Issues Magazine

Healthy Mothers Make Healthy Communities

By Amelia Poxon

As Australia’s population grows, cities expand, house prices rise and transport systems struggle to keep up. But imagine if you lived in a developing country where access to basic services is already difficult.

A large family is a source of joy for many but in countries like Timor-Leste, Sri Lanka or Kenya,where parents struggle to find food and medicine to keep their children healthy, a large family may also be a challenge. In these countries, and many more, there are enormous difficulties associated with accessing nutritious food, clean water, health care and education. These challenges often make it impossible for people living in poverty to learn skills that enable them to earn a sustainable income.

The World Bank estimates that more than three billion people, almost half the world, are living in poverty and surviving on less than US$2.50 a day. Many of these people do not have access to basic items such as food, water and shelter. But there are also forgotten consequences of poverty; people may not have the opportunity to make free and informed choices, participate fully in society and determine their own future.

CARE, an international humanitarian aid agency, works with poor communities in over 70 countries to help fight poverty and defend dignity. Our approach is to build local capacity to achieve change. We partner with communities to determine their priorities, and work together to implement projects such as building clean water systems and latrines, educating people about good hygiene, improving access to schools, helping families produce more food and increase their income, and improving access to health services, family planning, immunisation and HIV awareness and prevention.

With more than 60 years of experience, CARE has learnt that the most effective way to reduce poverty is to target women and girls. In thousands of projects worldwide, CARE has witnessed women transfer improvements in their own lives into the lives of their children and families, ensuring the whole community benefits. For example, we know that when women access employment opportunities we see an increase in family assets, an increased investment in children’s education and an increase in family nutrition. If CARE can ensure that women have the opportunity to gain an education, access health services, generate an income and take a lead in their community, they are able to support their family to be healthy and prosperous.

CARE is not the only organisation working to reduce global poverty. In 2000 more than 190 world leaders, including Australia’s Prime Minister, met to set goals to free a huge number of the world’s population from extreme poverty, hunger, illiteracy and disease. Together they set eight Millennium Development Goals to be reached by 2015:

  1. Eradicate extreme poverty and hunger.
  2. Achieve universal primary education.
  3. Promote gender equality and empower women.
  4. Reduce child mortality.
  5. Improve maternal health.
  6. Combat HIV/AIDS, malaria and other diseases.
  7. Ensure environmental sustainability.
  8. Develop a global partnership for development.

As an organisation that fights global poverty through the empowerment of women, CARE focuses on the third and fifth Millennium Development Goals and places a special emphasis on supporting women through motherhood. In essence this means working with mothers all over the world to make sure they can be healthy before, during and after their pregnancies.

Supporting Women Before Pregnancy

A key way of assisting women to have healthy families before pregnancy is to improve access to reproductive health services and information. In this way they can make an informed decision about when they would like to start their family and how big they want their family to be.

When a pregnancy occurs at a young age, there are high risks for both the mother and the child.

Young adolescents are more likely to die or experience complications in pregnancy and childbirth than adult women. The children of these young mothers also have a higher risk of dying if their mother doesn’t survive childbirth. And even if their young mother does survive, an infant’s risk of dying in his or her first year of life is 60 per cent higher when the mother is under the age of 18.

Early marriage is a major contributor to the large number of pregnancies amongst girls in the developing world. Worldwide there are over 60 million child brides – girls as young as 12 years old who are married to men twice their age and are likely to have children when they are young.

Providing access to reproductive health services is an important part of improving the health of mothers and babies in poor communities. When a woman becomes pregnant at a young age, her pregnancy often occurs under circumstances that are not only detrimental to her health but also to her chance of getting an education and learning the skills needed to earn an income.

Supporting Women During Pregnancy

When women are empowered to fulfil their potential, they invest in their families and work for lasting change. But women cannot fully participate in society if they cannot expect to survive childbirth. In most wealthy countries like Australia, the lifetime risk of a woman dying in childbirth is about 1 in 10,000. That risk for women in sub-Saharan Africa and parts of Asia can be as high as 1 in 7. In some countries, women are more likely to die in childbirth than to receive an education.

