Activists are calling for massive funding for midwife training in the more vulnerable parts of the world to reduce death of women at childbirth.
Half a million women die in childbirth each year, entirely unnecessarily - nearly all of these deaths could be prevented if only women have access to a skilled birth attendant.
AdvertisementThe Millennium Development Goals, agreed at the UN summit in 2000, set a target of cutting maternal mortality in the developing world by a third, by 2015.
"But halfway to the deadline, we are badly behind. The G8 leaders must get us back on track. They must commit to investing in countries where rates of maternal mortality are highest," stressed Carolyn Miller, chief executive of the medical aid agency Merlin, while talking to BBC.
The leaders of the world's richest countries at the G8 summit have an opportunity to change this, she said. The call comes as the summit opens in Tokyo.
The key to reducing rates of maternal mortality is increasing access to good health care, it is pointed out.
Rates of maternal mortality are directly associated with attendance of skilled birth attendants. Countries with the lowest maternal mortality report over 98% attendance by a skilled birth attendant. Those with the highest rates of maternal mortality report less than 60% attendance.
Without a trained, experienced midwife on hand, women are more likely to die from complications including bleeding, infection, unsafe abortion, high blood pressure and prolonged or obstructed labour.
Nearly half of the women who die in childbirth each year live in 46 fragile states - countries where the government is unable or unwilling to support the needs of its people.
Whether emerging from a decade of civil war or recovering from famine or disease, these countries have limited resources.
Only by committing to improving maternal mortality in times of crisis as well as stability can one reduce the number of women who die in childbirth.
A survey recently completed by the Johns Hopkins University in Baltimore found that up to 40,000 infants are saved each year across Afghanistan due to the increased presence of skilled birth attendants.
Fragile states do receive funding. In 2006 they received $12bn (Ģ6bn) of overseas aid and the levels have increased over time.
However, nearly half of this was dedicated to Sudan and Afghanistan, leaving the remaining 44 fragile states to split the rest between them. The Central African Republic received just $600m.
In the Central African Republic, maternal mortality levels stand at 1,100 per 100,000 live births, among the highest in the world. Not surprising when you consider that in one district there is just one midwife for 55,000 people.
More than a decade of insecurity has led to chronic neglect of the health care system.
Staff have not been paid for months. Health centres are crumbling. Drugs are in short supply. People have to pay for health care and women will often have to travel for miles to receive the care they need.
As food prices rise around the world, many will have to decide whether to feed their family or pay to see a midwife.
It is often a choice between life and death.
With dedicated long-term funding, NGOs such as Merlin can make a difference.
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