Maternal and Neonatal Health in Sub-Saharan Africa; The choice between losing a life and gaining one

Maternal healthChild birth is supposed to be a beautiful thing, a happy moment as a new life is brought into the world. But in most low and middle income countries, child birth is a matter of life and death both for the mother and the child she is carrying. When a woman goes into labour, the family is not celebrating; rather they wait anxiously to hear the outcome. Did she manage to deliver the baby; are both the mother and child alive and well? When the answers to all these questions are positive then the family can celebrate. Complications due to child births have claimed lives of many women and have left many babies orphaned at birth. The statistics on maternal and neonatal deaths vary between countries and regions with sub -Saharan Africa most affected.

More than half of maternal deaths occur in Sub Saharan Africa, a third in South East Asia and more than half of the deaths occur in fragile and humanitarian settings

More than half of maternal deaths occur in Sub Saharan Africa, a third in South East Asia and more than half of the deaths occur in fragile and humanitarian settings (Alkema et al., 2016).

Despite a 44% reduction of the global maternal mortality ratio between 1990 -2015 ( http://data.worldbank.org/indicator/SH.STA.MMRT?end=2015&start=1990&view=chart), there are still many women dying due to complications from pregnancy and child birth ( http://data.worldbank.org/indicator/SH.MMR.DTHS ). The top twenty countries with the highest mortality are in sub-Saharan Africa (Table 1, Figure 1) .

The maternal mortality ratio in developing countries in 2015 was 239 per 100 000 live births versus 12 per 100 000 live births in developed countries

The maternal mortality ratio in developing countries in 2015 was 239 per 100 000 live births versus 12 per 100 000 live births in developed countries. There are several factors that have contributed to these disparities not only between developed and developing countries but also within the individual countries; between the rich and the poor, and urban and rural populations (Alkema et al., 2016).

Table 1: Trends in estimates of maternal mortality ratio (MMR; maternal deaths per 100,000 live births) 1990-2015; Twenty Countries with the Highest Mortalities

Countries/Regions 1990 1995 2000 2005 2010 2015
Sierra Leone 2630 2900 2650 1990 1630 1360
Central African Republic 1290 1300 1200 1060 909 882
Chad 1450 1430 1370 1170 1040 856
Nigeria 1350 1250 1170 946 867 814
South Sudan 1730 1530 1310 1090 876 789
Somalia 1210 1190 1080 939 820 732
Liberia 1500 1800 1270 1020 811 725
Burundi 1220 1210 954 863 808 712
Gambia 1030 977 887 807 753 706
Democratic Republic of the Congo 879 914 874 787 794 693
Guinea 1040 964 976 831 720 679
Cote d’Ivoire 745 711 671 742 717 645
Malawi 957 953 890 648 629 634
Mauritania 859 824 813 750 723 602
Cameroon 728 749 750 729 676 596
Mali 1010 911 834 714 630 587
Niger 873 828 794 723 657 553
Guinea-Bissau 907 780 800 714 570 549
Kenya 687 698 759 728 605 510
Eritrea 1590 1100 733 619 579 501
 Source: WHO, UNICEF, UNFPA, World Bank Group and UNPD (MMEIG) - November 2015

There are several factors that have contributed to these disparities not only between developed and developing countries but also within the individual countries; between the rich and the poor, urban and rural populations

There are several factors that contribute to maternal mortality, these include;

  • Political stability and governance: civil unrest and poor governance has contributed to substandard healthcare and weak healthcare systems. As such the health of the pregnant woman and her pregnancy are poorly monitored; and complications are only discovered too late with no planned or poor interventions .
  • Economic stability : Limited resources have resulted in mediocre health services, due to lack of equipment, medicines and well trained staff in the available health facilities.
  • Access to healthcare: Most rural populations have limited maternal and newborn services. This is partly due to lack of infrastructure required to:
  1. Provide essential Interventions for normal and routine healthcare services
  2. Offer emergency care
  • Ignoring the needs of most rural health facilities and the affected rural communities.
  • Some of the underlying beliefs and socio-cultural factors have been attributed as contributing factor to some of complications associated with child birth in sub-Saharan Africa. These Include: early marriages, rural dwelling, female circumcision, education status, unskilled birth attendants and physical violence during pregnancy   (Gebrezgi, Trepka, & Kidane, 2017)

Despite all these, a reduction in maternal mortality has been observed between 1990- 2015 (Figure 1).

Figure -1: Reduction in Maternal mortality between 1990 and 2015

martenal mortality

Source: World Health Organization, UNICEF, United Nations Population Fund and The World Bank, Trends in Maternal Mortality: 1990 to 2015, WHO, Geneva, 2015.

According to WHO the following are the Key facts

Every day, approximately 830 women die from preventable causes related to pregnancy and childbirth, 99% of all maternal deaths occur in developing countries, Maternal mortality is higher in women living in rural areas and among poorer communities

  • Every day, approximately 830 women die from preventable causes related to pregnancy and childbirth.
  • 99% of all maternal deaths occur in developing countries. 
  • Maternal mortality is higher in women living in rural areas and among poorer communities. 
  • Young adolescents face a higher risk of complications and death as a result of pregnancy than other women. 
  • Skilled care before, during and after childbirth can save the lives of women and newborn babies. 
  • Between 1990 and 2015, maternal mortality worldwide dropped by about 44%.
  • Between 2016 and 2030, as part of the Sustainable Development Goals, the target is to reduce the global maternal mortality ratio to less than 70 per 100 000 live births

What are the situations in some of the low and middle income countries?

Between 1990 and 2015, most of the countries with the highest maternal Mortality have gone through economic hardships, political unrest,and other humanitarian situations.

in 2015, approximately 303 000 women died during and following pregnancy and childbirth with almost all of these deaths occurring in low-resource settings. With the right interventions , most of these deaths could have been prevented ( Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group).

References

Alkema, L., Chou, D., Hogan, D., Zhang, S., Moller, A.-B., & Gemmill, A. (2016). Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. The Lancet, 387, 462–474. http://doi.org/10.1016/S0140-6736(15)00838-7

Gebrezgi, M. T., Trepka, M. J., & Kidane, E. A. (n.d.). Barriers to and facilitators of hypertension management in Asmara, Eritrea: patients’ perspectives. http://doi.org/10.1186/s41043-017-0090-4

Useful Links

https://data.unicef.org/topic/maternal-health/maternal-mortality/

http://www.who.int/mediacentre/factsheets/fs348/en/

http://data.worldbank.org/indicator/SH.MMR.DTHS

Categories Uncategorized

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

w

Connecting to %s

%d bloggers like this:
search previous next tag category expand menu location phone mail time cart zoom edit close