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UNICEF: Extreme Risks for Pregnant Women and Newborn Babies in Developing Countries

UNICEF:  Extreme Risks for Pregnant Women and Newborn Babies in Developing Countries

Pregnancy 300 times deadlier in least developed world

Ulaanbaatar, 17 February 2009 - 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, according to UNICEF’s latest flagship publication State of the World’s Children report, launched today at the Maternal and Child  Health Research Center in Ulaanbaatar. (The report available
At the same time, a child born in a developing country is 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. Babies whose mothers die during the first six weeks of their lives are far more likely to die before their second birthday than babies whose mothers survive.
The 2009 report highlights the link between maternal and neonatal survival, and suggests opportunities to close the gap between rich and poor countries.
“On average, each day around 1500 women die from complications related to pregnancy and childbirth. Since 1990, complications related to pregnancy and childbirth has killed an estimated 10 million women. ” said at the launch Dr. Bertrand Desmoulins, UNICEF Representative. These complications include hemorrhage (25 percent of maternal deaths); infections (15%); unsafe abortion (13 %); eclampsia or hypertensive disorders (12 %); and obstructed labour (8%).  Mortality risks for mothers and newborns are particularly elevated within the first two days after birth.
Maternal mortality ratios are particularly staggering in sub-Saharan Africa with the highest maternal mortality ratio of 2,100 maternal deaths per 100,000 in Sierra Leone. As for Mongolia there has been a significant decline in maternal mortality ratio reaching 46  per 100,000 live births. “In 2008, number of deliveries increased by 18496 (or 41,5%) compare to 2004. However, there are many factors affect the quality of maternal and child care services, such as number of delivery beds and workload of medical personnel. This situation may negatively affect quality of medical services provided to mothers and newborns”, emphasized in his opening speech Mr. S.Lambaa, Minister of Health of Mongolia.
The risks faced by infants in the first 28 days remain at unacceptably high levels in many countries, although the rate of survival for children under five years of age is improving globally. In Mongolia, similarly the share of peri-natal mortality (infant death per 1000 births including live and stillbirth occurred  between 22 weeks of pregnancy and 7 completed days after birth: -WHO definition) and newborn mortality among infant mortality are high and remains stagnant during the last decade.  
The report underlines main causes of maternal and neonatal mortality, including weak health systems, which in many low-income countries suffer from weak administrative, technical and logistical capacity, inadequate financial investment and a lack of skilled health personnel. Geographic isolation is not the only impediment to accessing health-care facilities. Cultural reservations about women being attended by strangers and financial costs of skilled attendance are also deterrents that may prevent women from giving birth in health care facilities.
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. The essential services required to support a Continuum of Maternal and Neonatal Care include: enhanced nutrition, safe water, sanitation and hygiene practices, disease prevention and treatment; quality reproductive health services; adequate antenatal care; skilled attendance at delivery, emergency obstetric and newborn care; post-natal care; neonatal care; and Integrated Management of Neonatal and Childhood Illness.
“These essential services for mothers, newborns and children are most effective when they are delivered in a timely fashion at critical points in the life cycle of mothers and children:  adolescence, pre-pregnancy, pregnancy, birth, post-partum, neonatal, infancy and childhood,” said Dr. Desmoulins.
The report also emphasizes that saving the lives of mothers and their newborns requires more than just medical intervention.  To be truly effective, these interventions must exist within an environment supportive of women’s empowerment, protection, and education. Studies show that children of educated women have higher survival rates than those of uneducated women and tend to be better nourished.
Above issues were highlighted by the Mongolian maternal and child health experts who participated in the technical meeting held as a part of the launch of the State of the World’s Children report. The meeting was opened by Ms. J.Tsolmon, Vice Minister of Health. Participants discussed the continuum of care across life cycle and delivery of high impact services at family, community and secondary and tertiary hospital levels. 
As an outcome of this meeting, the participants have made the recommendations to the Implementation Plan of the Mongolian Government’s initiative “Healthy mother-healthy baby”, the endorsed component of its Plan of Action.
The report notes the importance of the civil society’s role in maternal and newborn health not only in improving people’s access to services and facilitating closer contact between health workers and individuals or households, but also encouraging behavioural change and social mobilization.
The launch was also attended by the Senior Advisor to the Deputy Premier, UN Resident Coordinator and other officials.




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