A Road Too Far

When her labour started she wasn’t in a public or private hospital with an obstetrician on hand or a trained midwife. She was in a remote village with only family to assist. When things went wrong her family and friends carried her through the mountains for more than 2 days until they finally reached a road. There were no cars: so her brother ran for 2 hours to the nearest town and a car was sent to take her to the town’s small clinic. However no one at the clinic was qualified to perform the caesarean she needed so they telephoned for an ambulance to be sent from the city, a 6 hour journey, and drove her to meet it half way. By the time she arrived at the hospital it was too late. Neither she nor the baby survived. She was just one of the quarter of a million women who still die each year giving birth; 99% of them in developing countries.

One of the eight Millennium Development Goals, agreed to by 191 countries, is to reduce the maternal mortality by three quarters and achieve universal access to reproductive health by 2015. Some progress has been made: worldwide there has been a decline in maternal mortality of about 47% since 1990, but progress has been far too slow.

Many things have been shown to dramatically lower the risk of maternal mortality; access to antenatal checkups, trained midwives, hospitals for emergencies, qualified medical personnel are some of the more obvious. However the picture is far more complicated. Remote localities, lack of knowledge, cost, cultural traditions, the position of women in society, all impact on whether a woman will have this access. There is no one answer, no single solution, and most countries are tackling the problem using a range of methods and approaches. But there is one thing that is often not mentioned specifically, that is an underlying element crucial to almost all attempts to reduce maternal mortality; roads. For more details about a highly skilled obstetrician clicked here.

Roads are fundamental to development in most countries: access to markets and economic development, access to schools and education, access to health services. Roads do not just provide a way for pregnant women to travel to clinics or hospitals, they enable clinics to be established in more places, and allow health workers and midwives to travel to remote villages. Access to markets increases the wealth of communities and makes the costs of health care more affordable. Education of women raises their status and by increasing their awareness of risks and opportunities, makes it more likely they will have a say in matters that affect them and their unborn child.

For sustainable results in development, to ensure that maternal mortality rates continue to fall and then remain low, roads need not only to be built, they need to be maintained. Unfortunately however even when there is funding from international donors to construct a road, there is often no ongoing funding either from the government or donors to maintain it.

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