Creating Good CARMMA for African Mothers

NEW YORK — Beginning today, all medical treatment and medicines for pregnant women, lactating mothers and children under 5 will be provided free of charge in all government health facilities in Sierra Leone, currently one of the most dangerous places on earth to get pregnant.  The new programme is expected to cover some 250, 000 women and a million children.

In addition, health workers will receive a general salary increase as part of the Free Health Care directive launched by President Ernest Bai Koroma with support from government and development partners, including UNFPA, the United Nations Population Fund.

This groundbreaking initiative is just one of the kinds of improvements to the well-being of women that Bunmi Makinwa, UNFPA's Africa Region director, expects to see across the continent as the result of the Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA). "In two to three years, we would like to see maternal mortality reduced -- not just plateau -- in every country," he said, adding that in some areas, maternal mortality has actually been on the rise.

CARMMA, said Makinwa, reflects the fact that high rates of maternal mortality are no longer acceptable to African leaders. "One minister told me he was ashamed of his country. And there is a realization that we can something to correct the situation. The investments required are not huge. The obstacles are not insurmountable. It’s a question of leadership."

The continent-wide CARMMA campaign was launched by the African Union Ministers of Health, in partnership with the UNFPA and other UN agencies, as well as bilateral aid and non-governmental organizations in May 2009. CARMMA is different than other safe motherhood campaigns because of the sense of ownership that African leaders have in it, said Makinwa. "This is a totally home-grown initiative," he said, adding that it enjoys widespread support.

Ms. Bience Gawanas, the African Union Commissioner of Social Affairs, said she agreed completely. "CARMMA is not just about safe motherhood -- it goes beyond that."

Ten countries have launched their own national campaigns with considerable political support and enthusiasm. These include Chad, Ghana, Ethiopia, Mozambique, Malawi, Namibia, Nigeria, Rwanda, Sierra Leone and Swaziland. A half dozen or more countries are expected to announce their own initiatives in 2010, Makinwa said.

The campaigns will build on current successful efforts and best practices, generate and monitor data on maternal and newborn deaths, and mobilize political commitment and support of key stakeholders including national authorities and communities.

Saving the lives of mothers and newborns is the key objective – one that everyone can agree on, Makinwa said. But in the process, the initiative will spawn a host of other improvements. "It's not a standalone agenda. Maternal mortality is tied to so many things: economic development, social interactions, young people, HIV prevention, family planning, health system strengthening, coordination – all can be improved when we focus on saving women's lives as an entry point."

The high incidence of maternal death in Africa must change, he added. "It's really sad that one of the worst things that could happen to a woman in Africa is being pregnant."