“The first hours and days of a baby’s life are especially critical. About three-quarters of all newborn deaths (over 2 million) take place within one week of birth. 36 percent of newborn deaths (over 1 million) occur on the day a child is born.”
~ State of the World’s Mothers Report, Save the Children
In 1990, global leaders, institutions and national governments agreed upon concrete goals to reduce poverty by 2015. Now known as the Millennium Development Goals (MDGs), MDG 4 aims to reduce the under-5 mortality rate by two-thirds and MDG 5 strives to reduce the maternal mortality ratio by 75 percent. Since implementing the MDGs in 1990, maternal deaths from pregnancy and/or childbirth have decreased nearly 50 percent worldwide (543,000 to 287,000). Unfortunately, the global newborn mortality rate has only declined by 32 percent. With 3 million babies still dying within the first year of life (43 percent of the global under-5 mortality rate), clearly much progress can still be made.
Yesterday, Save the Children published its State of the World’s Mothers Report, a report that analyzed and summarized the successes, failures, and lessons learned regarding global progress with MDG 4 and MDG 5. Here are the report’s major findings:
- Helping babies survive the first few days of life poses the greatest challenge to reducing child mortality;
- Three major causes of death include complications during birth, prematurity, and perinatal infections; and
- By using proven interventions, creating stronger health systems, and training more skilled health care workers, there is the potential to reduce newborn deaths by up to 75 percent.
Globally, there are over 1 million estimated child deaths on the first day of life – equating to 15 percent of all under-5 deaths. Of those first day deaths, 80 percent occur in Sub-Saharan Africa and South Asia.
Sub-Saharan Africa (SSA), a region accountable for 12 percent of the global population, suffers from 38 percent of the world’s first day deaths (397,000 per year; 34 deaths per 1000 live births). Unfortunately, pregnancy and childbirth also pose incredible risks to mothers. For example, mothers in Somalia face a 1 in 16 risk of dying during pregnancy and/or childbirth (18 maternal deaths per 1000 births). Across the entire region, ten SSA countries ranked as the worst for mothers to give birth and seven countries scored the highest number of first day child deaths.
In South Asia, approximately 83,000 women die each year during pregnancy and/or childbirth and 423,000 babies die each year on their first day of life (more than any other region in the world). With 24 percent of the global population, the region experiences 41 percent of the world’s first day deaths (420,000 per year; 11 deaths per 1000 live births).
Although most of South Asia has become synonymous with a growing economy, great disparities and inequalities still exist, particularly in India. Enduring the most maternal deaths in the world (56,000 per year) and 29 percent of the world’s first day deaths (309,000 per year), it is safe to say that India’s economic growth benefits are not shared equally.
Although 98 percent of newborn deaths occur in the developing world, 1 percent of first day deaths take place in industrialized nations. Ranked as the developed country with the highest amount of first day deaths, the United States sustains 50 percent more first day deaths than all other industrialized countries combined (11,300 deaths per year).
Highlighting the three most effective proven interventions, the Report advocates for further investments in female education, nutrition, and family planning in order to curb maternal and newborn deaths.
Although newborn death is most commonly caused by complications from preterm births, other prenatal and postnatal dangers exist. Therefore, investing in prenatal and postnatal care has also proven incredibly valuable.
For HIV-infected women, mother-to-child transmission rates can be reduced to less than 5 percent with the proper antiretroviral regimen. Similarly, by treating malaria in pregnant women, incidence of newborn low birthweight can decline by 40 percent.
Tetanus, a disease that kills 58,000 mothers and newborns every year, is entirely preventable with a $0.40 vaccination. Often caused by mothers cutting the umbilical cord with unsanitary tools, tetanus also can be avoided by applying chlorhexidine, a $0.25 antiseptic, to the newborn’s umbilical cord.
Other forms of important postnatal care include educating mothers on the importance of breastfeeding, a practice that provides the newborn with essential nutrients, warmth and a strong immunity; “kangaroo mother care,” a simple and effective approach that increases child survival rate in preterm and low birthweight babies by warming newborns through continuous skin-to-skin contact on the mother’s chest; and access to low-cost antibiotics to treat sepsis.
Does your country rank in the top or bottom 10 for maternal health?
All images courtesy of Save the Children.