Tanzania Aims to Save Women in Childbirth but Talks Little of Contraception and Safe Abortion

The good news is that Tanzania, helped by Bloomberg Philanthropies, has launched an innovative program to prevent mothers from dying in child birth. The bad news is that 23 women still die every day from birth-related complications.

Mayor Michael Bloomberg said the east African country's project of building clinics and training health personnel in isolated rural areas may be a model of what can be done in other developing countries. Tanzania has one of the world's highest maternal mortality rates.

"If you can build a model that you can show works, then you can start attracting capital," Bloomberg told a joint news conference with Tanzanian President Jakaya Kikwete. "We think it has the potential to become a model for other countries in Africa where maternal deaths are unacceptably high."

The aim is to reach 50,000 mothers and their children over the next three years. "For sure, we need more money," Kikwete said.

Bloomberg Philanthropies, the mayor's charitable foundation, and Helen Agerup, chair of the Geneva-based H&B Agerup Foundation, have made a commitment of $15.5 million for Tanzania.

The mortality statistics are staggering, said Kikwete. Worldwide 287,000 women die giving birth each year; in sub-Sahara Africa, the figure is 160,000, while in Tanzania it is 8,500 deaths.

This is four times as high as in Latin America and the Caribbean and nearly 50 times higher than in industrialized nations, according to research for The Lancet medical journal.

"Not acceptable"
"We are doing better than sub-Saharan Africa but higher than the world average," Kikwete said. "It is not acceptable."

The number of maternal deaths from bleeding and other complications in Tanzania has declined since the program began in 2006. In the coastal Uranga district, for example, the decrease has been 32 percent in just two years, Kikwete said.

Tanzania lacks doctors, nurses, equipment, and transport to whatever clinics may exist. The new program creates or upgrades clinics closer to where people live and has trained 100 local medical workers to save pregnant women, including through caesarean sections.

"There has been a two-thirds increase in the number of women who are giving birth in upgraded health centers and in several places we are witnessing decline in maternal mortality," Kikwete said.

Does one-stop health shopping include birth control?
Tanzanian women have an average of 5.5 children, which means families of 10 are not unusual. Yet the news conference, which included Helen Agerup and U.N. Secretary-general Ban Ki-moon, never mentioned birth control or family planning.

Kikwete told this reporter afterwards that about 26 percent of the women have access to contraceptives and he hopes the number will reach 60 percent.

Family planning is encouraged in Tanzania and abortions are legal to protect the health of life of the mother, although access is spotty.

The New York-based Guttmacher Institute, which researches reproductive health worldwide, says access to safe abortion is important:

Women confronting unplanned and unwanted pregnancies in countries where legal abortion is not available still resort to abortion. In fact, the abortion rate (the number of abortions per 1,000 women aged 15-44) is similar in regions where legal abortion predominates and in regions characterized by highly restrictive abortion laws. In other words, legal restrictions on abortion largely do not affect whether women will get an abortion, but they can have a major impact on whether abortion takes place under safe or unsafe conditions and, therefore, whether it jeopardizes women's health and lives.

The United Nations has created the Millennium Development Goals (MDGs), the world's most ambitious program to slash poverty by 2015. While the glass is half full on many of the goals, the decline in deaths of pregnant women is nowhere near the target of a 75-percent reduction by 2015. And sadly Tanzania won't reach it either.