Maternal Health in Africa

Maternal health is a huge problem in Africa, with 50 percent of maternal deaths happening on the continent. African woman are a staggering 100 times more likely to die during childbirth than elsewhere, with around one and a half thousand of such cases every day.

One of the main causes for these tragic statistics is the lack of adequate facilities. Hospitals can be few and far between in some areas, and the hospitals there are often do not have enough trained midwives, meaning the care is not of the same standard expected elsewhere in the world. This is compounded by some of the best doctors moving to other countries where salaries are better. There is also a lack of up-to-date equipment and drugs. Many pregnant women are forced to walk many miles to a hospital, which contributes towards only 20 per cent of births taking place in hospitals.

Around 50 percent of births happen at home, and unlike elsewhere these usually do not include the help of fully qualified midwives. As well as those outlined above, one reason for this is the cost. A hospital birth usually costs around $6, which goes up to $15 if a cesarean is required. Traditional birth attendants often help with home birth but they are not qualified. They do though only cost around $2. Many more maternal health problems arise at home births in comparison with those at hospitals. Local clinics account for 30 per cent of births in Africa. The mortality rate here is also much higher than hospitals, partly because they are insufficiently equipped to deal with complications such as cesareans.

There are significantly more births in Africa than on any other continent. With women typically having more children, it multiplies the risk of maternal health problems. Part of the reason for more births is the child mortality rate, due to epidemics such as aids, malaria and starvation, and the lack of contraception. Because so many children die, people tend to have more children to increase the chances of some reaching adulthood.

Aids is another massive problem. The lack of availability of education about contraception is one of the reasons for this. Even where there is availability it is not affordable for all. If a mother has Aids or HIV during pregnancy this will get passed onto her children. Many Mothers die from Aids leaving their children Motherless, and if their Fathers have also succumbed to the decease, as often happens, then Brothers and Sisters can be left to look after themselves. This causes all sorts of social issues, and further increases the changes of starvation.

Lack of education around the whole subject of family planning means there are more pregnancies not just for adults, but also for young girls. This results in many becoming pregnant young before their bodies are able to fully cope with giving birth, meaning yet more maternal health issues.

Poverty Trap in Africa

According to Sachs, Africa is characterized by growth in population, lack of growth in food production, fragmentation of land, and lack of basic infrastructure pushing it in the poverty trap. They have a high child mortality rate due to poor health programs. In contrast, the British colonial existence in India at least endowed her with a sound railway network penetrating to her villages. No similar infrastructure is found in Africa.

However, the economic burdens in Africa can be easily overcome. According to Sachs, the barriers to economic development evident in Africa can be overcome at a low cost, but finance is difficult for the African nations living on subsistence. “The escape from extreme poverty” argues Sachs, “requires four basic types of investment”. The proposed investments are required in (i) Agriculture (ii) Health (iii) Education, and (iv) Infrastructure, to attain sustained growth. A temporary aid over several years if utilized optimally can lead to permanent rise in productivity.

The initial external investment can be used for boosting agricultural productivity, and a parallel can be seen in the green revolution in India in the latter half of 1960s. With the initial investment in agriculture, the external aid can be further utilized for boosting growth in education, health, and infrastructure thereby triggering a process of self-sustained growth (Sachs 231). In agriculture, the experience shows that with little cost of inputs in terms of fertilizer and high yielding varieties of seeds, the return is spectacular. The yield per hectare can grow from as little as 0.5 ton per hectare to as high as 1 to 5 tons per hectare with as little investment as $200 but small farmers lack even that little finance. The same goes for health. A little investment can go a long way in controlling most of the diseases that commonly originate from infectious diseases, nutritional deficiencies, and unsafe childbirth. The nations like Zanzibar and Tanzania have already shown dramatic results from the help that arrived in the form of mass bed net, anti-mosquito spray from the Global Fund, and the United States.

Similarly a little investment in education and literacy will open doors to mass employment in agriculture, exports, agricultural processing and industry simultaneously with interventions in infrastructural upgradation and build up.

Regional development strategy is seen as going a long way in generating economic prosperity, employment and sound infrastructure in underdeveloped regions. Sachs offers two examples of successful regional development – Tennessee Value Authority (TVA) created under the New Deal package covering seven states in the southeastern United States, and world’s largest regional development project in the Western China Development Project. Out-migration from regionally underdeveloped to the developed regions is yet another strategy of development. However, migration of unskilled laborers from poor nations to rich nations is a deeply contentious issue. Also migration and sending remittances by the migrants are only part solutions to the development.

The UN sponsored Millennium Development Project and the Millennium Village Projects are quick impact investments aimed at uplifting depressed regions and villages. The goal here is to empower communities to achieve sustained long term growth through key investments in agriculture, health, education, and infrastructure. The initial results have been positive for agriculture productivity in Kenya, Ethiopia, and Malawi. The progress was also seen in health and education.

Sachs demystifies the concept that nations like Israel, India, Taiwan, and Korea developed on the strength of their internal resources as he goes on to show the sources of their external funding and time when these nations received financial aid that helped them take off before external aid became redundant. The railway infrastructure in India was bequeathed to her by the British rule. The green revolution in India was externally aided. It is also a myth that aid-propelled growth is unsustainable and that aid can sustain only on a small scale.