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Antenatal care could save millions

Where antenatal care is lowest
% of women (aged 15-49) attended by skilled health personnel at least once during pregnancy
Chad	23
Nepal	24
Mali	25
Bangladesh	26
Pakistan	26
Cambodia	34
Yemen	34
Niger	39
Morocco	42
Mauritania	48
Eritrea	49
India	49
Tanzania	50
Sources: DHS, WHO and UNICEF (1990-1999)

Ten years ago, leaders attending the World Summit for children pledged to ensure universal access by women to maternal health care by the year 2000. Yet 44 million women in the developing world still receive no antenatal care.

Insufficient maternal care during pregnancy and delivery is largely responsible each year for nearly 600,000 maternal deaths and an estimated 5 million infant deaths either just before or during delivery or in the first week of life.

Out of the 88 countries for which data are available, the situation is particularly desperate in 13 countries (see list). The lowest rates of maternal care were found in Bangladesh, Chad, Mali, Nepal and Pakistan.

The surveys also contained the good news that in 27 countries – including Kenya, Rwanda, Uganda and Zambia – more than 90% of women received skilled care at least once during their pregnancies.

Contact with a doctor, nurse or midwife facilitates maternal immunization and allows health personnel to manage the pregnancy, detect complications and promote good eating, hygiene and adequate rest.

Maternal care rates tend to be low and maternal mortality rates high in countries where women’s status is low, a consequence of women having fewer economic and educational opportunities and little access to social services. Also, fewer people have access to routine health services, including skilled maternity care, in impoverished, remote geographical areas than in urban areas.

The national percentages do not reveal the entire picture, as they mask huge rural/urban disparities.

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