Fewer maternal and child deaths
Data pinpoint areas of need
The Countdown report relied on all available data, though there are significant data gaps for many of the poorest countries. The data that are available highlight the obstacles that remain to meeting the goals for some countries.
“The detailed country-by-country data show where each country has made progress and pinpoint where greater effort is needed,” says Jennifer Requejo, Ph.D. of the Bloomberg School of Public Health at Johns Hopkins University and a lead author of the report.
“The report allows countries to compare their efforts with other countries and also to see if services across the continuum of care are equally available to everyone, urban and rural, rich and poor.” Data show, for instance, that vaccine coverage has increased to 80 percent in all Countdown countries and rapid progress has been made in the distribution of bed nets to prevent malaria.
Maternal Mortality Rates Rising in California
It is something we take for granted in the United States. A woman enters the hospital to give birth and she emerges a couple of days later with a beautiful bundle of joy.
That is how it usually goes. But this story is about the rare exception - women who die within 42 days of childbirth. In the health care community it’s called simply “maternal mortality.” And in the U.S., many experts believe it is on the rise.
According to the World Health Organization, the U.S. ranks behind more than 40 other countries when it comes to maternal death rates, with 11 deaths per 100,000 pregnancies when measured in 2005. More women die in the U.S. after giving birth than die in countries including Poland, Croatia, Italy and Canada, to name a few.
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A new report out of California found the number of women who died in the state after giving birth has nearly tripled over the past decade, from 5.6 deaths per 100,000 to 16.9 per 100,000 in 2006. The report was commissioned by the California Department of Health but has not yet been publically released. ABC News first learned of its existence from a watchdog group called “California Watch.”
Death after childbirth is still rare, but experts say many of those deaths could have been prevented.
In contrast, diarrhea and pneumonia still cause more than two million deaths that could be avoided through prevention or prompt treatment.
The data also show that newborn survival is lagging in most countries; Bangladesh, Nepal and Rwanda have achieved success in reducing newborn mortality and offer a model for other countries to follow.
According to Joy Lawn, M.D., PhD, of Save the Children and an author of the report, for preterm babies, antenatal steroid injections help develop immature fetal lungs and prevent respiratory problems. These injections cost $1 and could save almost 400,000 lives a year in low-income countries. They are only available and provided for 10 percent of premature babies in these countries.
“Also kangaroo care, where premature infants are held skin-to-skin on the mother’s chest to keep warm, could save 450,000 lives a year,” says Dr. Lawn. “It makes frequent breastfeeding easy and provides constant maternal supervision for the infant.”
“Besides using the data to drive our priorities and guide where the funding is spent, we need to focus on efforts to bring maternal and newborn services close to women and children in their own communities,” says Jennifer Bryce, PhD, of the Bloomberg School of Public Health and a lead author of the report.
The data also show that services must expand faster than population growth in order to improve coverage. Nigeria, for instance, has doubled the number of births attended by a skilled health care provider since 1990, but has increased its coverage rate by only 8 percent during that period, because the number of births has grown from 4.3 million in 1990 to 6.3 million in 2008, and is expected to reach 7 million by 2015.
The Countdown report highlights the fact that, whether or not countries are making progress in their national statistics, poor people have less access to health services than better-off people. Across the Countdown countries, for example, some 90 percent of the wealthiest women have access to a skilled birth attendant, while three-quarters of the poorest women give birth without lifesaving skilled childbirth care.
“Inequity in coverage for lifesaving interventions leads to inequity in health outcomes,” said Cesar Victora, M.D., PhD. of the University of Pelotas, Brazil and a lead report author. “Too many women and children are dying because they are poor, members of ethnic minorities or indigenous groups, or live in remote rural villages. Countries must ensure that every citizen has access to lifesaving health care.”