Yemen report
New marriage age could lower excessive maternal mortality

A proposal to raise the legal age of marriage to 18 in Yemen could see the country’s high maternal mortality rate drop drastically. Middle East Health reports.

Early marriage combined with illiteracy, poor health services and poverty make Yemen’s maternal mortality the highest in the Arab world, Yemeni officials and specialists say.

But now a radical proposal to raise the legal age of marriage to 18 by Yemen’s Supreme Council for Motherhood and Childhood could see the country’s high maternal mortality rate drop drastically, according to a report by IRIN News.

“We have made the proposal to the cabinet and we are now awaiting its approval,” said Fathia Mohammed, assistant secretary general of the SCMC, a government body.

Yemen’s most recent Demographic, Maternal and Child Health Survey (DMCHS), conducted in 1997, showed that 48% of women between the ages of 20 and 24 were married before the age of 18. In the poorest 20% of the population, 57% of girls were married before 18 and even among the richest families more than 35% were married early. Overall, 14% were married before 15.

Yemen’s Ministry of Health estimates that eight women die every day during child birth and 366 women die for every 100,000 live births. The situation is compounded by the fact that Yemen’s fertility rate is one of the highest in the world, with an average of seven children per woman.

Health specialists project the country’s current 20 million population will reach 35 million in 2025.

Specialists have singled out early marriage as one of the main causes of Yemen’s high rate of maternal mortality. “When a girl is married at the age of 13 or 14, she is then at risk of maternal death. This is very common in Yemen, especially in rural areas,” said Fathia.

According to her, girls getting married at an early age are not ready to give birth, because “a girl’s body is not matured and developed at this stage, and this also leads not only to death, but also to other complications such as haemorrhaging”.

Home births

Approximately 75% of maternal deaths are preventable, occurring because of a lack of access to – and availability of – high-quality reproductive health services, said officials at the United Nations Population Fund UNFPA) in Yemen. UNFPA says that 84% of all births in Yemen take place at home and only 20% of these births have trained attendants present.

“There are also cases where a husband refuses to take his wife to hospital for delivery,” Fathia said, as they are unaware of the delivery risks or because they don’t like their wives to give birth with the help of mid-wives.

In Yemen, doctors and health centres are not equally distributed. There is only one doctor per 10,000 people as doctors tend to be concentrated only in main cities, namely Sana’a, Aden and Taiz.

“Health services reach only 60% of the population,” Yahya al-Babeli, Senior Health Advisor at the Basic Health Services Project, which is funded by USAID, told IRIN. The project includes a free twoyear course for midwives employed in health institutions.

Al-Babeli also criticised the Ministry of Health for not employing more midwives. “There is a huge reservoir of midwives, but the ministry of health has not hired them due to its complicated administrative system,” he said.

According to al-Babeli, the USAID project has trained 120 midwives over the past two years in Amran, Marib, and Shabwa provinces.

Meanwhile, influential women from around the world gathered in London to mark Mother’s Day on 18 March. A Global Plan of Action agreed at the meeting calls for a universal right to health for mothers and their babies by ensuring skilled care at every birth, active community involvement, global monitoring networks, and better infrastructure including human resources. The plan calls on governments to take the lead in fighting maternal and newborn illness and death.

                                  
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