Too many women and newborns are dying worldwide during pregnancy and childbirth. Every year, between 350,000-500,000 girls and women die from pregnancy-related causes. Almost all of these deaths (99 percent) occur in the developing world. Four million newborn babies die every year, also from causes that are mainly preventable and typically linked to the mother's health.

"The causes of maternal death are not very different. The technologies and the approaches to do something about these deaths have been known for a very long time. So why is it that we continue to see them so very frequently in developing countries particularly in Asia and Africa. Recently we have seen that these deaths are coming down in Latin America and in many other parts of the world. Africa in particular doesn’t show that it is coming down too much," said Dr, Sai in an exclusive interview to CNS.

Dr. Sai was the moderator for the 1987 Safe Motherhood Conference which launched the Safe Motherhood Initiative and chairman for the Main Committees of the International Conference on Population in Mexico in 1984 and of the International Conference on Population and Development (ICPD), in Cairo in 1994. It was this last conference which produced the Program of Action, emphasizing the centrality of women to all development programs and called for world attention to the improvement in the status of women and for equity and equality between the sexes as the basis of all human relationships.

"When we met in Cairo in 1994 we decided that for reproductive health services the developing countries themselves should try to put in two-thirds and advanced countries about a third. Many of the developing countries have been providing their share but the advanced countries' money indeed failed to come and has been coming down particularly in the areas of family planning which are the No. 1 prevention for these deaths. So we don't think that the developed countries, the industrialized countries have contributed enough. Some of the developing countries too have not. I suppose majority of those in Africa, in Asia, in South Asia, haven't put in commensurate effort to the size of the problem, they haven't put in enough," said Dr. Sai.

"I believe, particularly in South Asia and parts of Africa, if the status of women can be improved, women's education and quality education shold be given more support. This would help in reducing these death rates very much, I think," said Dr. Sai.

According to Dr. Sai, to reduce mortality itself, we need:

1) to have better facilities, better health-care personnel trained for handling emergency obstetric care,

2) to have better treatment for women who are pregnant, improving care around delivery itself,

3) to be prepared to have an emergency evacuation setup, that will link the site of delivery to any emergency center that will be able to handle emergencies.

One of the problems with maternal mortality is that the major death rates don't occur in people whom you can diagnose before they go into labor. The majority of deaths occur around the time of labor or immediately after the delivery. So these are true emergencies and the person assisting in the delivery should be knowledgeable enough to respond to these emergencies and know how to manage evacuation setup so that the individual can be sent to these clinics.

"Lack of facilities and lack of trained health-care personnel at the receiving clinic" are key impediments in saving women's lives, said Dr. Sai. "Sometimes the people go to these clinics and no one is present and there is delay right inside the clinic. So we are trying to reduce that period of delay in the clinics and expand the number of clinics that can handle emergency obstetric care. Also emergency evacuation services need to be organized," said Dr. Sai.

"These are the things that can give confidence to the communities to bring the people to these clinics rather than them to think that people go to the clinics only to die," said Dr. Sai.

"We have tried for so many years to try and wake up the consciousness of the world to what we consider as a major fight to save women's lives. We have been successful only to a small extent. We want to think that this year 2010 is the beginning of the end of that battle — the battle we are going to wage now and will be taken on worldwide and we will save women's lives," he said.

Lets hope that the Women Deliver 2010 turns Dr. Sai's hopes into reality in saving women's lives.