Fewer maternal and child deaths
Since 1990, annual maternal deaths have declined by almost one half and the deaths of young children have declined from 12 million to 7.6 million in 2010.
Some of the world’s poorest countries have achieved spectacular progress in reducing child deaths. Rates of child mortality in many African countries have been dropping twice as fast in recent years as during the 1990s. In Botswana, Egypt, Liberia, Madagascar, Malawi, Rwanda and the United Republic of Tanzania, the rate of decline was on average 5 percent or more a year between 2000 and 2010.
Similar progress has been seen in reducing maternal deaths, although in fewer developing countries: Equatorial Guinea, Nepal, and Vietnam have each cut maternal deaths by 75 percent.
But all the news is not good. Every two minutes, somewhere in the world, a woman dies from complications of pregnancy and her newborn baby’s chances of survival are very poor. For every woman who dies, an additional 20-30 suffer significant and sometimes lifelong problems, as a result of their pregnancy.
In these same two minutes nearly 30 young children die of disease and illness that could have been prevented or effectively treated.
Many countries, especially in Africa and South Asia, are not making progress. Of the 75 countries with the highest burden of maternal and child mortality, 25 have made insufficient or no progress in reducing maternal deaths and 13 show no progress in reducing the number of young children who die.
Maternal health
Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. While motherhood is often a positive and fulfilling experience, for too many women it is associated with suffering, ill-health and even death.
The major direct causes of maternal morbidity and mortality include haemorrhage, infection, high blood pressure, unsafe abortion, and obstructed labour.
“Global efforts to save the lives of women, newborn babies and young children are not moving fast enough,” says Mickey Chopra, M.D., PhD., chief health officer of United Nation’s Children’s Fund (UNICEF) and co-chair of the Countdown to 2015 initiative. “Some countries are showing us what success looks like, but many other countries still have to learn the lessons of those successes.”
Progress on maternal, newborn and child health, in the 75 highest-burden countries, most in Sub-Saharan Africa and South Asia, where more than 95 percent of all maternal and child deaths occur, has been laid out in a new 220-page report, Building a Future for Women and Children, which is published by the Countdown to 2015 initiative.
The report is authored by a global collaboration of academics and professionals from Johns Hopkins University, the Aga Khan University, the University of Pelotas in Brazil, Harvard University, London School of Hygiene and Tropical Medicine, UNICEF, the World Health Organization, UNFPA, Family Care International, and Save the Children. The secretariat of the Countdown to 2015 initiative is based at The Partnership for Maternal, Newborn & Child Health.
“The Countdown report shows the who, what, where - and most importantly the why - of maternal, newborn, and child survival,” says Zulfiqar Bhutta, M.D., PhD, of Aga Khan University, Pakistan, who is the co-chair of Countdown and an author of the report. “It offers a clear, consistent report card that countries, advocates, and donors can use to hold each other - and themselves - accountable for real, measurable progress.”
Maternal deaths worldwide drop by third
15 SEPTEMBER 2010 | GENEVA - NEW YORK - The number of women dying due to complications during pregnancy and childbirth has decreased by 34% from an estimated 546 000 in 1990 to 358 000 in 2008, according to a new report, Trends in maternal mortality, released by the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA) and the World Bank.
The progress is notable, but the annual rate of decline is less than half of what is needed to achieve the Millennium Development Goal (MDG) target of reducing the maternal mortality ratio by 75% between 1990 and 2015. This will require an annual decline of 5.5%. The 34% decline since 1990 translates into an average annual decline of just 2.3%.
“The global reduction in maternal death rates is encouraging news,” says Dr Margaret Chan, the Director-General of WHO. “Countries where women are facing a high risk of death during pregnancy or childbirth are taking measures that are proving effective; they are training more midwives, and strengthening hospitals and health centres to assist pregnant women. No woman should die due to inadequate access to family planning and to pregnancy and delivery care.”
Pregnant women still die from four major causes: severe bleeding after childbirth, infections, hypertensive disorders, and unsafe abortion. Every day, about 1000 women died due to these complications in 2008. Out of the 1000, 570 lived in sub-Saharan Africa, 300 in South Asia and five in high-income countries. The risk of a woman in a developing country dying from a pregnancy-related cause during her lifetime is about 36 times higher compared to a woman living in a developed country.
“To achieve our global goal of improving maternal health and to save women’s lives we need to do more to reach those who are most at risk,” says Anthony Lake, Executive Director of UNICEF. “That means reaching women in rural areas and poorer households, women from ethnic minorities and indigenous groups, and women living with HIV and in conflict zones.”
The report assesses the progress that the 75 highest-burden countries are making towards achieving UN Millennium Development Goals 4 & 5 (MDGs). These MDGs call for reducing maternal deaths by three-quarters and the deaths of children under 5 by two-thirds, both by 2015 compared to 1990 levels.
“This is a race against time,” said Dr. Bhutta. “The pace has picked up, but countries need to make real change happen in the next three years if the world is going to keep its promise to millions of newborns, children, and women.”
Countdown to 2015 reports were first published in 2005 to track the progress in the highest-burden countries, to identify knowledge gaps, and to promote accountability at global and national levels for improving maternal and child survival.
Since then, massive global attention and resources have been focused on Millennium Development Goals 4 and 5.
In 2010, UN Secretary General Ban Ki-moon launched a Global Strategy for Women’s and Children’s Health, an effort that has generated $40 billion in commitments to meet key goals supporting women’s and children’s health. These goals include more trained midwives, greater access to contraceptives and skilled delivery care, better nutrition, prevention of infectious diseases and stronger community education.
Notably, 44 of the world’s poorest countries - among them Bangladesh, Ethiopia, Nigeria, Burundi, and Nepal - have now joined the Every Woman, Every Child effort, which takes forward the Global Strategy for Women’s and Children’s Health. This brings the total number of partners in this joint effort to 220, with low-income countries committing nearly $11 billion of their own limited resources.
The Countdown reports help to hold governments and donors accountable for fulfilling their commitments to the Global Strategy, and it will be a key input to the first report to the Secretary General in September 2012 from the independent Expert Review Group, set up following the launch of the report of the Commission on Information and Accountability for Women’s and Children’s Health, ‘Keeping Promises, Measuring Results’.