September 25, 2014

A Price Too High to Bear: The Costs of Maternal Mortality to Families and Communities

Written by Amy Boldosser-Boesch, Interim President, Family Care International

During the UNGA this week, many partners are committing to deliver on promises to accelerate progress on MDGs 4 and 5. There has also been a renewed focus on the importance of solid data to track progress on reproductive, maternal, newborn and child health and to hold governments and other stakeholders accountable for meeting their commitments. New research conducted in Kenya by Family Care International (FCI), the International Center for Research on Women (ICRW), and the KEMRI-CDC Research and Public Health Collaboration has the potential to increase the momentum of efforts to save the lives of nearly 300,000 women who die each year (5,500 of them in Kenya) from causes related to pregnancy and childbirth.

Each of these avoidable, premature deaths is a tragedy in its own right, and a terrible injustice. Each of these women — some of them barely more than girls — has a right to life and health, and to a standard of health care that protects her from preventable illness, injury, and death.

But we who work to improve maternal health have argued for years that each of these deaths also brings countless additional layers of loss, pain, and destruction. The tragic, sudden death of a woman in the prime of life — in many cases already a mother and often the most economically productive member of the family — begins a cascade of loss and pain that upends the lives of those around her: her newborn baby (if it survives) and her older children, husband, parents, and other members of her family and community. The cost of a maternal death is, quite literally, a price too high to bear.

This new study provides urgently needed data to help persuade governments, donors, and policy makers that investments in women’s health and maternal health are also investments in newborns and children, in stable families, in education and community development, in stronger national economies and, ultimately, in sustainable development.

Based on interviews and focus group discussions with families, across a poor rural area in Siaya County in western Kenya, that had lost a family member to maternal death over a two-year period, we found that:

• When a mother dies in or around childbirth, her newborn baby is unlikely to survive.
  Of 59 maternal deaths in the study, only 15 babies survived their first two months of life.
• A mother’s death harms the educational and life opportunities of her surviving children.
  Many children had to leave school because the loss of a mother’s income meant that they couldn’t pay tuition fees, needed to work for a living, or had to take up essential household chores.
• The cost of emergency care (even when unsuccessful), combined with high funeral costs, puts families under a crushing economic burden.
  Families spent more on funerals than their total annual expenditure on food, housing, and other household costs, after having already spent 1/3 of their annual consumption expenditure on medical costs.
• Loss of income and high, unexpected costs send many families into a spiral of debt, poverty, and instability.
  Many families, under desperate financial pressure, had to sell household property, borrow from moneylenders, or move children out of the family home.

At the national launch of the research findings, Kenya’s Cabinet Secretary for Health, Hon. James Macharia, said, “A mother’s death ignites a chain of disruption, economic loss, and emotional pain that often leads to the death of her baby, diminished educational and life opportunities for her surviving children, and a deepening cycle of poverty for her family.” As the MDG deadline approaches and the post-2015 development agenda is defined, we hope this research will help to catalyze renewed commitment to ending preventable maternal mortality, so that no woman has to pay the high price of losing her life, and so that families, communities and nations no longer have to bear the burden of maternal death.

Learn more: Harvard’s FXB Center for Health and Human Rights, Family Care International (FCI), and the International Center for Research on Women (ICRW) will host Women’s Lives Matter: The impact of a maternal death on families and communities, a live webcast on October 7th, 2014 (2:30 – 3:30 PM EDT). The webcast will feature research findings from the Kenya study as well as those from four other African countries which document the dramatic economic and social impacts of a maternal death. Panelists will also discuss opportunities and strategies for using these important findings to advocate for political commitment, policy change, and sustained investment in reproductive, maternal, and newborn health in the context of the evolving post-2015 global health and development agenda.

More information on the webcast and subsequent Q&A: http://bit.ly/WomensLivesMatter