|© UNICEF/HQ08-0043/David Turnley|
The continents of Africa and Asia together account for 95 per cent of maternal deaths and around 90 per cent of newborn deaths. Just as there are big differences in maternal and neonatal mortality between rich and poor countries, disparities across social groups within countries also exist.
The timing and causes of maternal and newborn deaths are well understood. Obstetric complications, such as post-partum haemorrhage, infections, eclampsia, and prolonged or obstructed labour – and complications of abortion account for most maternal deaths. Anaemia, exacerbated by malaria, HIV and other conditions, heightens the risk of maternal death from haemorrhage. For newborns, the greatest health risks are posed by severe infections, which include sepsis/pneumonia, tetanus and diarrhoea; asphyxia and pre-term births. These three main causes account for 86 per cent of newborn deaths.
There is good news: most of these conditions are preventable or treatable with essential measures such as quality reproductive health services, antenatal care, skilled health workers assisting at birth, access to emergency obstetric and newborn care when necessary, adequate nutrition, post-natal care for mothers and newborns, and education to foster healthy practices for women and newborns. Furthermore, research has shown that around 80 per cent of maternal deaths could be avoided if women had access to essential maternity and basic health-care services.
In addition to the direct causes of maternal and newborn mortality and morbidity, there are a number of factors at the household, community and district levels that also undermine the health and survival of mothers and newborns. Some examples of these are: lack of education and knowledge for girls and young women, who are still more likely than boys to be out of school; lack of access to nutritious food and essential micronutrients; poor environmental health facilities; and not enough access to basic health-care services. There are also basic factors, such as poverty, social exclusion, gender discrimination and political insecurity, which strengthen the direct and underlying causes of maternal and newborn mortality and morbidity.