CARMMA - Campaign for the Accelerated Reduction of Maternal Mortality in Africa

High rates of women dying in childbirth(maternal mortality) and children dying before they reach the age of 5 years is a formidable development challenge in Africa. The disturbing part of Africa’s maternal and child mortality is that the large number of deaths is due to preventable causes. The World Health Organization (WHO) estimates that worldwide, as many as 1500 women die every day due to complications related to pregnancy or childbirth. Similarly, 10 000 babies die per day within the first month of life and an equal number of babies are born dead. More than 90% of these deaths occur in developing countries, most of them in Africa. Although Africa is home to only 10% of the world’s population, it contributes to almost half of all child deaths worldwide.

In July 2010 the African Union, endorsed CARMMA. They endorsed a list of actions that governments signed onto. The first action reads as “ We commit to launch CARMMA in our countries and broaden it as an advocacy strategy for the promotion of maternal, newborn and child health and involve all key stakeholders such as the women, children and young people, persons with disabilities, parliamentarians, community and religious leaders, civil society organizations, the media, and the private sector and institutionalize an annual CARMMA week in solidarity with the women and children of Africa for the next four years”.

The campaign currently focuses on four key areas:

• Building on-going efforts particularly best practices. This means reporting, collecting and sharing information on various strategies and initiatives that countries have implemented to address maternal mortality.
• Generating and providing data on maternal and newborn deaths. This means that all countries have to keep up to date data on maternal and infant mortality and report regularly to AU health forums about this.
• Mobilizing political commitment and support of key stakeholders including national authorities and communities to mobilize additional domestic resources in support of maternal and newborn health and mobilizing communities to let them know that everyone has role in improving maternal and child health and reduction of maternal and child deaths. This means that efforts around maternal mortality cannot just remain in the realm of policy and legislation, but that a lot of work also needs to be done on the ground and through creative engagements and communication with local communities. And,
• Accelerating actions aimed at the reduction of maternal, infant and child mortality in Africa. This means that given the proposals coming from best practices, governments will be urged to take concrete steps to reform and improve their health systems appropriately.

Soul City sees CARMMA as a vital campaign to support and be involved in.

The following are the key components of CARMMA in South Africa:

A) Strengthen and promote access to comprehensive sexual and reproductive health services, with specific focus on family planning services.

B) Promoting early antenatal care and attendance/booking.

C) Improve access to Skilled Birth Attendants by:

i. Allocating dedicated obstetric ambulances to every sub-district to ensure prompt transfer of women in labour and women and children with obstetric and neonatal emergencies to care.

ii. Establishment of maternity waiting homes.

D) Strengthening Human Resources for Maternal and Child Health by:

i. Providing training on Essential Steps in Management of Obstetric Emergencies (ESMOE) to doctors and midwives.

ii. Intensifying midwifery education and training.

E) Improve child survival by:

i. Promoting and supporting exclusive breastfeeding for at least 6 months.

ii. Providing facilities for lactating mothers (boarder mothers) in health facilities where children are admitted.

iii. Promotion of Kangaroo Mother Care (KMC) for stable low birth weight babies at all levels of care.

iv. Advocacy for appropriate care and support for pregnant women and lactating mothers in the workplace.

v. Improving immunization and vitamin A coverage.

vi. Intensifying management of severe malnutrition in health facilities.

vii. Intensifying case management of sick children through:

a. Improving home management of diarrhoea including oral rehydration, and strengthening community recognition of serious illness in babies.

b. Strengthening implementation of integrated management of care for infants (IMCI) in all primary health care facilities

c. Strengthening clinical skills for the management of severe diseases including pneumonia and diarrhoea in referral facilities

F) Intensifying management of HIV positive mothers and children by:

a. Improving access to treatment for both mothers and children

b. Improving management of co-infections, particularly TB and

c. Eliminating Mother to Child Transmission of HIV

To view the full South African National Strategic Plan on CARMMA, click here.