The deadline for the attainment of a certain minimal level of development, encapsulated in the Millennium Development Goals is fast approaching. As a consequence of decades of meetings at conferences under the auspices of the United Nations, world leaders in September 2000, came together at United Nations Headquarters in New York to adopt the United Nations Millennium Declaration, committing their nations to a new global partnership to fast-track development across the world. The leaders set out certain basic and measurable development targets to be achieved within 15 years. These targets became known as the Millennium Development Goals and they included the eradication of extreme poverty and hunger (MDG 1); universal access to primary education (MDG 2); equal rights to be guaranteed for both men and women (MDG 3); sharp reduction child mortality (MDG 4) and significant reduction in maternal mortality (MDG 5) amongst others.

The leaders set out certain basic and measurable development targets to be achieved within 15 years. These targets became known as the Millennium Development Goals and they included the eradication of extreme poverty and hunger (MDG 1); universal access to primary education (MDG 2); equal rights to be guaranteed for both men and women (MDG 3); sharp reduction child mortality (MDG 4) and significant reduction in maternal mortality (MDG 5) amongst others.

Many countries across the world including Ghana have done extremely well in terms of attaining some of the MDGs. Ghana, for instance, attained MDG 1, i.e cutting extreme poverty and hunger by half long before the target date of 2015. Significant progress has been made in the area of primary education and fundamental rights for both men and women are guaranteed and safeguarded in this country.

The picture however looks disturbingly grim when one looks at the rate of success in achieving MDGs 4 and 5 which deal with child and maternal mortality respectively. Undoubtedly, noticeable progress has been made in the area of child mortality and maternal mortality since the 1990s. This progress has not come about accidentally; it has been on account of policies implemented by various governments. 

They include but not limited to:
    Maternal deaths notification
    Midwives authorized to provide all seven life-saving tasks
    Home visits within the first week of giving birth

These policies have enhanced access to healthcare by pregnant women and a number of life-saving steps. For instance, now nearly 90 per cent of pregnant women attend antenatal care at four or more times while about 70 percent of births are attended to by skilled birth attendants. Also, close to 90 percent of newborns are immunised against measles.

These policy measures and their resultant increase in access to care, has clearly reduced the number of children and mothers who died in childbirth. For example, Ghana's Maternal Mortality Ratio (MMR) has declined by 49 percent between 1990 and 2013 (from 760/100,000 live births in 1990 to 380/100,000 live births in 2013).
About 63.1 percent of deliveries were attended to by Skilled Birth Attendants in 2013 compared to 60.3 percent in 2010. This shows continuous progress.
The global picture also looks encouraging as latest figures released by the Maternal Mortality Estimation Inter-Agency Group, which comprises of the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), the United Nations Population Division (UNPD) and The World Bank, together with a team at the National University of Singapore and University of California at Berkeley, indicate that global maternal mortality has reduced by 45% between 1990 and 2013.According to the report, in 2013 an estimated 289 000 women died due to complications in pregnancy and childbirth, down from 523 000 in 1990.
Despite these encouraging figures, buried in them is the rather grim reality that many countries across the world in general and Ghana in particular may not achieve the target of significantly reducing child mortality and maternal mortality by next year. Available figures speak eloquently to this fact. The targets as they pertain to Ghana are that Ghana should, by the year 2015, record 40 or fewer deaths per 1000 live births, i.e. the number of children who die before their fifth birthday should not exceed 40 in every one thousand live births.

However, according to Child Mortality Estimates, the U-5 Mortality rate in Ghana stood at 82 per 1000 live births in 2011and an estimated 63 newborns (babies who die before their 28thday) die every day; more than twice the figure the country is expected to attain by next year.
Ghana’s MDG target for maternal mortality is 145 per 100,000 and according to the MMEIG, this currently stands at 380 per 100,000 live births. Meaning, a woman in Ghana has 1 in 68 lifetime risks of dying from a maternal cause.

These figures in fact are not surprising because despite the existence of a national plan for MNCH and the availability of all recommended life-saving commodities for reproductive health, critical information on the use of these life-saving commodities for maternal and newborn health does not exist and only 37% of the recommended minimum of Emergency Obstetric Care services was available in 2011.

Even worse, only 10 percent of total government expenditure was spent on health in 2012. This is below the Abuja target of at least 15 percent. It gets even more disturbing when one considers the fact that large chunks of this expenditure are not investments but simply recurrent expenditures.

The situation is compounded by challenges in accessibility to healthcare. The State of the World’s Midwifery report released in 2014  shows that the number of available health workers can only meet a third of the population’s need for reproductive, maternal and newborn health services. Furthermore, access to skilled birth attendance is very unequal; while 59% of pregnancies take place in rural areas, births are much less likely to benefit from skilled birth attendance.

This is precisely the reason why the figures on maternal and child mortality look ugly in some respects and the prospects of attaining MDGs 4 and 5 bleak. 
Due partly to the challenges stated in the preceding paragraphs, 3,100 women died from pregnancy-related complications in 2013 alone in Ghana. Maternal and newborn mortality campaigners, MamaYe, quote the World Health Organisation as saying MMR in 2013 was 380 deaths per 100 000 live births, a far cry from the target of 145 per 100,000 live births.

The situation in Ghana is a reflection of the general situation in Sub-Saharan Africa which has been identified as the region with the highest MMR (510), accounting for 62% (179 000) of global maternal deaths.The MMR in developing regions (230) is 14 times higher than in developed regions (16).
Some African countries are however ‘on track’ to meet MDG5. They are: Equatorial Guinea, Cape Verde, Eritrea and Rwanda. Ghana obviously is not one of them.

The situation is so urgent that civil society, medical practitioners and most importantly, the media need to get involved in the campaign to pressurize government to make the needed investment to cut down the numbers. It is a stain on the collective conscience of all Ghanaians and a travesty to have women die during childbirth and through preventable causes. It is equally shameful that babies die within weeks of their birth. This cannot be acceptable in any civilized society.
Musician Nana Wiafe Asante Mensah, known in showbiz as ASEM could not have put it better in his inspirational song on the subject when he said “The woman is the heartbeat of every nation so this is not an issue for procrastination.”

Government can no longer dither on this matter. It was Mahatma Ghandi who said “A nation's greatness is measured by how it treats its weakest members." We owe a duty to protect the most vulnerable in your society.

See the video of the song here