Biofortification, a panacea to global maternal mortality

The smell of death engulfed the room.

By Tendai Makaripe

Man’s mighty foe appeared to be wielding its axe on a defenceless young lady whose only desire was to see the fledging life that was inside her get an opportunity to prove itself on this side of heaven.

Unfortunately, her dream was slowly becoming a horror show.

She lay on the small hospital bed, deathly pale. Opening her eyes was proving to be a mammoth task while gathering the strength to utter a few words was sadly a futile exercise.

Sarah (not real name) would mumble a few words between her breath but unfortunately, close relatives who had come to visit her could not pick any word from the muttering.

With sullen faces, arms folded, heads shaking in despair, they painfully beheld one of their own suffering to the point of death.

Every passing second was a slow confirmation to those in attendance that it was only a matter of time before their loved one sleeps to wake up no more.

Sarah, unlike her biblical namesake, the wife of the great patriarch Abraham, was not going to have blissful child birth.

Upon the delivery of her son, Sarah suffered from postpartum hemorrhage, a medical condition characterised by severe and excessive bleeding after the birth of a baby.

This condition is the leading cause of maternal deaths globally.

Losing lots of blood quickly can cause a severe drop in one’s blood pressure and may lead to shock and death if not treated.

The most common cause of postpartum hemorrhage as was the case with Sarah, is when the uterus does not contract enough after delivery.

Once a baby is delivered, the uterus normally contracts and pushes out the placenta.

After the placenta is delivered, these contractions help put pressure on the bleeding vessels in the area where the placenta was attached.

If the uterus does not contract strongly enough, these blood vessels bleed freely and may lead to death.

Maternal mortality is a global health problem killing 830 women daily from preventable causes related to pregnancy and childbirth according to global health watchdog, the World Health Organisation.

In Zimbabwe, the Maternal Mortality Ratio (MMR) is 443 deaths/100,000 live births.

Though it has decreased over the past years, it is still too high and attaining the global target of reducing the global MMR to less than 70 per 100 000 live births by 2030 as espoused by Sustainable Development Goal number 3 remains a mammoth task.

Health analysts have highlighted that the most agonising thing about maternal mortality is that it is preventable yet it kills mothers on a daily basis.

One way to prevent maternal mortality is through improving one’s iron uptake as lack of it leads to iron deficiency anemia.

According to a 2018 study by the Barts Research Centre for Women’s Health titled Risk of maternal mortality in women with severe anaemia during pregnancy and post-partum: A multilevel analysis, as many as half of all pregnant women in low-income and middle-income countries are diagnosed with iron deficiency anaemia which affects 32 million pregnant women worldwide.

“Women in low-income and middle-income countries are at increased risk of anaemia because of the higher frequency of dietary iron deficiency, haemoglobinopathies, macronutrient deficiencies, and infections such as malaria, HIV, and hookworm infestation in those countries than in high-income countries.

Anaemia has been associated with increased prevalence of ante-partum and post-partum haemorrhage,” read the report in part.

WHO has recognised anaemia as a global problem with serious consequence for mothers and their babies.

Writing in a research paper titled: Anemia and iron deficiency: effects on pregnancy outcome, academic Lindsay Allen buttresses the importance of iron among adolescent mothers.

“Even for women who enter pregnancy with reasonable iron stores, iron supplements improve iron status during pregnancy and for a considerable length of time postpartum, thus providing some protection against iron deficiency in the subsequent pregnancy,” reads part of the paper.

Having realised the importance of iron among adolescent women and how lack of it can contribute to an increase in the number maternal deaths, researchers in Zimbabwe have turned to biofortification.

Biofortification is the process of conventionally breeding food crops that are rich in micronutrients, such as vitamin A, zinc, and iron.

These crops “biofortify” themselves by loading higher levels of minerals and vitamins in their seeds and roots while they are growing. When eaten, they can provide essential micronutrients to improve nutrition and health.

In Zimbabwe, biofortified crop varieties are conventionally bred by the Department of Research and Specialist Services (DR&SS) in conjunction with the International Maize and Wheat Improvement Centre for vitamin A maize, and the International Centre for Tropical Agriculture (CIAT) for iron beans, and they are not genetically modified.

Research carried out by 263Chat proved that through biofortification, groups that are vulnerable to deficiencies in micronutrients such as vitamin A, zinc and iron especially pregnant and breastfeeding women can effectively prevent these micronutrient deficiencies rather than treating acute or established deficiencies.

Through biofortification came iron beans variety called NUA45, a high yielding bean variety that contains more iron and zinc than most bean varieties.

Consuming this bean variety is important for pregnant women because the body requires iron to make blood and insufficient dietary iron increases the risk of women dying during childbirth.

Commenting on Harvest Plus’ success story in promoting iron-biofortified beans in several African counties, south Asia, and Latin America, Steve Beebe, leader of the bean research program at CIAT said: “This is a clear example of how agriculture and nutrition need to work together to improve quality of life. In this vein, high iron beans are a superfood of our time.”

HarvestPlus’ mission is to develop and scale up the delivery of biofortified nutritious crops around the world so that everyone who needs them has access to them.

A recent study published in the journal of nutrition underscored the importance of consuming beans that are bred to contain higher levels of iron to pregnant women and how it can contribute to lowering global maternal mortality.

“The encouraging findings of the Rwandan study further confirm that biofortified foods can break the intergenerational anemia poor school performance low productivity cycle,” said Erick Boy, head of nutrition at Harvestplus.

Improving women’s health and their ability to succeed at school and at work positively impacts their daily lives and the lives of their future children,” he added.

While maternal mortality is a danger that stands in the way of many women, biofortification is a panacea that can contribute to the reduction of global maternal deaths.




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