If one has a choice, sub-Saharan Africa would not be a place to be born. The Lancet published a report card on maternal, newborn and child mortality just before a conference to present and discuss the implications of the findings in Cape Town, South Africa, on April 17–19, 2008. It is certainly time for action. What kind of society have we become if we cannot even take care of the weakest among us?
Some quotations from the report:
At least half of maternal and child deaths take place in sub-Saharan Africa. There are critical gaps in contraceptive services, skilled birth attendance, and clinical management of newborn and child illnesses.
In sub-Saharan Africa, 12 countries are experiencing worse rather than improved under-5 mortality rates. Listed according to the magnitude of these reversals, they include: Botswana, Swaziland, Zimbabwe, Lesotho, Kenya, Congo, Equatorial Guinea, South Africa, Cameroon, Chad, Central African Republic, and Zambia.
The major limitation to expansion of essential services—such as coverage for oral rehydration therapy, treatment of childhood pneumonia, and provision of skilled and emergency obstetric care—is the capacity of the health system.
Maternal and child undernutrition account for 20% of maternal deaths and 35% of under-5 deaths, respectively. Yet nutrition accounts for only 8–13% of total aid flows.
Taken together, these analyses indicate that, despite isolated examples of welcome progress, national and global attention to maternal, newborn, and child health is still strikingly inadequate. Children and mothers are dying because those who have the power to prevent their deaths choose not to act. This indifference—by politicians, policy makers, donors, research funders, and civil society—is a betrayal of our collective hope for a stronger and more just society, one that values every life no matter how young or hidden from public view that life might be. It signifies an unbalanced world in which only those with money, military strength, and political leverage determine what counts and who counts. As health professionals, we should not accept this pervasive disrespect for human life. We have a voice, a platform, and a constituency that should be an instrument for radical change. Let that voice be heard in Cape Town.