WUNRN
FATAL FLAWS - BARRIERS TO MATERNAL
HEALTH IN PERU
Direct Link to Full 52-Page Amnesty
Report:
_________________________________________________________________________
PERU - HUNDREDS OF PERU'S POOR,
RURAL & INDIGENOUS
PREGNANT WOMEN DIE IN HEALTH SERVICE
LOTTERY
Health centre in rural Huancavelica, Peru, 26 September 2008. Maternal mortality rates in Peru are among the worst in the region
© Amnesty International
9 July 2009
Hundreds
of poor, rural and Indigenous pregnant women in Peru are dying because they are
being denied the same health services as other women in the country, Amnesty
International has concluded in a new report.
Published on Thursday the report, Fatal Flaws: Barriers to Maternal
Health in Peru, explores the high levels of maternal mortality
amongst poor and Indigenous women in rural Peru and evaluates the impact of
recent government policies designed to tackle the problem.
"The rates of maternal mortality in Peru are scandalous," said Nuria
García, Peru researcher at Amnesty International. "The fact that so many
women are dying from preventable causes is a human rights violation. The
Peruvian state is simply ignoring its obligation to provide adequate maternal
healthcare to all women, regardless of who they are and where they live."
Peru has one of the highest rates of maternal mortality in the Americas.
According to official figures, 185 women die for every 100,000 live births in
Peru. The United Nations puts the number even higher at 240. Most of these are
rural, poor and Indigenous women.
Amnesty International's report highlights that pregnant women in Peru die
because they face a number of barriers, including: lack of access to emergency
obstetric care, unavailability of information on maternal health and lack of
health staff who can speak Indigenous languages.
In addition, women living in poverty are largely excluded from political
decision-making processes. Their voices are rarely heard and their views rarely
influence the state's laws and policies so that these violations of human
rights pass largely unnoticed by society and by those in authority.
According to the 2007 National Census of Indigenous Peoples, nearly 60 per cent
of the communities covered by the census did not have access to a health
facility.
"Health services for pregnant women in Peru are like a lottery: if you are
poor and Indigenous, the chances are you will always lose," said Nuria
Garcia.
The mother of 24-year-old José Meneses Salazar, from Ccarhuacc, one of the
poorest areas in Peru, died in childbirth nine years ago. She avoided going to
check-ups out of fear that the staff would treat her badly. When she went into
labour, the midwife at the nearest health post was on leave, so José’s father
and other relatives delivered the baby themselves. After the baby was born, the
placenta did not come out and they did not know what to do. Two hours later the
mother died. The baby girl survived.
Amnesty International's report also assesses the impact of a number of
government policies aimed at reducing the rates of maternal mortality,
including the increase of maternal waiting houses – rooms where women who live
a long way from health centres can stay before the birth – greater promotion of
the vertical birth method common among Indigenous women in Peru and
implementation of Quechua language teaching for health professionals.
While welcoming the new initiatives, women and health professionals consulted
by Amnesty International in Peru complained they are not being effectively
implemented and questioned their real impact.
Amnesty International found that even though the number of waiting houses has
risen more than threefold in the last eight years, only half of them are in
rural areas, where women are at most need of emergency obstetric care.
Women and local civil society organizations have told Amnesty International
that training for health professionals on the vertical birth method is not
sufficiently widespread. According to Peru's Human Rights Ombudsperson, more
than 45 percent of health staff last year said they had not received
appropriate training.
Although there have been government initiatives to provide Quechua training to health
professionals, its use is not widespread and many women from Indigenous
communities whose first language is not Spanish cannot communicate with them.
"Official initiatives to reduce maternal mortality are good news,"
said Nuria Garcia. "However, lack of clear responsibilities for
implementing them and the absence of effective resourcing and monitoring puts
any initiative in great jeopardy."
Amnesty International urged the Peruvian authorities to allocate resources to
maternal mortality and reproductive health care in a way that prioritizes
regions with the highest mortality ratios in order to ensure that all women
have equal access to access emergency obstetric care in case of complications
during birth. It also recommended an increase in training for health
professionals and the provision of Indigenous language support in all health
centres.
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