Invest in young people to reduce maternal mortality

As part of the worldwide project Why Poverty , SVT broadcasts a series of documentaries about poverty in the world. The aim is to initiate a global conversation on the issue of poverty and the first film undeniably raises questions: How come complications associated with pregnancy and childbirth are still the most common cause of death among young women in developing countries?
More resources for maternity care are of the utmost importance. But if we are to reduce maternal mortality, girls and women must be given the power to decide for themselves if and when they want to become pregnant. It requires a change in society's attitudes that extend far beyond the walls of the delivery room, writes Plan Sweden's Secretary General Anna Hägg-Sjöquist.

The film "Welcome to the World" follows a number of pregnant girls and women in three continents and depicts traumatic births with devastating consequences. Foreign doctors work hard to save women and children in these acute stages and we are told that for only two dollars you can save a life. Expanded healthcare in developing countries is part of the solution so that more women can give birth in a clinic. But, if infant and maternal mortality are to decrease in the world, we must work preventively at the same time. We have to think about why the 13-year-old girl from Sierra Leone in the film ended up on the couch where she gave birth to a child who died after just a few minutes. Or how it comes about that a 24-year-old woman will give birth to her fourth child.

Globally, great progress has been made on the UN Millennium Development Goal 5 (the so-called MDG5), the goal of reducing maternal mortality by 75% and increasing access to reproductive health. Maternal mortality in the world has halved since 1990.  However, it is a fact that almost 800 girls and women die each day each year from pregnancy-related causes and that progress has stopped when it comes to reducing the number of pregnancies among young girls. I UN Population Report 2012, which was released a couple of weeks ago, you can read that the number of teenage pregnancies even has increased in some regions and generally among poor, uneducated girls in rural areas.

Scary figures show that Complications associated with pregnancy, childbirth and unsafe abortions still remain the most common cause of death among girls and young women in developing countries. Girls under 18 are four times more likely to die in connection with pregnancy and childbirth than women over 20. The risk of severe physical and mental problems is also significantly higher for girls, as is the risk of the child dying. A child of a young girl in a developing country is twice as likely to die in childbirth as a child of a woman over the age of 20.

Every year, 16 million young girls aged 15-19 give birth to children. The vast majority live in developing countries and the vast majority become mothers within the framework of a child marriage. Many of these do not have the opportunity to choose whether they want to get pregnant or not. They do not have the resources, knowledge or power to make their own choices about their sexual and reproductive health. They do not rule over their own bodies.

Plan, and many with us, work from a rights perspective where we believe that everyone has the right to sexual and reproductive health. We focus on preventive measures. In order to achieve Millennium Development Goal 5, more young people - both girls and boys - must have access to sex education, contraception or health care adapted to the needs of young people.

Such initiatives should be integrated with initiatives to increase the status of girls and the power to decide over their own lives in other areas. Plan works to change the underlying notions and norms about sexuality and gender roles, which contribute to young girls being discriminated against. Of course, we do this work together with local organizations, networks, schools, families and local and religious leaders.
If we are to be able to achieve Millennium Development Goal 5, girls must be given the power to be able to decide for themselves if and when they want to become pregnant. It requires a change in society's attitudes that extends far beyond the walls of the delivery room.

We view positively and support the work that Sweden's Minister for Development Aid Gunilla Carlsson conducts to promote sexual and reproductive health in development policy. We know that there is great opposition in the global arena. UN Secretary-General Ban Ki-moon has appointed an expert panel (the UN High Level Panel), whose work aims to draw conclusions around the Millennium Development Goals and propose new global development goals that are adapted to the challenges of the future. As a member of this expert panel has Gunilla Carlsson a unique opportunity to specifically promote ungas sexual and reproductive health and rights in the new targets. We hope she takes advantage of that opportunity.

Anna Hägg-Sjöquist, Secretary General of Plan Sweden.

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