People's Stories Equality

We are failing to deliver quality care to the poorest and most vulnerable mothers
by UNICEF Executive Director Henrietta Fore
June 2019
More than 5 million families across Africa, Asia, and Latin America and the Caribbean spend over 40 per cent of their non-food household expenses on maternal health services every year, UNICEF said today in a new analysis on maternal health.
Nearly two-thirds of these households, or around 3 million, are in Asia while approximately 1.9 million are in Africa. According to the analysis, the costs of antenatal care and delivery services can deter pregnant women from seeking medical attention, endangering the lives of mothers and their babies.
“For far too many families, the sheer costs of childbirth can be catastrophic. If a family cannot afford these costs, the consequences can even be fatal,” said UNICEF Executive Director Henrietta Fore. “When families cut corners to reduce maternal health care costs, both mothers and their babies suffer.”
The report notes that although much progress has been made around the world in improving women’s access to maternal services, every day over 800 still die from pregnancy-related complications. At least 7,000 stillbirths also occur every day, half of these babies who were alive when labor began, and 7,000 babies die in the first month of life.
The reality is stark for the poorest women. Across South Asia, three times as many rich women receive four or more antenatal care visits than women from poorer families. When it comes to women giving birth at a facility, the gap between the poorest and the richest is more than double in West and Central Africa.
Doctors, nurses and midwives play a critical role in saving mothers, yet millions of births occur every year without a skilled attendant. According to the analysis, from 2010 to 2017, the coverage of health personnel increased in many countries. However, the increase in coverage has been minimal in the poorest countries where maternal and neonatal mortality levels were the highest.
For example, from 2010 to 2017, coverage increased from 4 to 5 health workers per 10,000 people in Mozambique, and from 3 to 9 in Ethiopia. In Norway that number increased from 213 to 228 health personnel per 10,000 people over the same period.
The report also notes that globally, pregnancy-related complications are the number one cause of death among girls between 15 and 19 years of age. Because adolescent girls are still growing themselves, they are at great risk of complications if they become pregnant. In addition, their children are at higher risk of dying before their fifth birthday.
Yet the report finds that child brides are less likely to receive proper medical care while pregnant or to deliver in a health facility, compared to women married as adults.
Typically, child brides end up having many children to care for, often more than women who marry as adults, thwarting their own life chances while increasing the overall financial burden on their families.
In Cameroon, Chad and the Gambia, over 60 per cent of girls aged 20-24 who married before turning 15 had three or more children, compared to less than 10 per cent of women at the same age who married as adults.
“We are failing to deliver quality care to the poorest and most vulnerable mothers,” said Ms. Fore. “Too many mothers continue to suffer endlessly, especially during childbirth. We can stop this suffering and save millions of lives with a safe pair of hands, functional facilities and better quality of care before, during and after their pregnancy.”
UNICEF’s Every Child ALIVE, a global campaign to demand and deliver solutions on behalf of the world’s newborns, is calling on governments, health care providers, donors, the private sector, families and businesses to keep every mother and child alive by:
1. Investing financial resources in health systems, starting at the community level;
2. Recruiting, training, retaining and managing sufficient numbers of doctors, nurses and midwives with expertise in maternal and newborn care;
3. Guaranteeing clean, functional health facilities equipped with water, soap and electricity, within the reach of every mother and baby;
4. Making it a priority to provide every mother and baby with the life-saving drugs and equipment needed for a healthy start in life; and
5. Empowering adolescent girls and families to demand and receive quality care.

