Posts Tagged ‘maternal mortality’

New Estimates Show Major Reduction in Maternal Mortality, But More Progress Needed

Wednesday, May 16th, 2012 by KateMitch

New global maternal mortality estimates were released today in a report by the World Health Organization (WHO), United Nations Children’s Fund (UNICEF), United Nations Population Fund (UNFPA) and the World Bank. The report,“Trends in maternal mortality: 1990 to 2010”, shows that the number of women dying of pregnancy and childbirth related complications has almost halved in 20 years.  The estimates show that from 1990 to 2010, the annual number of maternal deaths has dropped from more than 543,000 to 287,000–and that a number of countries have already reached the MDG target of 75 per cent reduction in maternal death.

 

Major highlights from the report:

• In 2010, the global maternal mortality ratio was 210 maternal deaths per 100,000 live births. Sub-Saharan Africa had the highest maternal mortality ratio at 500 maternal deaths per 100,000 live births.

 

• In sub-Saharan Africa, a woman faces a 1 in 39 lifetime risk of dying due to pregnancy or childbirth-related complications. In South-eastern Asia the risk is 1 in 290 and in developed countries, it is 1 in 3,800.

 

• Ten countries have 60 per cent of the global maternal deaths: India (56,000), Nigeria (40,000), Democratic Republic of the Congo (15,000), Pakistan (12,000), Sudan (10,000), Indonesia (9,600), Ethiopia (9,000), United Republic of Tanzania (8,500), Bangladesh (7,200) and Afghanistan (6,400).

 

• Ten countries have already reached the MDG target of a 75 per cent reduction in maternal death: Belarus, Bhutan, Equatorial Guinea, Estonia, Iran, Lithuania, Maldives, Nepal, Romania and Viet Nam.

 

Read the full press release here.

 

Read the full report here.

 

Join the conversation on Twitter at hashtag: #motherhood #MMR2012

 

Over the past few years, the global health community has witnessed and contributed to the publication of more frequent and more technically advanced estimates for maternal mortality than ever before. This report adds to the growing body of evidence that is helping the maternal health community to measure and better understand the scope and trends of the problem. It is an exciting time in the field–and we encourage you to read the new report.

 

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Buzz Meeting: Is There a Maternal Health Movement?

Tuesday, October 4th, 2011 by Christopher Lindahl

Written by: Janna Oberdorf, Director of Communications and Outreach, Women Deliver

 

I was incredibly lucky and honored to participate in the Maternal Health Task Force Buzz Meeting today with a room full of professional researchers, advocates, and maternal health experts from around the world. The day was interesting, educational, and challenging all at the same time, and I feel like I left with a lot of difficult questions to answer in my own work and to bring back to my organization.

 

One of the biggest and most contentious questions posed during the day’s discussion was: “Is There a Maternal Health Movement?” Jeremy Shiffman, associate professor of Public Administration and Policy at American University, laid out a clear and concise answer from his perspective: No. According to Professor Shiffman, grassroots mobilization and action, an element that he defines as essential and at the core of a “movement,” is missing from the maternal health work and community. Unlike other movements, including HIV/AIDS, breast cancer, or the Arab Spring, the maternal health community is still weak in engaging grassroots-level action, according to Professor Shiffman.

 

I agree that the maternal health community has a long way to go in mobilizing the women and the families on the ground who are truly affected by maternal mortality and morbidities. But, I am perhaps more optimistic than Professor Shiffman. I see the seeds that have been planted – though I know that it will take time, effort, and care to grow those seeds into action. Much of today’s discussion focused on the fact that there has been a “top-down” push for maternal health instead of “bottom-up” – a criticism of global advocacy. What I am hoping for, and what I think we need to work towards, is a sandwiching of advocacy and activism for better health for girls and women around the world. Let’s refocus from top and bottom, and start to focus on a push from both sides.

 

Additionally, much of today’s discussion was around whether we need a maternal health movement? What constitutes a movement and what doesn’t? What would and should a maternal health movement look like? Should it mimic the HIV/AIDS movement or have an identity all its own? How can we encourage a movement in countries where women are disenfranchised, poor, illiterate, and/or marginalized? To me, all of these questions are missing the point.