When a mother dies, her babies face a substantially increased risk of dying, especially if they are girls.

These statistics expose the cruel reality behind the largest disparity in global public health statistics: that giving life, a joyous experience for most women in Australia, amounts to risking life for women in many developing countries.

The reasons women die are complex. Often they are unable to choose if and when they get pregnant. They may not have access to money or the power to decide how family resources are spent – even for lifesaving medical care. They may live far from the nearest health facility and have no way to get there in an emergency. If they do, they may find a health facility without basic medicines, supplies or trained staff. They may be victims of gender violence and discrimination. They may have limited or no education.

What makes this terrible situation much worse is the fact that so many of these deaths are preventable. For women to safely give birth they need access to health advice and services, information about nutrition and access to a clean birthing space where they are supported by a trained health worker.

Supporting Women During Emergencies

A key problem that CARE works to address is the maternal health risks following an emergency. In January 2010 the small Caribbean island of Haiti was devastated by an earthquake, killing over 220,000 people. An astonishing 9.6 million people live in Haiti, which is less than half the size of Tasmania, where only 500,000 people live.

Even before the devastation caused by the earthquake, the living conditions in Haiti were very basic. More than 80% of the population was living below the poverty line. This meant that the infrastructure was terrible, houses were built with substandard materials, and access to any services was poor. And, because the population was so large in such a small area, people were literally living on top of each other.

Following the quake there were an estimated 37,000 pregnant women in the earthquake-affected area. They were living without shelter or adequate access to clean water, sanitation, nutritious food and health services.

One of CARE’s first priorities in Haiti was to support pregnant women, lactating women and new mothers by distributing water purification tablets, food, infant kits for mothers with babies and hygiene kits including soap, toothpaste and sanitary napkins.

Yet, even if a mother can overcome the risks of giving birth to a healthy baby, challenges still remain after childbirth in poor communities.

Supporting Mothers and New Babies

Timor-Leste (East Timor) is one of Australia’s closest neighbours, yet between our two nations there is great disparity, especially when we look at maternal and child deaths.

Over one-third of Timor-Leste’s population regularly experiences food shortages. This means around 360,000 people live in fear of hunger and starvation at some point each year. The impact on pregnant women and children – especially new babies – can be crippling. In Timor-Leste, 61 of every 1000 babies don’t survive childbirth.

CARE is working with the Timor-Leste government to train local health volunteers to provide health services to mothers, children and entire communities to help mothers be healthy and informed about starting a family. Each month, hundreds of mothers in remote areas of Timor-Leste take their children to access nutritional information, immunisations, food and hygiene items provided by CARE. The volunteers weigh and measure children and distribute supplementary food to malnourished babies, pregnant women and mothers who are breastfeeding, allowing mothers to build their children’s immune system and improve their chance of survival, growth and long-term development.

Providing advice to women so they can be informed about their reproductive health, providing skilled health workers to assist them during pregnancy and childbirth, and providing nutrition, immunisation and support for mothers and newborns are all fundamental to improving maternal and child mortality.

Supporting Girls to Break the Cycle of Poverty

Many challenges must be overcome to help women in poor communities to be healthy mothers. An essential part of breaking the cycle of poverty is to provide education to children, particularly girls, so that they can continue to have healthy families.

Improving access to girls’ education is crucial to fighting global poverty. As girls receive an education we see healthier families of a more manageable size. In fact, when a girl in the developing world receives seven or more years of education she marries four years later and has two fewer children. An educated mother also leads to greater economic independence and decreased malnutrition, infant mortality and HIV infection rates.

Put simply, educated girls grow into educated women who are more likely to educate their own children and break the cycle of poverty.

Even the poorest woman is powerful – for what she contributes as an individual, as a mother, as a family member, as a community member, as a citizen. The empowerment of women is at the heart of CARE’s strategy to reduce global poverty and nurture the growth of healthy societies.

Many organisations and individuals are contributing time, know-how and money to meet the Millenium Development Goals set by the United Nations.

To find out about how you can help mothers have healthy families, go to www.careaustralia.org.au. If you would like CARE to come and speak with your school about empowering women to overcome poverty, email jess.perrin@careaustralia.org.au