As world nears 7 billion population mark, high birth rates deter nations from achieving better maternal and child health outcomes.
Bank financing for reproductive health programs jumps 59% in one year; Reproductive Health Action Plan focuses on 57 poor countries.
Stronger health systems, girls’ education among factors that contribute to fewer maternal deaths, lower birth rates.
July 19, 2011— On October 31 this year, the world is on target to cross a momentous threshold when the global population reaches 7 billion, up from 2.5 billion in 1950—a remarkably fast rise in 61 years.
The population milestone is an important reminder, say World Bank experts, that birth rates in many developing countries are significantly higher than in better-off parts of the world, making it more difficult for poor nations to achieve better maternal and child health results called for by the 2015 Millennium Development Goals.
Between 10 and 20 million women continue to suffer from preventable reproductive health illnesses every year, with young women especially at risk of death and illness. Maternal deaths fell from 546,000 in 1990 to 358,000 in 2008. However, 99% (355,000) of these deaths still occur in developing countries, with the highest maternal mortality rates in sub-Saharan Africa (640 per 100,000 live births).
In an update this week on the Bank’s one-year-old Reproductive Health Action Plan, Bank experts pointed to several countries taking the lead in improving reproductive health outcomes. With Bank support, Mozambique is improving supplies of essential drugs and medical supplies, including contraceptives. Swaziland is training doctors and midwives in obstetrics. Bangladesh is improving the delivery of reproductive, maternal and child health services, including better access to skilled-birth attendants and better nutrition for pregnant women and children.
In Yemen, Bank programs are increasing access to maternal and child health services, especially in the country’s remote rural areas. Bank financing for better reproductive health jumped by 59%, to $ 830 million in the last fiscal year, up from $490 million in FY10. In addition, the Bank has developed detailed profiles for 47 of its 57 high-priority countries under the Reproductive Health Action Plan. This includes 35 countries as part of the Bank’s commitment to the U.N. Secretary General’s Global Strategy for Women and Children.
Stronger Health Systems
According to Bank Vice President for Human Development Tamar Manuelyan Atinc, “The great majority of pregnancy-related deaths and illnesses can be prevented with stronger health systems, good governance, and vastly less poverty.”
Atinc says better girls’ education is also essential to improving maternal and child health in poor countries. Analysis of demographic and health surveys shows that women with secondary or higher education have fewer children than women with primary or no education in all regions.
A Bank program in Tamil Nadu, India, reduces maternal and neonatal mortality.
“Promoting contraception and family planning is vital to reducing birth rates, as is strengthening health systems to ensure that these services actually reach poor women,” says Dr. Sadia Chowdhury, the Bank’s team leader for the Reproductive Health Action Plan, and a former pediatrician in Bangladesh.
“And time and time again, we see how a woman’s education allows her to better care for her children, builds job skills that allow her to join the workforce and marry later in life, gives her the power to say how many children she wants and when, and these are enduring qualities she will hand down to her daughters and sons as well.”
High Levels of Maternal Deaths
The Bank’s commitment to improving women’s and children’s health is underscored in its 2007 Health, Nutrition and Population Strategy, which emphasizes improved family planning, nutrition, health information, management of health services, and more and better trained health workers to ensure that the poorest get the help they need.
Building on this framework, the Reproductive Health Action Plan details the Bank’s engagement on sexual and reproductive health from 2010 to 2015, focusing on 57 priority countries with high levels of maternal deaths and disability, high fertility rates, and above average levels of sexually transmitted infections (STI) prevalence.
The great majority of pregnancy-related deaths and illnesses can be prevented with stronger health systems, good governance, and vastly less poverty.
—Tamar Manuelyan Atinc, World Bank Vice President for Human Development
The majority of these countries are in sub-Saharan Africa and South Asia, and many qualify for zero-interest credits under the Bank’s fund for the poorest countries, the International Development Association.
The action plan focuses on strengthening health systems for better reproductive health outcomes, including use of various innovations in financing, service delivery and human resource management. The Bank’s aim is to provide reproductive health services to the poorest families, with a special focus on reaching young people with better access to services and information.
The Bank also is making good on its pledge at the 2010 UN Millennium Development Goals Summit to provide an additional $600 million for results-based financing over 5 years to countries that face challenges in achieving their MDGs because of high fertility and poor child and maternal nutrition and disease.
So far, the Bank has committed $314 million to seven countries in keeping with this pledge, including $233 million in IDA financing, linked to an additional $81 million from the Health Results Innovation Trust Fund, supported by the governments of the United Kingdom and Norway. The seven countries are: Benin, Burkina Faso, Burundi, Democratic Republic of Congo, Ethiopia, Laos, and Nigeria.
In addition, from July 26-28 in Washington, D.C., the Bank, along with the U.S. Agency for International Development, Norwegian Agency for Development Cooperation, the Bill and Melinda Gates Foundation and Grand Challenges Canada, will co-host the finals of a global competition, “Saving Lives at Birth: Grand Challenge for Development,” which identifies and funds life-saving technologies and innovations targeting mothers and newborns. Of the 600 submissions received from civil society organizations, universities, and business, 76 finalists were selected to compete for the awards.