Ribbon Alliance for Safe motherhood (WRASM) Malawi chapter is calling on aspiring candidates to declare, and act on, their commitment to ensuring the health and well-being of the nation’s mothers.

"Mothers have delivered for the nation, without their votes, aspiring members of parliament (MPs) would not win,” observed President of the Association of Malawian Midwives (AMAMI) Lennie Adeline Kamwendo. “Mothers walk long distances to access health care and they must be empowered."
The campaign challenges all aspiring MPs to sign a declaration committing themselves to combating maternal mortality. Based on the declaration, WRASM will track progress amongst all MPs who sign the document, to strengthen safe motherhood efforts in the country.
Speaking at the campaign launch, new mother Lucy Konyani narrated how she nearly lost her life due to the negligence of health personnel when she was about to deliver. “I suffered many complications to give birth to this baby,” she said as she held her newborn in her arms. “When I was about to deliver, the medical personnel did not attend to me early.”
“Doctors suggested removing the placenta upon noticing that it was difficult to remove the baby. They attended to me after I had already lost a lot of blood,” said Konyani. She called upon health workers to be professional in their duties, instead of ignoring expectant mothers in dire need of attention.
The advocacy campaign is part of efforts to lobby legislators for more resource allocation in the country’s national budget, in order to reduce maternal and neonatal deaths, and hold them accountable to their campaign promises.
Recent statistics from the national Multiple Indicator Cluster Survey (MICS) show that 16 mothers die in the country every day due to pregnancy-related complications, translating to 5,840 deaths in a year. Malawi has one of the highest rates of maternal death in the world.
WRASM chairperson Darlington Harawa says members of parliament are responsible for ensuring more resources for interventions in safe motherhood.  "MPs make a lot of promises during campaigning, but they need to be result-oriented in making sure that maternal deaths are reduced," he stressed.
Harawa also contends that maternal deaths in the country are on the rise due to poor policy formulation and prevalent cultural practices. “Women are crucial to socio-economic development and so maternal health is a social issue,” adds Harawa. “Each MP has the obligation to stop maternal deaths."
Kamwendo echoes this sentiment, encouraging every Malawian to hold all the members of parliament and other officials accountable to ensure progress in improving safe motherhood in the country. "MPs must always be accountable to improve maternal health, most of them make many promises but when they go into parliament they forget," she laments.
Kamwendo explains that the advocacy campaign will continue after the general elections. "The MPs will be held accountable for as long as possible, they must give back. We can’t continue to lose women, we will talk to them and those in decision making positions," she emphasised.
The commitment statement contains ten key action points. These include increasing resource allocation and ensuring transport and communication resources are in place, as well as influencing district assemblies, constituencies, and traditional leaders to combat maternal mortality. It also tasks MPS with curbing harmful cultural practices and reviewing the minimum marriage age, which is presently at 15 years.
Unfortunately, the example of Malawi is not unique when it comes to the dire situation of mothers. Across the world, women continue to die of pregnancy-related causes at a rate of about one a minute, with ninety-nine percent of maternal deaths occurring in developing countries, primarily in Africa and South Asia.
Writing in the Lancet Journal Series, Carine Ronsmans of the London School of Hygiene and Tropical Medicine (LSHTM) notes that most women in developing countries remain without care during delivery.
"There is a move towards the professionalism of child birth but despite these trends, millions of women are left without care," she says. “Nearly one in 4 women in developing countries continue to be either alone or only with a relative to assist them at child birth and this has not changed since the early 1990’s.”
Ronsmans observes that midwives working in health centres can oversee a large number of deliveries and can ensure cleanliness, detect complications early, facilitate referrals for emergency care more easily (i.e. Caesarian sections and blood transfusions). "Projections, using data from Bangladesh, suggest that teams of midwives and midwife assistants working in health centres can increase the proportion of women with professional care by 40% by the year 2015.                              
Funded by the Department for International Development (DfID) and Save the Children, the campaign highlights the need for greater action if the country is to work towards achieving the United Nations’ Millennium Development Goal 5, which calls for the reduction of maternal deaths by the year 2015. The country is also a signatory to the Cairo and Beijing Declarations, as well as the SADC Protocol on Gender and Development, which all include provisions for reducing maternal mortality.
There is no shortage of agreements, and there is an urgent need to these commitments into action. Governments in Africa and around the world often pay lip service to issues such as maternal health, it is time that the mothers of the continent, and all those who support them, hold leaders accountable to act.
Dingaan Mithi is programme officer for Journalists Association Against AIDS in Malawi. This article is part of the GL Opinion and Commentary Service that offers fresh views on everyday news.

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