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Mothers and children matter - so does their health
Most pregnant women hope to give birth safely to a baby that is alive and well and to see it grow up in good health. Their chances of doing so are better in 2005 than ever before - not least because they are becoming aware of their rights. With today’s knowledge and technology, the vast majority of the problems that threaten the world’s mothers and children can be prevented or treated. Most of the millions of untimely deaths that occur are avoidable, as is much of the suffering that comes with ill-health. A mother’s death is a tragedy unlike others, because of the deeply held feeling that no one should die in the course of the normal process of reproduction and because of the devasta-ting effects on her family (
). In all cultures, families and communities acknowledge the need to care for mothers and children and try to do so to the best of their ability.
An increasing number of countries have succeeded in improving the health and well-being of mothers, babies and children in recent years, with noticeable results. However, the countries with the highest burden of mortality and ill-health to start with made little progress during the 1990s. In some, the situation has actually worsened in recent years. Progress has therefore been patchy and unless it is accelerated significantly, there is little hope of reducing maternal mortality by three quarters and child mortality by two thirds by the target date of 2015 - the targets set by the Millennium Declaration (
In too many countries the health of mothers and children is not making the progress it should. The reasons for this are complex and vary from one country to another. They include the familiar, persistent enemies of health - poverty, inequality, war and civil unrest, and the destructive influence of HIV/AIDS - but also the failure to translate life-saving knowledge into effective action and to invest adequately in public health and a safe environment. This leaves many mothers and children, particularly the poorest among them, excluded from access to the affordable, effective and responsive care to which they are entitled.
For centuries, care for childbirth and young children was regarded as a domestic affair, the realm of mothers and midwives. In the 20th century, the health of mothers and children was transformed from a purely domestic concern into a public health priority with corresponding responsibilities for the state. In the opening years of the 21st century, the Millennium Development Goals place it at the core of the struggle against poverty and inequality, as a matter of human rights. This shift in emphasis has far-reaching consequences for the way the world responds to the very uneven progress in different countries.
1 1.Loudon I. Childbirth. In: Bynum WF, Porter R, eds. Companion encyclopedia of the history of medicine. London and New York, NY, Routledge, 1993:1050-1071.
2 Haines A, Cassels A. Can the Millennium Development Goals be attained? BMJ, 2004, 329:394-397.
3 Nullis-Kapp C. The knowledge is there to achieve development goals, but is the will? Bulletin of the World Health Organization, 2004, 82:804-805.
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