The World Health Report 2005

The World Health Organization’s 2005 Report, Make Every Mother and Child Count, examines why eleven million children under age five will die this year, and why 529,000 mothers will die during pregnancy, childbirth, or soon thereafter. One strategy that can make pregnancy safer is to reduce gender-based violence, it says.

Make Every Mother and Child Count proposes building societies that support women who are pregnant by tackling the low status of women, violence against women, and the lack of employment rights for pregnant women. “Gender-based violence or exposure to hazards in the workplace may not be readily recognized by pregnant women as problems that health workers can help to resolve,” the report says, “but [they] constitute major and underestimated public health problems.”

It notes that unequal power relations between men and women often cause unwanted pregnancy, finding that seven to 48 percent of adolescent girls around the world report that their first sexual experience was forced. Women who have experienced a sexual assault often fear the pregnancy and delay getting health care.

“Violence against women by a partner is a global public health problem and a human rights violation,” says Make Every Mother and Child Count. Studies from Egypt, Ethiopia, India, Mexico and Nicaragua have found that 14 to 32 percent of women report having been physically or sexually abused during pregnancy – and the perpetrator is usually their partner. Violence increases risk of premature labor, low birth weight babies, sexually transmitted diseases, depression and other mental health problems.

Violence can also kill. In Pune, India, 16 percent of all deaths during pregnancy in 400 villages and seven hospitals were attributed to partner violence.

The World Health Organization recommends screening for abuse to protect women during and after pregnancy. “Health workers must not only be sensitive to the subject, but also need to know how to deal with it,” the report says. It recommends that doctors, nurses, midwives and other health care providers be specifically trained to recognize and inquire about intimate partner violence and provide information, care, support and referrals.

Make Every Mother and Child Count also notes that laws establishing a minimum age for marriage, criminalizing violence against women, and prohibiting harmful practices such as female genital mutilation can protect girls and women who are pregnant and improve their overall health.

In the U.S., the Pan American Health Organization (PAHO), the regional office of WHO, is sponsoring a series of events featuring Health and Human Services Secretary Mike Leavitt, U.S. Agency for International Development Administrator Andrew S. Natsios, PAHO Director Dr. Mirta Roses, and others to draw attention to efforts to reduce maternal deaths and child mortality.

Make Every Mother and Child Count is available online at www.who.int/whr/2005/en/index.html

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