African heads of state are gathering in Kampala this week to face an embarrassing question: why does Africa lag so far behind the developed world in rates of maternal and infant mortality? Africa's women are pushing their mostly male leaders to address the continent's failure in providing mother and child health care.
The numbers are alarming. In the developed world, a woman dying during childbirth is rare. By contrast, in Africa nearly a quarter of a million women a year die of pregnancy or childbirth related causes.
Even worse, a recent study indicated progress in curbing maternal mortality almost every place in the world except sub-Saharan Africa.
As the point person for women's issues, Bience Gawanas, African Union Commissioner Of Social Affairs, and the veteran Namibian human-rights activist, has traveled the continent repeating the mantra, "No woman should die giving life".
She says the decision to make women's and children's health the theme of this summit is a sign Africa's policymakers are getting the message.
"Issues of maternal mortality need the urgent action of our heads of state if we are to reverse the negative image of women dying on our continent," said Gawanas.
Gawanas has won the attention of Africa's male-dominated leadership, partly by enlisting their first ladies to promote a women's and children's health care initiative known as CARMMA.
"Before we came to this summit we did a lot of work. Last year the African Union launched CARMMA, the Campaign on Accelerated Reduction of Maternal Mortality in Africa, and one of the pleas we made is for countries to launch CARMMA nationally," she said. "And not just launch CARMMA nationally but take ownership over the lives of women and children in their countries. Since the launch of CARMMA, 17 countries launched CARMMA. And I can tell you that we are going to make a difference."
CARMMA will need money to ensure trained health workers are available to help in complicated births. One contributing factor in the high maternal mortality rate is the number of women who give birth at home, without access to professional health care if complications arise. And in chronically poor African countries, funding is a difficult issue.
But Commissioner Gawanas says CARMMA is not about throwing money at a problem. It is about starting at the grass roots and respecting Africa's widely varying cultures.
"The difference: involve traditional leaders, involve religious leaders. Let us start a social movement for women and children in Africa," she said. "When a woman does not have access to a clinic it is not just a medical condition, it is also based in our culture, in gender issues within our societies. And I believe some of these factors do not need money. It needs a commitment by all stakeholders."
Commissioner Gawanas admits being a bit of a dreamer when it comes to tackling a challenge that has defied solution. But she says CARMMA has already notched a few victories.
In recent weeks, summit host Uganda committed $30 million for women's health, Sierra Leone decided pregnant women, lactating mothers and children under five will have free access to primary and pre-natal care, and Malawi's first lady opened a foundation for safe motherhood.
"I want to see the day that the fact that you are pregnant on the African continent should not be a death warrant," she said. "That women in Africa will be placed in the same situation as women in the developed world. That children in Africa will also live in an Africa fit for children."
Gawanas has dropped from the summit agenda the planned speeches on maternal and child health. Too boring, she said.
Instead, heads of state will witness a panel discussion on CARMMA and other innovations in maternal and child health. Summit host, Ugandan President Yoweri Museveni will join the panel, along with Gawanas and other renowned experts. The internationally known Sudanese-born television news anchor Zeinab Badawi will act as moderator.