Even though Naimah* had sought care a couple of times during her pregnancy at a clinic near her village in western Kenya, she died during childbirth. Her baby lived for a short period afterward before eventually dying, too.
Naimah’s husband, Kareem,* was devastated. His wife had handled everything in their home, from taking care of the children and planting and harvesting crops, to managing all of the household purchases. Naimah also operated a small business outside of her home, which brought in extra money for her family.
The loss felt by Kareem, the surviving six children, and the rest of the family was widespread and overwhelming. Their experience in the aftermath of Naimah’s death, however, is not uncommon in developing countries; it is illustrative of the typical economic and social costs of maternal mortality, which will be a major topic of discussion today at the Women Deliver conference in Kuala Lumpur, Malaysia.
Maternal deaths have reduced by nearly half since Millennium Development Goal 5 – which aims to improve maternal mortality – was established, but there is still a ways to go to achieve this goal by 2015. It’s possible to prevent more deaths and eliminate their affiliated costs, but doing so requires well-coordinated approaches that straddle multiple sectors.
ICRW is working to better understand the ripple effect maternal death has on families through a groundbreaking study in Nyanza Province, Kenya that is examining the immediate and long-term economic, emotional and social costs and consequences of maternal mortality. Working in partnership with Family Care International (FCI) and Kenya Medical Research Institute (KEMRI), the ICRW study is one of a few examining maternal mortality costs; most research efforts to date have focused on understanding the causes of maternal mortality and designing interventions to address it.
Preliminary findings from our research suggest that a family often will spend considerably more on a funeral – burial, food for visitors, etc. – than other non-food expenses such as rent and school fees for the entire year. Our early data also show that after a maternal death, families immediately reassign to other family members tasks that were handled by the deceased. It is a necessity, but also a disruption on relatives’ routines and children’s studies.
In the case of Naimah, her death resulted in a complete overhaul of how her home had operated. Kareem lamented the loss of companionship that followed his wife’s passing, especially her input on household-related decisions. Meanwhile, Naimah’s children had to focus more on household chores such as fetching water, caring for livestock and doing laundry, than on their schoolwork, potentially affecting their chances of completing their education. Other relatives in the home had less time to pursue income-generating activities, and instead became consumed with completing Naimah’s household tasks.
Developing nations like Kenya, where Naimah’s family lives, have not experienced the overall decrease in maternal mortality enjoyed across the globe. Although more Kenyan women are using skilled health workers to deliver their babies, the number of mothers who have died as a result of childbirth has increased since 1990. That year, Kenya reported a maternal mortality ratio of 360 per 100,000 live births, according to the World Health Organization; in 2010, this number jumped to 530 per 100,000 births.
Given the data, it is clear that more needs to be done to address the impact of maternal death on families and communities, and design effective approaches to help them navigate the aftermath. We believe that capturing data on the disruptions and the social and economic costs of maternal death will arm programmers and funders with crucial information to better direct investment in and development of solutions to address maternal mortality.
* Not their real names.
Zayid Douglas is a program associate at the International Center for Research on Women.