 

However you want to define a “movement,” and whether you think it’s happening right now or might happen in the future, I feel like we would all agree to a few key points:

  1. We need to raise awareness about maternal health and quality of care within communities and to educate the women who are vulnerable to maternal mortality and morbidity to seek proper care.
  2. By raising the awareness among women, their families, and their communities, the goal is for them to seek quality care and understand that maternal deaths aren’t normal, aren’t right, and aren’t something everyone should just expect to happen based on the flip of coin.
  3. When women and communities understand the components of the continuum of care and a healthy pregnancy and childbirth, and if they don’t receive the care they seek, they should push their governments to action and hold them accountable.

To me, this is the point. We need women on the ground to understand maternal health, to seek maternal health services and information, to understand that maternal deaths are not a necessary evil, and to hold their governments accountable when they are denied such services. Call it movement… call it grassroots advocacy… call it activism… call it what you will. The goal is the same. And we need to encourage this type of action.

 

At Women Deliver, we’ve been pushing for a global response to maternal mortality in the form of political will and financial investment in MDG5. And over the last few years, we’ve had some success in getting on the political agenda and in having promises and commitments made to maternal health. But we need to focus on the sandwich – we need women, families, and communities on the ground to push for improved health services for girls and women in their nations while continuing to put pressure on global actors to meet their commitments. It doesn’t matter to me if you call it a movement or if it goes down in the history books as one, but I think we’d all agree that there needs to be a push from both sides to have sustainable progress on issues that affect girls’ and women’s health.

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The Maternal Health Buzz Meeting

Friday, September 30th, 2011 by Christopher Lindahl

 

Next week, we are gathering 60 people from around the world in a retreat-like setting just north of New York City for 2½ days. Our goal is to discuss and debate today’s tough questions in maternal health and to learn from the MHTF’s initiatives over the past 3 years. We’ll be focusing on big questions such as:

  1. Do we really know what works?
  2. What steps are needed to ensure routine accountability of donors’ and governments’ efforts to reduce maternal mortality?
  3. Have we failed to make key decisions to support and implement short/medium term interventions for maternal health vs. long-term systems changes?
  4. Why did maternal mortality decline and where does responsibility lie for accelerating progress?

The result of our Buzz Meeting may be some solid strategies and action plans. Or the result may be better questions. Either will constitute success for us. As the meeting occurs, we’ll be posting on our blog and Twitter about some of topics of discussion so be sure to stay tuned next week!

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Report: Most Countries Will Not Meet MDGs 4 and 5

Tuesday, September 20th, 2011 by Christopher Lindahl

With maternal mortality estimates published last year by the Institute for Health Metrics and Evaluation and the United Nations, and the recent neonatal mortality estimates, it became relatively clear that most countries would not meet the ambitions set in Millennium Development Goals 4 and 5. A new report from IHME, published in The Lancet, confirms that few countries are on track:

An estimated 31 developing countries will achieve Millennium Development Goal (MDG) 4, which calls for a two-thirds reduction in the child mortality rate between 1990 and 2015, and 13 developing countries will achieve MDG 5, which calls for a three-fourths reduction in the maternal mortality ratio over the same period. Of those countries, nine will achieve both goals: China, Egypt, Iran, Libya, Maldives, Mongolia, Peru, Syria, and Tunisia.

 

Although many countries will not meet the lofty goals set in 2000, progress has been made in many countries, especially recently, that should allow us to still be optimistic about maternal and child health.

 

The report continues:

In 125 countries, maternal mortality has declined faster since 2000, the year that countries signed the Millennium Declaration, promising to make improvements in child and maternal health, and the progress has been particularly strong in the past five years. Over the same period, in 106 countries, child mortality rates have declined faster between 2000 and 2011 than in the previous decade.

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WASH for Mothers: Water, Sanitation and Maternal Health: Inter-dependent Systems Challenges

Monday, August 22nd, 2011 by Christopher Lindahl


Photo courtesy of Water.org

 

The following post is part of a series of posts, WASH for Mothers, exploring water, sanitation, and hygiene (WASH) and maternal health. It is written by Margaret Catley-Carlson who is currently Chair of the Board of the Crop Diversity Trust, and the Foresight Advisory Committee for Group Suez Environment. She is a patron of the Global Water Partnership, a member of the UN Secretary General’s Advisory Board, World Economic Forum Global Advisory Council on Water, the Rosenberg Forum, and serves on the boards of the Syngenta Foundation, IFDC (Fertilizer Management), the World Food Prize And Tyler prize. To read other posts in the series, click here.

