Leading and underlying causes of maternal mortality
There is no mystery about why so many the women are dying while giving birth.
They are dying because they have no access or limited access to health care, or because the quality of care is poor.
They die due to haemorrhage, sepsis, hypertensive disorders, unsafe abortion and prolonged or obstructed labour – complications that can often be effectively treated in a health system that provides skilled personnel facilities to handle emergencies when they occur and post-partum care. This underscores the importance of having a skilled attendance at delivery. Research has shown that approximately 80 per cent of maternal deaths could be averted if women had access to essential maternity and basic health-care services.
Haemorrhage is the leading cause of maternal death in Africa
Causes of maternal death (1997-2002) in Africa
Source: Progress for children 7 (UNICEF, September 2008)
A woman’s health and nutritional status, including HIV and anaemia, underlie these causes, along with societal factors such as poverty, inequity, women’s low status and
attitudes towards women and their needs.
Underlying causes of maternal mortality include early marriage and early pregnancies, pregnancies spaced too closely together, female genital mutilation/cutting, lack of education and empowerment.
A few facts:
- 44 per cent of women 20-24 years old in West and Central Africa were married or in union before they were 18 years old. In Niger, the rate of child marriage is 75% - the highest in the world.
- Adolescent pregnancy and motherhood are exceptionally high in West and Central Africa. The highest rates of adolescent fertility are found in the Democratic Republic of the Congo (225 births per 1,000 girls and young women aged 15–19), Liberia (221) and Niger (204).
- West and Central Africa has the highest fertility rates in the world, with a total fertility rate of 5.6; up to 7.3 in Niger - the highest in the world.
- 28 per cent of women 15-49 years old in the region have been mutilated/cut.
- The region's levels of adult female literacy, an associated indicator, are among the lowest in the world. Access to education for girls is pivotal.
- The level of poverty is also explaining the level of maternal mortality. For mothers as well as for their infants, the risk of dying during or shortly after birth is 20-50 per cent higher for the poorest of 20 percent of households than for the richest quintile. There is also a significant divide in access to maternal health care between rural and urban dwellers. In Chad, only 1 per cent of the poorest women are attended by skilled health personnel during delivery, compared with 48 per cent of the wealthiest women.
- West and Central Africa has the highest fertility rates in the world, with a total fertility rate of 5.6 and an average adolescent birth rate of 146 births per 1,000 girls and young women aged 15–19.
- Lack of use of family planning: in 17 countries, fewer than a fifth of women aged 15–49 who are married or in union are using some method of contraception. In addition, this region’s levels of adult female literacy, an associated indicator, are among the lowest in the world
- Women suffer from a disadvantaged position in the society; In Mali, Burkina Faso and Nigeria, more than 70 per cent of women surveyed said they had no say on the decision regarding their own health or that of their children.