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You can and should do more to include people with disabilities young advocate tells Security Council
by International Disability Alliance, agencies
Apr. 2019
‘You can and should do more’ to include people with disabilities, young Syrian disability advocate tells UN Security Council.
The Council was told that people with disabilities “can’t wait any longer” for more of a say in how their needs are recognised in its work.
The passionate appeal from 20-year-old wheelchair-bound Syrian refugee, Nujeen Mustafa, who briefed the Council on the acute vulnerabilities of people with disabilities in conflict and disaster situations, describing how once war began in her home city of Aleppo, she lived with the intense fear that she would be responsible for her own family dying in an airstrike.
“Every day, buildings in our neighbourhood were bombed, leaving people trapped beneath the ruins. Every day, I feared that I could be the reason my family was one or two seconds late. My brother called us the walking dead”, she said to the hushed chamber.
Even fleeing the country, she had to be carried out of the country by her siblings, as she had no wheelchair at the time.
“The structure of supports that people with disabilities rely on, is broken down during conflict, leaving us at higher risk of violence and with more difficulties in getting assistance – especially for women”, said the cerebral palsy sufferer.
She said she had three key insights to deliver. Firstly, the crisis in Syria has a “disproportionately high impact” on people like her. Secondly, she said that people with disabilities “like women and girls, seem to be an afterthought”. Finally, she noted that people with disabilities should always be treated as “a resource, not a burden”.
“Count us, because we count too”, said Ms. Mustafa, urging better data collection on how they cope in conflict. “This should not be just another meeting where we make grand statements and then move on...You can and should do more, to ensure that people with disabilities, are included in all aspects of your work – we can’t wait any longer”, she told Council members.
Briefing members on the latest humanitarian situation across Syria, deputy UN Emergency Relief Coordinator, Ursula Mueller, said that over eight years, civilians had endured a “litany of horrors” with those in the northeast and northwest, living in fear “of yet another humanitarian catastrophe unfolding”. More than eight in 10 people in Syria live below the poverty line and nearly 12 million Syrians depend on assistance.
Apr. 2019
Disability Rights Activist urges stronger, Inclusive Humanitarian Action by UN Security Council
The Syrian disability rights activist Nujeen Mustafa will brief the United Nations Security Council on April 24, 2019, on the situation for people with disabilities in Syria, Human Rights Watch said today. It will be the Security Council’s first formal consideration of the rights of people with disabilities who are caught up in armed conflict.
Mustafa, 20, will be the first person with a disability to formally brief the Security Council, and one of very few Syrians given such an invitation since the Syrian conflict began in 2011. She fled Syria when she was 16 and has since travelled the world to advocate for governments and UN agencies to include people with disabilities in the humanitarian response. The Security Council should urgently act to improve the protection of people with disabilities in armed conflict, Human Rights Watch said.
“The UN Security Council has a duty to protect all civilians in armed conflict, including people with disabilities,” said Shantha Rau Barriga, disability rights director at Human Rights Watch.
“Nujeen Mustafa’s briefing to the Security Council should prompt council members, the UN leadership, and all UN member states to ensure that their humanitarian commitment to ‘Leave no one behind’ is not just rhetoric.”
Mustafa has cerebral palsy and cannot walk independently. Mustafa is the recipient of Human Rights Watch’s 2019 Alison Des Forges Award for Extraordinary Activism.
The Syrian conflict, now in its eighth year, has been characterized by widespread and serious violations of international human rights and humanitarian law by all parties to the conflict, including indiscriminate attacks, the use of prohibited weapons, and restrictions on humanitarian aid. Nearly six million people have fled the hostilities, often taking arduous and life-threatening journeys to reach safety.
People with disabilities are among the most at-risk in humanitarian emergencies. As shelling, airstrikes, or raids threaten their lives, people with disabilities may not be able to run for safety.
Those with intellectual or psychosocial disabilities (mental health conditions) may not understand danger. In the chaos of rushed evacuations, they also risk being separated from family members, or losing assistive devices, such as wheelchairs or hearing aids.
The situation is further complicated by countries’ refusal to accept more refugees or facilitate their ability to flee. People with disabilities have been disproportionately harmed by these violations and restrictions on the ability to seek refuge in other countries.
People with disabilities often struggle to access humanitarian aid, particularly in places like Syria, where aid providers have been attacked and where the government and anti-government armed groups have unlawfully restricted aid deliveries and the movement of civilians.
The humanitarian response in Syria and neighboring countries should include disability-inclusive protection programming and access for people with disabilities to basic services, including shelter, sanitation, health, psychosocial support, and education. Resources need to be dedicated toward evacuating civilians with disabilities from areas of hostilities.
The Security Council and member states should also ensure that neighboring and host countries facilitate the ability of civilians most at risk to escape violence, and dismantle policies that create additional risk for people with disabilities who attempt to flee.
The council should also ensure that UN data collection, monitoring, and reporting on all conflicts includes the specific situation of people with disabilities, Human Rights Watch said. Otherwise, their needs and equal rights will continue to be overlooked.
The International Disability Alliance, a network of 14 global and regional organizations of persons with disabilities working to advance the rights of persons with disabilities with governments and the UN system, emphasized the need to consult people with disabilities about their situation.
“The Security Council briefing is an important step in recognizing the unique and disproportionate impact of conflict on persons with disabilities,” said Vladimir Cuk, executive director of the International Disability Alliance.
“Close consultation with and active involvement of persons with disabilities and their representative organizations in humanitarian response is critical to address their situation on the ground.”
# People with disabilities, when compared to the general population, face higher risks in conflict situations and natural disasters. Research shows that the mortality rate among persons with disabilities tends to be up to four times higher than among the general population.
Moreover, for every person who dies during a disaster, it is estimated that three people sustain an injury, many causing long-term disabilities.
To compound matters, persons with disabilities are disproportionately more likely to be left behind in emergency responses and to fail to benefit from humanitarian services due to a range of barriers.
A recent study has confirmed that three-quarters of persons with disabilities do not have adequate access to basic assistance, such as water, shelter or food, in a crisis situation.
Half of the persons with disabilities surveyed also reported no access to disability-specific services, such as rehabilitation or assistive devices.
People with disabilities are a unique resource of knowledge and experience, who are too often overlooked in policies and actions to address their challenges and to build more resilient societies and communities.

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