Source: Tanzania Daily News
MATERNAL mortality and morbidity remain a critical global problem. In 2010, estimates suggests that globally there were 287,000 maternal deaths-- down from 543,000 in 1990.
This is a 47 per cent decrease, but obviously not enough. Only one country has met MDG 5 namely Equatorial Guinea) and two are on track to meet by 2015, Eritrea and Eqypt.
In contrast, Botswana, Cameroon, Chad, the Congo, Lesotho, Somalia, South Africa, Swaziland and Zimbabwe saw maternal mortality rise since 1990.
Vast majority are due to preventable causes like unsafe abortion that need minimal cost to address.
The Ipas Africa Alliance Senior Policy Advisor, Ms Naisola Likimani said recently at a regional workshop that globally unsafe abortion contributes 13 per cent of all maternal deaths and is the fourth largest cause of maternal deaths.
"However in Africa the WHO estimates that up to 40 per cent of maternal deaths are caused by unsafe abortions accounting to over a third! So this is not an issue we can afford to ignore in our region and in our countries," she said.
Unsafe abortion is a procedure for terminating an unplanned, unwanted pregnancy performed by individuals without the necessary skills, or in an environment that does not conform to the minimum medical standards, or both.
Ms Likimani said that unsafe abortion is expensive for affected women and their families and consumes large amounts of national health resources.
Citing statistics from the WHO, in 2006 Sub Saharan Africa incurs a total of 117 million US Dollars annually to treat cases of unsafe abortion.
"Imagine if we could apply this amount of money to other health activities or to improve the health of women, rather than spend it on treating complications from unsafe abortions.
Evidence in Tanzania shows that as the need increases for safe abortion services in the country, more and more women from the lack of them are using life threatening methods to get rid of unplanned pregnancies.
An impeccable source from the Muhimbili National Hospital who preferred anonymity exclusively told the 'Daily News on Saturday' that the use of fresh cassava stems is fast becoming a popular method among women that can't afford good services.
"I conducted a study for my PhD thesis on unsafe abortion and found that over 40 per cent of women admitted in the maternal ward due to delivery complications were due to abortions gone wrong," the source said.
The gynaecologist said that cassava stems are used because they are able to suck up the fluid in the womb causing the foetus to drop.
The stem is sharply pierced into the vagina and on many occasions injurs the woman temporary though there are cases when the injury is permanent and even fatal.
According to the World Health Organisation, 21.6 million women experience an unsafe abortion worldwide each year; 18.5 million of these occur in developing countries. An estimated 47,000 women die from complications of unsafe abortion each year. Deaths due to unsafe abortion remain close to 13 per cent of all maternal deaths.
"Over the years I have seen many horrifying cases of abortions gone wrong and it is high time that safe services are provided. As a Christian, I am not advocating for the legalisation of abortion but a woman should have the right to want and not want a child," the source said.
A social worker operating at the Mwananyamala hospital, Ms Nayla Magotti concurs with the source in the increase of cassava stems as well as drinking washing detergents, consuming crashed pieces of glass and swallowing prescription drugs.
Ms Magotti said that back door unqualified doctors are minting thousands of shillings on a daily basis from conducting unsafe induced pregnancy terminations from women who cannot afford to use specialised doctors from recognised hospitals in the country.
Ms Mary John (not her real name) admitted to this paper that she had aborted more than twice and that it wasn't an experience she would recommend to another woman but circumstances forced her to do so.
"If I had the money (300,000/-) I would have sought a better doctor but I was forced to use a 50,000 'doctor' who obviously didn't know much what he was doing.
The experience is very humiliating and I needed bed rest for up to two weeks to fully regain my strength," she narrated. Statistics made available to this paper by the United Nations Population Fund (UNFPA) state that of the 529,000 women who die annually from pregnancy related causes, about 13 per cent (one in eight maternal deaths, or 68,000) are related to complications of unsafe abortion.
"Since some 13 per cent of maternal deaths globally are due to unsafe abortion, its impact on women's health, lives and well-being should be addressed, as agreed at the Cairo Conference. Post-abortion care should be provided.
Where abortion is legal, national health systems should make it safe and accessible, as agreed by United Nations Members," says UNFPA Representative, Ms Mariam Khan. In Tanzania unsafe abortions are responsible for 9 per cent of maternal deaths.
The 2003 populationbased adult morbidity and mortality study (AAMD) which was conducted in Hai, Kilimanjaro, Morogoro and Dar es Salaam showed that unsafe abortions contributed to between 9 per cent and 31 per cent of maternal deaths.
There is a growing recognition at the global level and within developing countries that access to comprehensive reproductive health services must include access to abortion - and removing legal barriers to safe abortion not only protects women's health, but restores their dignity and vindicates their basic human rights.
While it is difficult to get the exact amount of money that is going into Post Abortion Care (PAC) in the country, there are a couple of things that remain as facts.
Abortion is illegal in Tanzania with restrictions like the case of many other countries in the world but Tanzania has ratified a number of international conventions like the Plan of Action on Sexual and Reproductive Health and Rights (Maputo Plan of Action) that stresses on addressing the sexual and reproductive health needs of adolescents and youth, addressing unsafe abortion and delivering quality and affordable services in order to promote safe motherhood, child survival, maternal, newborn and child health.
The Addis Ababa Declaration on Population and Development in Africa beyond 2014 which Tanzania is also a signatory committed to harmonise national legislation with ratified international instruments and accelerate the implementation of the respective national, regional and international commitments on gender equality and women's empowerment in all sectors and eliminate all forms of discrimination against women and girls.
The Continental Policy Framework on Sexual and Reproductive Health and Rights and the Maputo Plan of Action for its implementation, remain key tools for Africa to attain MDGs 4 and 5 in the period running up to 2015.
The Campaign on Accelerated Reduction of Maternal, Newborn and Child Mortality in Africa (CARMMA) serves as a critical advocacy platform for improvement of maternal, newborn and child health in Africa. CARMMA has motivated significant national ownership, having been launched by 37 AU Member States.