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NICARAGUA
Controversy Over
Pregnancy-Related Death Toll
By José Adán Silva
MANAGUA (IPS) - Non-governmental
organisations in Nicaragua are
questioning data on the maternal
mortality rate released by the
government, which is claiming a historic
decline in the indicator, and they warn
that the reduction target that the
country has committed itself to by 2015
is still out of reach.
Miriam Chávez, the Health Ministry's
head of nursing, reported that Nicaragua
had achieved a reduction of the maternal
mortality rate to 90 per 100,000 live
births in 2009, by means of a campaign
sending health brigades to work among
the poor.
Health Ministry statistics indicate that
in 2007, the first year of the
administration of leftwing President
Daniel Ortega who took office that
January, there were 107 maternal deaths
per 100,000 live births, and that in
2008 the number was 94.
The health authorities forecast that by
the end of 2010, the maternal mortality
rate will be reduced by up to 25
percent, giving a rate of 70 maternal
deaths per 100,000 live births.
In 2006, the year before Ortega began
his second term - he previously governed
from 1985 to 1990 - the maternal
mortality rate was 140 per 100,000 live
births.
Chávez attributed the achievement to
government health promotion measures,
like sending medical brigades to the
most isolated and vulnerable parts of
the country, creating 72 maternity homes
and training the nursing personnel of
the Local Comprehensive Healthcare
System.
She told IPS that her office has already
trained 394 obstetric nurses to care for
women during pregnancy and labour in the
poorest rural areas and those furthest
away from the towns. "By the end of this
year, we will have 500 trained obstetric
nurses," she said.
Nicaragua is one of the poorest
countries in Latin America, with 47
percent of the population living on less
than two dollars a day.
This Central American country has a
population of 5.7 million, of whom more
than one million are living in extreme
poverty, with incomes of less than one
dollar a day, according to official
statistics from the National Institute
for Development Information (INIDE).
In 2000, the United Nations member
countries adopted the eight Millennium
Development Goals (MDGs), to be met by
2015.
The eight MDGs, with quantifiable
targets, seek to eradicate extreme
poverty and hunger, achieve universal
primary education, promote gender
equality and women's empowerment, reduce
child mortality, improve maternal
health, combat HIV/Aids, malaria and
other major diseases, ensure
environmental sustainability and develop
a global partnership for development.
On the basis of this platform, each
country has its own national goals.
Nicaragua committed itself to reducing
the maternal mortality rate from the
1999 level of 90 per 100,000 live
births, down to 27 in 2015.
According to Francis Bustos, an
independent clinical pathology
researcher, the official figure
announced this month "seems hard to
believe."
"The government's figures contrast with
the World Health Organisation's (WHO)
global health statistics for 2009, which
say Nicaragua's maternal mortality rate
is 170 per 100,000 live births, higher
than the 1999 average for the Americas,"
said Bustos.
In her view, the true figure may be
higher than the official statistics
indicate. "Every year, the Health
Ministry records approximately 400 cases
of ectopic pregnancy, one of the main
causes of maternal deaths," she said.
"And if we consider the approval of the
law banning therapeutic abortions ,
which forces many families to avoid the
health system, it would imply a possible
increase in maternal deaths" that are
not being registered, she said.
Passage of the 2006 law made Nicaragua
one of the few countries in the world
where abortion is illegal under all
circumstances, even in cases where the
mother's life is in danger or the fetus
is deformed.
In contrast, Débora Grandison, Special
Ombudsperson for Women, endorsed the
official statistics and said the
government has made efforts to improve
maternal health indicators.
"I think there has been an improvement,
making a small difference in the
figures, perhaps, but representing a
great effort. Access to healthcare and
treatment for women has improved, but
there is still much to be achieved" in
terms of the fifth MDG - reducing by
three-fourths the number of maternal
mortality cases - she said.
Juanita Jiménez, of the non-governmental
Autonomous Women's Movement, rejected
the maternal mortality figures reported
by the government.
"Ever since they stopped posting
up-to-date data on the Ministry's web
page and started handling the figures as
if they were state secrets, I lost all
faith in the official information," she
told IPS.
In Jiménez's view, the low mortality
rate announced by the government is an
attempt to counteract international
disapproval of the banning of abortion
in any circumstances.
"There has been strong international
pressure to reinstate therapeutic
abortion, and one way or another the
government is seeking to improve its
image (with these new data)," the
activist complained.
Fátima Millón, of the Central American
organisation Network of Women against
Violence (RMCV), expressed doubts about
the new official maternal mortality
statistics.
"The government generally tells lies,
hides and manipulates figures when it
doesn't want them to become public
knowledge, so I doubt that it's true,"
she told IPS.
Millón accepts figures provided by the
New York-based international
organisation Human Rights Watch, which
estimated this year that in Nicaragua,
170 women die per 100,000 live births. |
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