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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.

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

Research on Maternal and Infant Sepsis

In Maternal and early onset neonatal bacterial sepsis: burden and strategies for prevention in sub-Saharan Africa, Seale et al find gaps in the research on maternal and newborn sepsis.  I just read the summary here http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(09)70172-0/abstract.  Their work seems to substantiates providing clean, antiseptic conditions for birth.

Bolstering the argument for preventing sepsis following birth, they find that:

Although existing published data suggest that sepsis causes about 10% of all maternal deaths and 26% of neonatal deaths, these are likely to be considerable underestimates because of methodological limitations.  Successful intervention strategies in resource-rich settings and early studies in sub-Saharan Africa suggest that the burden of maternal and early onset neonatal bacterial sepsis could be reduced through simple interventions, including antiseptic and antibiotic treatment.

Health Poverty Action: Mothers on the Margins

Health Poverty Action  advocates,among other things, for women throughout the world:

Indigenous women, or those from other cultural minorities, are more likely to die or face complications related to pregnancy. Health Poverty Action’s new Mothers on the Margins campaign is calling for action to change this – and working in partnership with indigenous communities themselves, innovative solutions can be found.

Specifically in Laos they:

We are improving maternal and child health through our project with indigenous communities in Attapeu. Regular Health Days reach remote communities to provide basic services such as immunisations, prenatal and postnatal care, and to identify and feed malnourished children.

I wonder if clean birth kits might fit well with this mission?

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