The failure to provide adequate health care during pregnancy and delivery has resulted in obstetric complications becoming the main cause of death and disability of women of reproductive age in the developing world.

United Nations Family Planning Association (UNFPA) deputy executive director Kunio Waki said this problem has affected Asia and Africa most severely, with 95 percent of all maternal deaths occurring in these two continents.

"Studies show that poor maternal health is dramatically reducing the capacity of women to work and thereby constraining their ability to generate income and get out of poverty," he said at the 3rd Global Conference on Averting Maternal Death and Disability (AMDD) in Kuala Lumpur this morning.

The tragedy, said Waki, is that almost all maternal deaths can be avoided if the women are provided with greater access to emergency obstetric care.

"Today, many women die because they do not seek or receive emergency medical care or their complications are not properly diagnosed. All women need skilled attendants, whether trained midwives, nurses or doctors...and they need transportation to nearby health facilities," he noted.

Waki said that another vital intervention required is family planning, because it reduces the incidence of high-risk pregnancies.

"Unsafe abortion alone is responsible for an estimated 78,000 maternal deaths each year or about 16 percent of all deaths.

"Young women are particularly vulnerable. Teenage girls between the ages of 15 and 19 account for at least a quarter of the estimated 20 million unsafe abortions performed each year."

Neglected systems

AMDD programme director Deborah Maine said the three-day conference, with over 300 delegates from more than 50 countries, marked a milestone in efforts to reduce maternal mortality worldwide - a UN Development Programme 'Millenium Development Goal'.

Maine said the key focus of the programme was to enable governments and non-government organisations to work together to identify ways in which national heath care systems could be improved.

"In essence, the AMDD network is made up of active partnerships built around the central fact that once women are pregnant, most serious obstetric complications cannot be predicted or prevented but can be treated," she said.

Consequently, all projects should focus on ensuring that pregnant women have access to medical treatment when complications arise.

"In developing countries today, health systems are often so neglected, dilapidated and dysfunctional that no one wants to touch them...Health systems consume large amounts of government resources but the people who pay for this often get little benefits," she said.

A way of dealing with this, said Maine, would be for governments to improve facilities, staff skills as well as human resources distribution.

She urged participants to consider adopting ideas proven to be successful in projects that have been underway for several years in countries such as Pakistan, Bangladesh, Bhutan and Rajasthan state in India.

The AMDD programme was established in 1999 at the Columbia University Mailman School of Public Health with a US$50 million grant from the Bill and Melinda Gates Foundation.

Partners in the global movement includes the UNFPA, the UN Children's Fund (Unicef), the Regional Prevention of Maternal Mortality Network, the Reproductive Health for Refugees Consortium and non-government organisations CARE and Save the Children.