Preference for large families continues to be a major factor determining levels of fertility in Sub-Saharan Africa. Recent data from DHS demonstrate reasons why men and women prefer and choose to have large families. Though factors influencing women’s decisions are complex and vary from one society to another, there are also similarities.
According to the United Nations, this child will be born in India, and statistically should be a girl. But many of India’s girls are going missing at birth, because of parents’ desire to have boys. In 2008, the number of missing girls in India increased in 2008 to 275,000 as compared to 1,000 for the rest of South Asia.
If a girl child is lucky enough to be born, she faces high female mortality in infancy and early childhood in South Asia. What causes excess mortality among girls during infancy and early childhood? One possible explanation that has received a lot of attention is discrimination by parents against girls. Certainly, in parts of the world like Afghanistan, China, northern India, and Pakistan, such discrimination is a serious problem. Studies have shown delays in seeking medical care and lower expenditures for girls. In India, despite stellar economic growth in recent years, maternal mortality is almost six times what it is in Sri Lanka.
"Several mothers’ life is in danger due to placenta previa at child birth however either the village is too far flung to receive medical assistance or the family refuses to let the mother seek a specialist’s help,” the lady health worker said in response to my query regarding the past month’s performance in-field.
Maternal Health Care remains a low priority concern not only amongst the rural and urban poor households in Punjab, Pakistan, but amidst the policy circles as well. In Pakistan, for every 100,000 babies born, some 260 women die during childbirth. The country is one of 11 countries that comprised 65% of global maternal deaths in 2008. Yet most maternal deaths could be prevented if a skilled practitioner attended the birth.
The solution to this problem is multi-pronged. The issue must be tackled individually at the following thresholds:
a) Quality of the Maternal Health Care Program
b) Receptivity by the public
c) Data, Research and Execution
It is evident the solution requires institutional, cultural and political changes, however is it possible to evade the long term institutional changes and usher in economic and social independence, thereby pardtially addressing the solution in the short run?
So the big news out of the MDG Summit today is the launch of Every Woman, Every Child, the new joint action plan to help reach MDGs 4 and 5 on child and maternal health.
The World Bank, numerous UN agencies, governments and civil society groups have all pledged their support. But another document with pledges is not going to make much difference to poor mothers and children in developing countries unless we act on three things.