Countries in the MENA region have made tremendous progress in reduction of maternal and under-five mortality. The maternal mortality ratio (MMR) declined by 50 per cent in the MENA region from 1990 to 2015 (from 220 to 110 maternal deaths per 100,000 live births); Under-5 mortality rates (U5MR) dropped 59 per cent in the Middle East and North Africa region from 1990 to 2015 (from 71 to 29 deaths per 1,000 live births). Trends in neonatal mortality rate (NMR) have been similar to MMR and U5MR (49 per cent decline from 1990 to 2015) and current NMR is approximately 15 deaths per 1,000 live births in the MENA region.
Of particular note has been the unbalanced progress within countries with all segments of the population not making progress at the same rate. Higher income countries have better coverage of maternal, newborn and child survival inventions such as antenatal care visits, skilled birth attendance, protection against neonatal tetanus, and measles vaccination. Moreover the inequities and bottlenecks between countries are replicated within national borders.
The leading causes of maternal mortality in MENA have barely shifted since 1990. Pregnancy and delivery-related complications such as hemorrhage (~20%), hypertensive disorders (~15%), maternal sepsis and other infections (~10%), obstructed labor (~10%), and abortive outcomes (~13%) endure as the major causes of maternal death. Together, these preventable causes accounted for almost 70 per cent of all maternal deaths in MENA. Although the share of child deaths attributable to pneumonia and diarrhea has dropped since 2000, these avertible causes persist as the main reasons for post-neonatal deaths in the region.
For many years the MENA region has been plagued by ongoing conflicts, detrimentally affecting the health status of the most vulnerable population, women and children. Outbreaks of diseases have been occurring in many parts of MENA region and particularly in countries affected by conflict. Outbreak of wild polio virus in Syria and cholera in Yemen are some examples of continued public health challenges in this region. Degradation of the health system in countries in the region that are affected by conflict poses a serious challenge to the attainment of the children’s right to health.