 

All of us working to break the cycle of poverty that holds hostage too many people in the world are tracking closely the progress of the Millennium Development Goals which are set for review in 2015. The eight MDGs cover the gamut of issues that keep that cycle of poverty spinning, and they are inextricably linked. Goals 5(a) and 7(c) are perfect examples. The former aims to ‘reduce by three quarters the maternal mortality ratio, and the latter aims to “halve… the proportion of the population without sustainable access to safe drinking water and basic sanitation.”

 

Experts agree: access to clean water and sanitation is essential for healthy pregnancies and childbirth. Vitamin deficiencies, trachoma and hepatitis can be caused by unsanitary conditions and poor hygiene. Anemia, one of the 5 major causes of maternal death and disability, is most often associated with malnutrition, but it can also be caused by intestinal worms or malaria both of which occur when clean water and safe sanitation are lacking.

 

Fifteen percent of all maternal deaths are caused by infections in the 6 weeks after childbirth mainly due to unhygienic conditions during home deliveries and in institutions. Another of the 5 major causes of maternal death and disability, sepsis, is caused when clean water and adequate sanitation are not available to a woman during labor and childbirth.

 

Environmental stability and maternal health are both systems issues. Clean water and sanitation are essential factors in our collective efforts to eradicate preventable maternal mortality and morbidities. The logic here is clear: If humanity is to break the poverty cycle once and for all, we must address concomitantly the fundamentals that weaken the systems needed to provide and sustain good health.

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Ugandan maternal deaths in the NYT

Tuesday, August 2nd, 2011 by Christopher Lindahl

Recently, The New York Times featured a piece on free health care in Sierra Leone for mothers and children. Maternal health had another prominent space in The Times last weekend with a discussion of maternal deaths in Uganda, which have led to a lawsuit against the Ugandan government. The article was featured on the front page of Saturday’s edition.

 

The Times reports:

Jennifer Anguko was slowly bleeding to death right in the maternity ward of a major public hospital. Only a lone midwife was on duty, the hospital later admitted, and no doctor examined her for 12 hours. An obstetrician who investigated the case said Ms. Anguko, the mother of three young children, had arrived in time to be saved.

 

Her husband, Valente Inziku, a teacher, frantically changed her blood-soaked bedclothes as her life seeped away. “I’m going to leave you,” she told him as he cradled her. He said she pleaded, “Look after our children.”

 

Half of the 340,000 deaths of women from pregnancy-related causes each year occur in Africa, almost all in anonymity. But Ms. Anguko was a popular elected official seeking treatment in a 400-bed hospital, and a lawsuit over her death may be the first legal test of an African government’s obligation to provide basic maternal care.

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Misoprostol for postpartum hemorrhage: from evidence to action

Monday, August 1st, 2011 by Christopher Lindahl

Written by: Shafia Rashid, Senior Program Officer, FCI Global Advocacy program.

 

The following was originally posted on FCI’s blog. It is reposted here with permission.

 

Around the corner from the New York Stock Exchange, where financial decisions of global importance are made every day, more than 50 obstetricians, midwives, women’s rights advocates, public health programmers, researchers, and policy makers from around the world gathered last week for discussions on a different, but equally momentous, subject. FCI, working in collaboration with Gynuity Health Projects, brought together this diverse group for a two-day meeting to help shape policy and advocacy on the use of the drug misoprostol for the prevention and treatment of postpartum hemorrhage (PPH). In the developing world, uncontrolled post-partum bleeding is the leading cause of death in childbirth, killing a woman every five minutes.

 

In studies conducted by Gynuity and others, misoprostol has been shown to be a safe and effective medicine both for the prevention and for the treatment of PPH. While another drug, oxytocin, is generally recognized as the “gold standard” among uterotonic drugs for preventing or treating PPH, misoprostol has significant advantages for use in settings where maternal mortality is high and most births take place outside of hospitals: misoprostol is delivered in tablet form, and — unlike oxytocin — requires neither refrigeration nor intravenous administration. Earlier this year, misoprostol was added to the World Health Organization’s Model List of Essential Medicines for the prevention of PPH, providing another opportunity to expand women’s access to this safe and inexpensive medicine. Misoprostol, originally developed for treatment of stomach ulcers, is also used for a range of reproductive health indications, including induction and augmentation of labor and medical abortion.

 

The New York meeting aimed to translate the scientific evidence on misoprostol’s safety and efficacy into effective strategies for expanding women’s access to misoprostol at the country level. After reviewing the scientific research, the global clinical and policy guidelines that shape the use and availability of misoprostol, and the strategies being used by misoprostol advocates and programmers, participants discussed opportunities, barriers, and challenges related to promoting greater access to misoprostol for PPH. Human rights experts framed how access to misoprostol is a human right enshrined in several international frameworks, including the Universal Declaration of Human Rights. Presentations and discussions highlighted the need not only to drive policy change at the country level (e.g., getting misoprostol registered for this indication, including it on national essential drug lists, and incorporating it within national clinical norms and guidelines), but also to ensure that these policies are adequately implemented and funded so that they translate into real progress for women.

