|Mariama Coulibaly, 16, sits on a bed in the maternity ward at Vélingara Health Centre in the town of Vélingara, in Senegal’s southern Kolda Region.|
The State of the World’s Children 2009: Maternal and Newborn Health, calls attention to the wide maternal and neonatal mortality gap between the developing and the industrialized world. Women in the world’s least developed countries are 300 times more likely to die in childbirth or from pregnancy-related complications than women in developed countries, while infants born in the developing world are almost 14 times more likely to die during the first month of life than a child born in a developed one.
The health and survival of mothers and their newborns are linked, and many of the interventions that save new mothers’ lives also benefit their infants. The 2009 edition of UNICEF’s flagship publication highlights the link between maternal and neonatal survival, and suggests opportunities to close the gap between rich and poor countries.
Every year, more than half a million women die as a result of pregnancy or childbirth complications. Since 1990, an estimated 10 million women have lost their lives in the process of giving life.
Both mothers and infants are vulnerable in the days and weeks after birth – a critical time for life-saving interventions, such as post-natal visits, proper hygiene, and counseling about the danger signs of maternal and newborn health.
While many developing countries have made excellent progress improving their child survival rate in recent years, there has been less headway in reducing maternal mortality. Niger and Malawi, for example, nearly cut their under-five death rates in half between 1990 and 2007. In Indonesia, under-five death rates fell to nearly a third of what they were in 1990, and in Bangladesh they fell by more than a half.
The same progress has not been made in addressing health risks for mothers, who are most vulnerable during delivery and in the first days after birth. And while the rate of survival for children under five years of age is improving globally, the risks faced by infants in the first 28 days remain at unacceptably high levels in many countries.
In the developing world, a woman has a 1 in 76 lifetime risk of maternal death, compared with a probability of 1 in 8,000 for women in developed countries. Approximately 99 percent of global deaths arising from pregnancy and complications occur in the developing world, where having a child remains among the most serious health risks for women. The vast majority occur in Africa and Asia, where high fertility rates, a shortage of trained personnel and weak health systems spell tragedy for many young women.
The ten countries with the highest lifetime risk of maternal death are Niger, Afghanistan, Sierra Leone, Chad, Angola, Liberia, Somalia, the Democratic Republic of Congo, Guinea-Bissau, and Mali. A woman’s lifetime risk of maternal death in these countries ranges from 1 in 7 in Niger to 1 in 15 in Mali.
To lower maternal and infant mortality, the report recommends essential services be provided through health systems that integrate a continuum of home, community, outreach and facility-based care.
This continuum of care concept transcends the traditional emphasis on single, disease-specific interventions, calling instead for a model of primary health care that embraces every stage of maternal, newborn and child health. Yet saving the lives of mothers and newborns takes more than just medical intervention. These essential services are most effective in an environment that supports women’s empowerment, protection and education.
Related press releases and news notes:
27 October 2008 - Project launched to improve mother and child healthcare in Uzbekistan
25 September 2008 - Joint statement on maternal and newborn health
19 September 2008 - UNICEF: Report highlights risk of maternal mortality in developing world