Draft first regional report on the implementation of the Montevideo Consensus on Population and Development

<strong>Draft</strong> <strong>first</strong> <strong>regional</strong> <strong>report</strong> on the implementation of the Montevideo Consensus on Population and Development
Chapter III
Figure III.17
Latin America and the Caribbean: coverage of prenatal care with at least four check-ups, 2010 and most recent year
(Percentages)
100
90
80
70
60
50
40
30
20
10
0
Antigua and Barbuda
Argentina
Bahamas
Belize
Bolivia
(Plur. State of)
Brazil
Colombia
Costa Rica
Cuba
El Salvador
Guyana
Haiti
Honduras
Jamaica
Mexico
Nicaragua
Panama
Peru
Dominican Rep.
Saint Lucia
Suriname
Trinidad and Tobago
Uruguay
Venezuela
(Bol. Rep. of)
Latin America and
the Caribbean
Most recent
2010
Source: United Nations, “SDG Indicators Global Database” [online database] https://unstats.un.org/sdgs/indicators/database; Economic Commission for Latin America
and the Caribbean (ECLAC), CEPALSTAT [online database] http://estadisticas.cepal.org.
(iv) Maternal mortality
Rates of maternal morbidity and mortality are still very high in some countries of Latin America, and their
reduction is one of the Millennium Development Goal targets that were not met in the region. It is a cause of
death that can be avoided in the great majority of cases if proper care is received during the prenatal period,
the birth itself and the period just after it. Consequently, priority measure 40 of the Montevideo Consensus on
Population and Development recommends that sexual and reproductive health services should be comprehensive
and available to all pregnant women, including care both around childbirth and after abortion, based on the risk
and harm reduction strategy. Although there are problems of estimation because of incomplete recording of
reproduction-related causes of death, 78 it can be said that the maternal mortality rate remains high and actually
increased on aggregate in the region in the period from 2013 to 2016, rising from 50.6 deaths per 100,000 births
in 2013 to 57.9 in 2016 (see figure III.18).
The average maternal mortality rate masks large differences, since there are countries such as Chile
and Uruguay with rates below 20 deaths per 100,000 births, while in some Caribbean countries the figure
exceeds 150. The <strong>report</strong>s of the Governments of Brazil and Colombia state that mortality differs by age
and that maternal deaths are very frequent among young women. 79 For this reason, avoiding unwanted
pregnancies, which are more common among adolescent and young women, may reduce maternal mortality.
The Government of Guatemala has provided an important summary of the cumulative situations leading to the
deaths of women: (i) lack of information, (ii) gender inequality, (iii) difficulty in accessing services because of
inadequate communication and transport infrastructure and (iv) inadequate and delayed institutional care. These
cumulative deficiencies, which put the lives of the poorest women and those living in hard-to-reach places
at high risk, call for integrated and comprehensive policies to guarantee reproductive rights for all women.
78
To provide this information, preference is given to estimates supplied by the countries and systematized by PAHO, although these differ from the estimates <strong>report</strong>ed
in SDG indicator 3.7.1, which are based on modelling. The maternal mortality ratio is an indicator whose denominator is the number of births and not the number
of pregnant women: the latter would better reflect the universe at risk, since many deaths are known to occur when abortions are carried out under insalubrious
conditions. Indeed, voluntary termination of pregnancy is one of the main causes of maternal death.
79
The high rates in these countries (about 50%) result in a great many deaths, raising the <strong>regional</strong> average.
101