By Stephanie Nebehay
GENEVA (Reuters) - More than half a million women still dieeach year in pregnancy and childbirth, often bleeding to deathbecause no emergency obstetrical care is available, the UnitedNations Children's Fund (UNICEF) said on Friday.
Despite modest progress, particularly in Asia, the globalmaternal mortality toll remains stubbornly stable due to a lackof financial resources and political will, it said.
More than 99 percent of the estimated 536,000 maternaldeaths worldwide in 2005 occurred in developing countries, halfof them in sub-Saharan Africa, it said in a report entitled"Progress for Children: A Report Card on Maternal Maternity".
"One of the critical bottlenecks has always been access tohighly skilled health workers required to deliver emergencyobstetrical care, particularly caesarean sections," PeterSalama UNICEF's chief of health, told a news briefing.
Around 50 million births in the developing world, or about4 in 10 of all births worldwide, are not attended by trainedpersonnel, according to the report.
Haemorrhaging is the leading cause of maternal death inAfrica and Asia, causing one in three deaths, it said.Infections, hypertensive disorders, complications of abortion,obstructed labour or HIV/AIDS are other causes.
Such complications can be easily treated in a health systemwhose facilities are staffed with skilled personnel to handleemergencies around the clock, but disparities persist, it said.
"The lifetime risk of maternal death in the developingworld as a whole is 1 in 76, compared with 1 in 8,000 in theindustrialised world," UNICEF said.
The riskiest place to give birth is Niger, where the riskof dying in pregnancy or childbirth over the course of awoman's lifetime is one in seven, it said. In Sierra Leone itis 1 in 8.
But developing countries including Sri Lanka and Mozambiquehave succeeded in reducing maternal mortality rates, it said.
A combination of family planning, training skilled birthattendants, emergency obstetrical care and post-natal care isthe key to reducing maternal mortality, according to theagency.
At the current average reduction rate of less than one percent a year, the world will miss the goal of reducing maternalmortality rates by 75 percent between 1990 and 2015, to lessthan 150,000, one of the Millennium Development Goals, it said.
"The time is right. We now know exactly what to do formaternal mortality reduction to make this one of the next bigissues in global health," Salama said.
Programmes to combat three major epidemics -- HIV/AIDS,tuberculosis and malaria -- now receive the requiredinternational attention and billions in funding, he said.
"But maternal mortality and child mortality do not yetreceive the attention that the scale of the problem deserves,"he said. An additional $10 billion would be needed each year tocombat both child and maternal mortality, according to Salama.
UNICEF said last week that more than 9 million childrendied before their fifth birthday in 2007, down slightly from ayear before, but a huge gap remains between rich and poorcountries.
(Editing by Jonathan Lynn and Richard Balmforth)