 

Presenters from Nepal, Kenya, and Ecuador shared lessons from successful efforts to achieve policy approval and expand distribution of misoprostol, and participants from countries including India, Tanzania, Uganda, Burkina Faso, and Laos also contributed their experiences. These discussions included promising results from several countries where distribution of misoprostol tablets to women in their communities has proven effective in addressing the risk of hemorrhage among women who give birth at home — where more than half of births in the developing world still take place — with extremely low levels of diversion of the drug for other uses, incorrect dosage or timing of administration, or other signs of poor compliance. Attendees also learned about advocacy campaigns in related sectors, including emergency contraception, medical abortion, and the HPV vaccine for cervical cancer, and considered how those lessons may be applied to improving access to misoprostol for PPH.

 

Looking ahead, FCI will work with our partners to develop and implement an advocacy and communications strategy that will drive real progress in helping countries, health care providers, and women themselves address the leading cause of maternal death. Please stay tuned to The FCI Blog for more information as this exciting and important project moves forward.

 

To read FCI’s mapping report on advocacy for access to misoprostol, click here: Mapping_Miso_For_PPH.

 

To read about FCI’s work on misoprostol for PPH, click here.

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Morocco Forum on Maternal Mortality: Sharing Experience and Sustaining Progress

Monday, July 25th, 2011 by Christopher Lindahl

We posted recently about the success that Morocco has had in reducing its maternal mortality ratio and a recent meeting in Rabat that “brought together leaders in research, policy, and implementation. Participating in the Forum were national and regional health policymakers, UN development agencies, academics, foundations, and medical leaders.” The forum generated a policy brief attributing Morocco’s progress to:

  • Strong political engagement;
  • Mobilizing funds to finance free delivery, including Caesarian-section delivery;
  • A participatory and multisectoral governing body to oversee strategy and identify priority actions;
  • A whole-of-health-system approach that strengthened multiple health system building blocks and processes;
  • Mobilization of professionals and professional organizations to support the strategy;
  • Large expansion of pre-service midwifery education and some expansion of medical specialty training;
  • Decision-making based on evidence, and involvement of the scientific community;
  • Creation of strong links with communities;
  • Attention to non-technical quality of care to ensure a positive patient experience in facilities;
  • Implementation of the maternal mortality surveillance system.
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Progress towards MDG5 in Morocco

Thursday, July 14th, 2011 by Christopher Lindahl

Morocco has been making strides in reducing its maternal mortality ratio over the past few years. In 2000, the MMR stood at 262 deaths per 100,000 live births, while in 2008 it was 124, a reduction of over 50%. Since 1990, the baseline for the Millennium Development Goals, Morocco’s MMR has decreased by about 68%, which means that it is on pace to accomplish MDG 5.

 

Recently, a conference was held in Morocco on the topic of maternal mortality. Karen Grepin, from NYU, attended the conference and reports:

The [Moroccan] strategy involves three major components: addressing physician and financial barriers, improving quality of care, and improving the management of governance of the programs themselves…Given the number of interventions that were simultaneously launched it is difficult to tease out exactly what work, when, for whom, and why. The academic in me me wished there had been more evaluation of their experience and was left really wondering which interventions had been the most effective and why — but we we may never know.

 

But I did not leave the country disappointed as in the end I did learn why Morocco was able to achieve such a miraculous decline in maternal mortality: strong political commitment.

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Midwives in the Mountains of Vietnam

Monday, May 2nd, 2011 by Christopher Lindahl

Understanding disparities within countries regarding maternal mortality ratios, access to health services and other health factors are necessary to fully address and provide maternal health care and a number of other health indicators. Vietnam, a middle income country, currently has a maternal mortality ratio of 64 deaths per 100,000 live births, according to IHME. However, for Hmong women in northern Vietnam, that ratio is significantly higer, according to a report from Al-Jazeera English (embedded below).

 

In order to efficiently allocate maternal health resources, it is imperative that good data exists regarding the regional, ethnic, and socio-economic differences for health outcomes so that the appropriate groups can be targeted for interventions.

 

 

Can’t see the video? View it on YouTube

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