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WHO – 10 Facts on Child Health

OK after reading the Top 10 for maternal health, I am hooked.  Here is the summary of the WHO’s fantastic glimpse into children’s health:

1. The first month is the most dangerous.  “Preterm birth, birth asphyxia and infections cause most newborn deaths.”  After one month – until 5 years – the primary causes of death are:  pneumonia, diarrhoea, and malaria.

2. 3 million babies die per year in the first month.  Prenatal care, birth attendants and postnantal attention to: “breathing and warmth, hygienic cord and skin care, and exclusive breastfeeding”.

3. Pneumonia is the leading killer of under-5s.

4. “Exclusive breastfeeding helps prevent diarrhoea (leading killer of young children) among young children.”

5. Malaria is a leading killer in Africa but nets can prevent the spread.

6.  HIV+ mothers can prevent transmission to their babies by: “use of antiretrovirals, as well as safer delivery and feeding practices”.

7. Breast is best: “Optimal breastfeeding and complementary feeding help prevent malnutrition and can save about a million children.”

8. “Three-quarters of child deaths occur in Africa and South-East Asia.”

9. 2/3rd of child deaths can be prevented by:” low-cost interventions, and effective primary care up to five years of age.”

10. Greater investment is needed.

 

 

WHO – 10 Facts on Maternal Health

This is an excellent review of the state of maternal health in the developing world.  See this article on WHO’s website:

1. “1000 women die every day due to complications during pregnancy and childbirth “.   After HIV “conditions related to pregnancy and childbirth” are the leading cause of death of women.

2. 4 things that cause 70% of maternal death: “severe bleeding, infections, unsafe abortion, and hypertensive disorders (pre-eclampsia and eclampsia).”  Postpartum bleeding can kill an otherwise healthy woman in 2 hours.

3. Postpartum Morbidity (fever, anemia, fistula, incontinence, infertility and depression) afflicts 20 million women per year.

4.10% of all births are to girls 15-19. In many countries teen moms are twice as likely to die in childbirth.

5. Rich people don’t die giving birth, poor people do. “Of the 1000 women who die every day, 570 live in sub-Saharan Africa, 300 in South Asia and five in high-income countries.”

6. Trained birth attendants prevent deaths.

7. Rural women in the developing world are less likely than urban women to attend 4 prenatal visits, which are important for identifying problems.

8. 46,000 women die every year from unsafe abortions.  Preventing unwanted pregnancy is crucial.

9. Missing the Millenium Development Goals.  “Since 1990 the global maternal mortality ratio has declined by only 2.3% annually instead of the 5.5% needed to achieve MDG 5, aimed at improving maternal health.”

10.  Women need skilled medical care above all.

Study: An Intervention Involving Traditional Birth Attendants and Perinatal and Maternal Mortality in Pakistan

A study  in the New England Journal of Medicine shows that use of clean birth kits by birth attendants, in conjunction with to antenatal visits, effectively reduced perinatal mortality in Pakistan.

Background.  There are approximately 4 million neonatal deaths and half a million maternal deaths worldwide each year. There is limited evidence from clinical trials to guide the development of effective maternity services in developing countries.
Me thods.  We performed a cluster-randomized, controlled trial involving seven subdistricts (talukas) of a rural district in Pakistan. In three talukas randomly assigned to the intervention group, traditional birth attendants were trained and issued disposable delivery kits; Lady Health Workers linked traditional birth attendants with established services and documented processes and outcomes; and obstetrical teams provided outreach
clinics for antenatal care. Women in the four control talukas received usual care. The primary outcome measures were perinatal and maternal mortality.

Conclus ions

Training traditional birth attendants and integrating them into an improved health care system were achievable and effective in reducing perinatal mortality. This model could result in large improvements in perinatal and maternal health in developing countries.

Mobile Clinics in Laos

I want to learn more about these mobile clinics in Laos … and perhaps contribute to the mission vis a vis clean birth kits.

http://www.k4health.org/toolkits/communitybasedfp/country_experiences/mobile-rh-clinics_laovillages

Mobile Reproductive Health Clinics Make Motherhood Safer in Remote Lao Village

Source: United Nations Population Fund [UNFPA], 2005

Working in cooperation with the the Lao Women’s Union, UNICEF and others, the mobile clinic teams vaccinate children and provide a range of reproductive health services, information and counselling for adults and adolescents 15 and older—including family planning, prenatal care, treatment of sexually transmitted infections and education on HIV/AIDS prevention. Over two days, one team will provide services for everyone who needs them. The team will stay overnight in the village, showing health education videos in the evening.

Save the Children’s Facts on Health in Laos

Here’s a quick look at Laos health stats thanks compliments of Save the Children.

The health situation of women and children in Laos is amongst the poorest in Southeast Asia; Infant mortality rate is 70 per 1000 live births and under five mortality claims 98 per 1000 live births1.

Every day 36 children under-five die due to preventable and treatable diseases.

Percentages of underweight children have been almost unchanged between 1990 and 2006 (40% and 37.1%) and the prevalence of stunting in under-fives is up to 40.4%.

According to UNICEF/WHO official estimate (2007), immunisation coverage has declined—only 27% of children by their first birthday have received all eight recommended vaccinations2.

Maternal mortality remains very high at 405/100,000 live births, approximately 800 deaths per year or 2 deaths per day.

A high percentage of children (71.5%) are born to mothers who received no antenatal care and 84.8% of pregnant women give birth at home3 .

These are clear indicators of low health service utilization and poor quality health services/facilities.

1 Lao Reproductive Health Survey 2005, this is the official figure and most reliable for reference – the 2008 survey, although it quotes lower figures is not ‘official’

2 Strategy and Planning Framework for the Integrated Package of Maternal Neonatal and Child Health Services 2009 – 2015

3 Lao Reproductive Health Survey 2005

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