Women’s Health and Rights Advocacy Partnership (WHRAP) – South Asia
South Asia women’s rights advocates meet in Kathmandu push for the context specific implementation of the Continuum of Care for Maternal, Adolescent, Newborn and Child Health
16 – 22 December, 2011
Women’s Health and Rights Advocacy Partnership (WHRAP) South Asia brings together women led organisations and other civil society actors for evidence based advocacy on Sexual and Reproductive Health and Rights (SRHR) through strengthened civil society engagement and accountability for health governance.
WHRAP-South Asia is implemented as a partnership program between the Danish Family Planning Association (DFPA); AsianPacific Resource and Research Centre for Women (ARROW); Beyond Beijing Committee (BBC) in Nepal; Naripokkho in Bangladesh; Shirkat Gah in Pakistan; Centre for Health Education, Training and Nutrition Awareness (CHETNA); and SAHAYOG in India.
The South Asian sub-region accounts for a substantial part of preventable maternal deaths in the world. Despite progress in the region, maternal mortality estimates continue to remain high. Maternal Mortality Ratios (MMR) according to national statistics estimated for Bangladesh are 194, India 230, Nepal 281, and Pakistan 260. Ensuring Continuum of Care across time (pre pregnancy to post partum/ postabortion) and across place (home, community and health facilities) is important to reduce maternal, newborn and child mortality and improve maternal and newborn health. Women and adolescent girls have the right to services to help them to plan and space their pregnancies and to avoid or treat sexually transmitted infections.
However, based on evidence from the ground WHRAP South Asia believes that the push for achieving MDG 5 through a continuum of care framework centering on increasing the number of women who have access to skilled attendance at birth is leaving out home deliveries. Consequently this approach has led to an increased focus on Institutional Delivery rather than on Safe Delivery. Data from Pakistan, India, Bangladesh and Nepal demonstrate that due to the shortfall of health budgets and skilled health personnel; as well as the lack of strong health systems; the singular focus on institutional delivery will not always ensure comprehensive maternal health. In addition, multiple levels of discrimination and marginalization are experienced by women and adolescent girls within communities where the Maternal Mortality Ratio is highest. These are also communities that are invariably linked with poverty, lack of access to education; under nutrition and issues of food security.
WHRAP-South Asia believes that Healthcare for all is responsibility of the state. A comprehensive Continuum of care approach will ensure access to information and care at all stages of pregnancy, given the difficulties faced by women in accessing affordable skilled care. Consequently a continuum of care framework must call for availability and access to essential health and reproductive services that should be affordable and acceptable for women from adolescence through pregnancy, delivery, and beyond; as well as for newborns and children.