LONDON, Dec - Boosting water and sanitation investments in hospitals and clinics in low income countries is essential to reduce maternal and newborn deaths, according to research published on Friday.
Many women in developing countries give birth at home, often without access to clean water and toilets, exposing themselves and their babies to infections.
But even health facilities may not guarantee safe delivery as some do not have adequate services, researchers wrote in the medical journal PLOS Medicine, calling on governments to address the problem to save lives.
"We have known since Victorian times about the importance of clean water and good hygiene in birth. Yet today tens of thousands of mothers will be giving birth in places where doctors and midwives, if present, do not have access to clean water," Yael Velleman, senior policy analyst at charity WaterAid, said in a statement.
"The process of giving life should not mean unduly risking death."
Although maternal mortality worldwide has dropped by 50 percent in the last two decades, 289,000 women died from complications related to pregnancy and childbirth in 2013, according to the World Health Organization (WHO).
Almost all of those deaths occurred in developing countries, where some 38 percent of healthcare facilities are without an improved water source, according to WHO figures.
Poor access to water and sanitation is associated with higher levels of maternal mortality, therefore improving access in those facilities would rapidly reduce the number of women dying in childbirth, researchers wrote in their paper.
Clean water is essential to prevent sepsis or cord infections, and limit transmission of diseases. It is also needed for medical staff to wash their hands and clean instruments.
Current efforts to improve birth conditions in low income countries - following specific maternity care measures, strengthening health systems and increasing the number of women who give birth in hospitals and clinics - can be undermined without improved access to water and sanitation, said the paper.
"Nearly half of women (who die from childbirth in Tanzania) are giving birth at home, and almost none of these homes have clean water and basic sanitation," said Lena Benova of the London School of Hygiene and Tropical Medicine.
"But women cannot be expected to go to a health facility to deliver if it is dirty."
The authors of the paper - from the London School of Hygiene and Tropical Medicine, WHO, UNICEF, U.N. Population Fund and WaterAid - said that in the new post-2015 development goals, maternal and newborn health must be linked with access to water, sanitation and hygiene in order to be successful.
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