Key Socio-Economic Determinants of Maternal Health

Human Development Sector South Asia Region The World Bank

Dr. Bushra Binte Alam The World Bank

Magnitude of the problem

Maternal and Newborn Mortality constitute a silent Emergency

Every day 1,000 women die of pregnancy related causes, 99% in Developing countries 570 in Sub-Saharan Africa 300 in South-Asia The risk of a women dying from pregnancy related causes 36 times higher in developing countries 34% decline in MMR from 1990 to 2008

Bangladesh: Maternal Mortality Ratio dropped by two thirds in 20 years

700 600 500 400 300 194 200 322

574

100
0

1999

Source: BMMS 2010

2010

1990

1991

1992

1993

1994

1995

1996

1997

1998

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

Socio-economic determinants

Access to Education Life expectancy Female participation in labor force Female participation in politics Womens legal and human rights Poverty, particularly among women

Access to Education

Last 20 years, university enrollments(women) grew 7-fold . and in 2009, 51% of college students were women . yet 35 million girls are still out of school today

Primary level
100

school enrollment, girls

80

60

Some SubSaharan Africa countries lag behind

East Asia and Pacific Europe and Central Asia

Latin America and the Caribbean

Middle East and North Africa South Asia

40

20

School enrollment in 20 40 60 80 primary in 100 Bangladesh school enrollment, boys Girls: 89.9% Boys: 82.9%

Sub-Saharan Africa

High-income countries

Bangladesh: more women have secondary / higher education last 15 years

60

No education
50 40 30 20 10

Primary

Secondary+

Source: BDHS 1993-2007 and UESD 2010

2010

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

Female life expectancy 2009 vs. 1960

Bangladesh: 46.7 years in 1960 68.9 years in 2009
World Sub-Saharan Africa South Asia

54

+17

71

42 42 48

+12

54
+24
+25

66
73 77 83 79 75
90

Middle East & North Africa Latin America & Caribbean High income Europe & Central Asia East Asia & Pacific 0 10

58 72 71 50
20 30 40 50 60 70 female life expectancy at birth

+19 +11 +8

+25
80

Increasing number of women joining the labor force

World

Bangladesh:
Sub -Saharan Africa

+ 2%

56.5% in 1980 58.7% in 2009

+ 4% + 2% + 5%
+ 16% + 7% - 7% - 3%
0% 10% 20% 30% 40% 50% 60% 70% 80% female labor force participation rate

South Asia

Middle East & North Africa Latin America & Caribbean High income Europe & Central Asia

East Asia & Pacific

For every dollar a man makes, a woman earns

Bangladesh 12

Sri Lanka 50

Malawi 90

Nigeria 60

Germany 62

Mexico 80

Women in parliaments remain low

Single House or Lower and Upper combined
World

Bangladesh:
Arab States

18.6% in 2011

19% female
parliamentarians

Pacific Asia

Sub-Saharan Africa Europe - OSCE member countries Americas

Nordic countries
0% 20% 40% 60% 80% 100%

Political participation

In India, women in

political office increased public investments in water

. In Nepal , giving

women a greater say in managing forest significantly improved conservation outcomes

Legislation and its implementation

All except 6 countries have ratified the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW)

and yet 510 million women will be abused by their partner in their lifetime.

percentage women abused

Domestic violence: percentage women abused

Bangladesh (Matlab)

42%
49% 27% 13%

Ethiopia (Butajira)

Brazil (Sao Paulo)

Japan (Yokohama)

246,000 women

Economic empowerment
Among 1.5 billion of the worlds absolute poor, 70% are women
eliminating employment segregation would increase labor productivity by 25% improve women income and decision making power

these barriers do not go away with growth

and in fact costs grows bigger in a globalized world foster more decision making power educated women invest more in children better access to health services

Call to Action
Priority actions to address these barriers are: Close the education gaps Improve access to economic opportunities Increase female participation in labor force and in control over resources Increase women's voice in political arena Enforce implementation of existing legislation Invest in women

THANK YOU

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