Ministry of Health & Environment

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Deputy Representative of the United Nations Population Fund (UNFPA), for the English and Dutch-speaking Caribbean, Jaime Nadal-Roig addresses the weekly JIS 'Think Tank' on April 30. Mr. Nadal-Roig was speaking on the role of the UNFPA and other UN agencies in promoting safe motherhood in Jamaica.

Deputy Representative of the United Nations Population Fund (UNFPA) for the English and Dutch-speaking Caribbean, Jaime Nadal-Roig, has called on governments to place greater emphasis on maternal health related issues.

"This should be from the perspective of reproductive health, which is more holistic. we have to look at root causes of the problem and the broader picture," he told JIS News in a recent interview.

For each woman that dies in pregnancy, it is estimated that 20 more will suffer long-term conditions related to the pregnancy, including uterine collapse, fistula incontinence, depression and infertility.

Mr. Nadal-Roig said that these health conditions are not often discussed. "The UNFPA is heavily into the management of fistula mostly in Africa and it is a condition that mostly originates from pregnancy, from delivery and prolonged labour," he noted.

Stressing further the need for more focus on these issues, Mr. Roig-Nadal said that 15 per cent of expectant mothers will suffer fatal complications during pregnancy, birth and post partum. The most common cause of death is due to haemorrhage followed by toxemia (pregnancy induced hypertension). Other causes are unsafe abortions, sepsis and obstructed labour and hypertensive disease.

"About 15 per cent of all causes of maternal death are due to post partum complications and about 17 per cent are due to other direct causes with 11 per cent due to unsafe abortions," he pointed out, adding that these percentages may change with the age group of the population.

Agencies of the United Nations (UN) system have been working in partnership with governments across the world to assist in reducing maternal mortality rates. In fact, in 2003, the UN developed an inter-agency strategy for the reduction of maternal mortality in the Americas, with some representatives from the Caribbean.

Mr. Nadal-Roig informed that a work plan was developed covering the period 2003-2010, encompassing a variety of interventions, which involve support for national and local actions; proper surveillance systems; quality maternal health services including pre and post natal care, and family planning.

"We are working with the governments in order to solve the problems that affect their countries in order to be able to reduce the number of maternal mortality to the minimum possible level. The international community has set out a number of goals by 2015, to achieve for instance, gender equality and reducing maternal mortality by three quarters from 190 levels," he remarked.

Outlining the roles of the UN agencies involved, Mr. Nadal-Roig said that the World Health Organisation (WHO) focuses on the clinical aspects and the development of protocols and standards; the United Nations Children's Fund (UNICEF) has centred on issues related to mothers with special emphasis on adolescent mothers; while the UNFPA provides strong coordination among the agencies.

In the case of Jamaica, he cited the strong support in assisting the Ministry of Health and Environment in developing its 2007 to 2011 Strategic Plan for Safe Motherhood.

"We respond to the priorities as stated by countries and in the case of the Ministry of Health and Environment, we do this by taking stock of different comparative advantages, priorities and mandates," he informed.

The average maternal mortality ratio is determined by the number of women who die per 100,000 live births. In the Pan-American region, 190 women die per 100,000 live births. However, it must be noted that this range is very wide as there are countries and population sub-groups that have 10 deaths to every 100,000 live births and some population groups that almost have 1,000 deaths.

"The range is pretty enormous between the rich and the poor countries," Mr. Nadal-Roig noted.

In Jamaica, the maternal mortality rate is 95 deaths in every 100,000 live births.

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