Maternal Health in Burkina Faso has potentially improved over the last decade, however rates of maternal death remain among the highest in the world and significant structural and cultural barriers must be before removed before preventable maternal mortality is eradicated.
Burkina Faso has take several legal steps to improve their maternal mortality rates. Government leaders have signed several binding UN resolutions which require increased state investment to address maternal mortality. Despite these commitment no substantive steps have been take to actual increase the quality of care, or ease access to needed care. A principle deterrent to care are the government levied fees to give birth in state run hospitals. Government officials had indicated a willingness to waive these fees so that the most poverty stricken mothers would still have access to adequate care, these waivers have still not taken place. Further, even when professional health care is available, workers are frequently inadequately trained to handle the more difficult birth emergencies which are often preventable conditions related to poverty and the inferior positions of women in Burkina Faso’s culture ((The World Bank, World Development Report: Gender Equality and Development, The World Bank, Washington, D.C., 2011, 17 September 2012)) ((Burkina Faso 2003, Nutrition of Young Children and Mothers
While access to infrastructure, and access to care certainly contribute to the high rate of maternal mortality, cultural patterns are bear a significant share of the blame.
Child marriages are technically forbidden by law – as are polygamous marriages without consent of all parties – but these laws are rarely enforced ((US, State Department, Country Reports on Human Rights Practices, 2007) Women, para 6)). This is especially true in the rural populations, were two-thirds of the population happen to live ((CIA World Factbook)). The average age of marriage, considering both official and practitioner records, for the whole country is 17 years old for women and 27 for men ((International Women’s Rights Action Watch (IWRAW), CEDAW Shadow Report)). The age differences are greatest in polygamous marriages for the second or third wife. On average the second or third spouse is over 20 years younger than her husband ((Population Council, Girls’ Adolescence in Burkina Faso: A Pivot Point for Social Change, Population Council, New York & Ouagadougou, 2007)). In the rural areas over 60% were married before 18, and 20% were married before age 15 ((United States Department of State, Country Report on Human Rights, (Accessed 7/10/12)). It is not uncommon, especially in polygamous relationships, for higher order brides to be married as young as 12 or 13 ((Population Council, Girls’ Adolescence in Burkina Faso: A Pivot Point for Social Change, Population Council, New York & Ouagadougou, 2007)). “Childbearing begins soon after marriage and is a dangerous proposition for Burkinabe girls and young women. Just over half (55 percent) of births to women younger than 20 are attended by skilled personnel during childbirth (PRB 2006) ((Population Council, Girls’ Adolescence in Burkina Faso: A Pivot Point for Social Change, Population Council, New York & Ouagadougou, 2007)).
These demographic conditions of extremely young marriages as well as such young women bearing children before their bodies are fully mature and when they willingly desire to have children creates conditions prone to high rates of mortality and morbidity. When combined with cultural attitude prohibiting women from accessing health care without approval from her husband, as well as practical consideration of distance for the majority of the population and it is not shocking that maternal mortality rates remain among the worst in the world.
At the same time, it must be recognized that rates have begin to fall again after rising for nearly a decade. In the mid 1990’s rates were already 600 deaths per 100,000 live births ((African Development Bank, Gender Poverty and Economic Indicators on African Countries, Economic and Social Statistics Department: Tunis, Tunisia, 2007)), this rate began increasing in the late 90’s and remained over 1000 deaths until the mid 2000’s ((UN Statistical Database, http://unstats.un.org/unsd/default.htm)). According to the latest measurements the rate has dropped to approximately 300 deaths per 100,000 live births, but this figure is only an estimate and likely does not reflect a significant number of deaths which happen in the rural population as well as deaths related to pregnancy, but not directly associated with birth ((World Health Organization, World Health Statistics, Part III, Global Health Indicators, (Published 2012), (Accessed 1 June 2012),http://www.who.int/gho/publications/world_health_statistics/2012/en/)).