Case Study: How CARMMA is winning the battle against maternal mortality
This year marks the 25th anniversary of the International Conference on Population and Development (ICPD) Programme of Action adopted by 179 governments at the ICPD Conference in Cairo, Egypt in 1994. This focused on sustainable growth, education for girls, gender equality, and maternal and infant mortality reduction, among other areas.
It is thus also an opportune moment to look at the Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA), 10 years after its launch in 2009. The AU Commission launched the campaign with increasing concerns about the continuing vulnerability of pregnant women and the untenable high rates of maternal mortality in Africa, and in a bid to add value to ongoing efforts.
The launch was undertaken in collaboration with AU member states and partners such as the United Nations Population Fund (UNFPA) and the International Planned Parenthood Federation (IPPF) during the 4th Conference of the AU Ministers of Health, which had the theme ‘Universal Access to Quality Health Services: Improve Maternal, Neonatal and Child Health’ and was held at the AU headquarters in Addis Ababa, Ethiopia in May 2009. To date, 50 member states have launched CARMMA.
“Africa Cares: No Woman Should Die While Giving Life” is the slogan CARMMA adopted, to show that Africa should do something to prevent deaths amongst those giving life to societies, to communities and to nations.
It was clear that action needed to be taken to change this scar on the face of Africa, and show that behind the statistics were human beings. Maternal mortality is not only a health issue calling for health interventions, it is also a gender issue, that required and still requires societal interventions.
The campaign’s launch was therefore fundamentally about addressing issues of poverty, inequality and the low status women occupy in societies. It was also about shining the spotlight on an issue which has been a silent killer of women, as the focus had shifted to HIV, malaria and TB, which was justifiable but had unfortunately put the fight for maternal health in the background.
The CARMMA initiative was therefore born. Led by the AU’s Department of Social Affairs, it promotes and advocates for renewed and intensified implementation of the Maputo Plan of Action on Sexual and Reproductive Health and Rights, with special emphasis on the accelerated reduction of maternal mortality.
The initiative built on existing strategies and best practices. It has generated and provided data on maternal and newborn deaths to inform and mobilise the necessary responses from policy makers and healthcare providers; helped mobilise political commitment and the support of key stakeholders and communities for additional resources and involvement, and helped to accelerate actions to reduce maternal and associated infant mortality.
At the end of the MDGs in 2015, the Maternal Mortality Ratio had improved from 965/100,000 to 542/100,000 live births in Africa, a reduction of about 44%. However, the estimated annual total number of maternal deaths in Africa was still at 195,000 in 2015, and a woman had a 1 in 37 lifetime risk of dying as a result of maternal death on the continent. The marked reduction in maternal deaths in Africa occurred mainly after the development of the continental policy and the plan of action on Sexual and Reproductive Health Rights (SRHR) in 2005 and 2006, and the launch of CARMMA in 2009.
After the continental launch of CARMMA in 2009, AU members started introducing the campaign nationally to take ownership and provide the necessary leadership and commitment. The first countries to launch CARMMA in 2009 were selected on the basis of: high maternal mortality ratios, a low gender development index ranking for the country, ready political commitment on the part of policy makers, a willingness to demonstrate results by ensuring a conducive environment for implementation (countries not in political crisis), and, the need to ensure sub-regional balance.
Written By Bience Gawanas