FACT SHEET Understanding Maternal, Newborn and Child Health The Basics About 8 million children die each year – greater than the number of adults who will die from AIDS, malaria and tuberculosis combined.1, 2 Approximately 350,000 women die every year as a result of childbirth and 15 million more suffer life-long complications.2, 3 The vast majority of these deaths occur in developing countries and most are preventable. Pregnancy and childbirth are particularly dangerous for young women and their children. Maternal mortality is the leading cause of death for girls between the ages of 15 and 19, and perinatal deaths are 50 percent higher in this age group compared to women over the age of 204 Maternal and Child Mortality – A Global View5, 6 Causes of maternal deaths, 1997-2007
Causes of child deaths, 2008 /ŶũƵƌŝĞƐ ϯй
www.globalhealth.org
ŵďŽůŝƐŵ ϭй
ďŽƌƚŝŽŶ ϵй ^ĞƉƐŝƐ ϴй
DĞĂƐůĞƐ ϭй
DĂůĂƌŝĂ ϴй
/ŶĚŝƌĞĐƚ ϭϴй KƚŚĞƌ ĚŝƌĞĐƚ ϭϭй
,/sͬ / ^ Ϯй
,ĂĞŵŽƌƌŚĂŐĞ ϯϱй
WŶĞƵŵŽŶŝĂ ϭϰй
,LJƉĞƌƚĞŶƐŝŽŶ ϭϴй
EĞŽŶĂƚĂů ĐĂƵƐĞƐ ϰϮй
ŝĂƌƌŚĞĂ ϭϰй KƚŚĞƌ ϭϲй
Indirect causes of maternal deaths include malaria, HIV/ AIDS and cardiac diseases. Deaths related to obstructed labor and anemia are now included within hemorrhage or sepsis.
!
! !
Mothers are at the greatest risk of death within the first 48 hours after delivery. Hemorrhage and hypertension are the two leading causes of maternal death, and “are among the top three causes of deaths in South Asia and sub-Saharan Africa.”5 Each year, about 3.6 million newborns die in the first month of life, roughly equivalent to the number of children born annually in the U.S.7 Pneumonia and diarrhea are the leading killers of children over a month old, accounting for a third of under five deaths.
Healthy Mother, Healthy Child !
Maternal death increases the risk of death for her children. A study in Bangladesh found that maternal death adversely affected child survival up to age 10 years.8
Maternal infections may be transmitted from mother to child during pregnancy, delivery, or breastfeeding. Of the 430,000 children newly infected with HIV the same year, more than 90 percent were infected through vertical transmission from their mothers.9 Undernutrition is the underlying cause of 3.5 million maternal and child deaths.10 Maternal undernutrition increases the risk of maternal death during delivery, and is a associated with intrauterine growth restriction, low birth weight, and other neonatal conditions.10
Making Progress
Over the past 20 years, the child mortality rate has declined by a third from 89 deaths per 1,000 live births in 1990 to 60 per 1,000 in 2009; maternal deaths have also declined by about one third.1, 3 Despite overall reductions maternal and child deaths, progress is geographically uneven, both between and within countries. Since 1990, 23 countries have shown an increase in maternal mortality ratio, and the child mortality rate has either increased or remained constant in at least 17 countries. 1, 3
Challenges
Labor and delivery are particularly dangerous for mothers and newborns; access to skilled birth attendants and emergency obstetric care would reduce many of the 2 million deaths that occur during this time.5 Over 200 million women who want to avoid pregnancy do not have access to modern contraceptives.11 Meeting the unmet need for family planning would reduce the number of unintended pregnancies and unsafe abortions, and lower maternal and child mortality.11 High rate of HIV infection is an obstacle to reducing maternal mortality in many countries, especially in sub-Saharan Africa. 2, 12 Progress in reducing newborn deaths is slow and the proportion of newborn deaths in the under-five population has increased from 2000 to 2008.7 Social disparities prevent specific populations from accessing services. Women who are poor or living in rural areas are less likely to access services than women who are wealthy or living in cities.13
NOVEMBER 2010
References 1. You D, Jones G, Wardlaw T, United Nations Inter-agency Group for Child Mortality Estimation. Levels & trends in child mortality: estimated developed by the UN Inter-agency Group for Child Mortality Estimation. New York: UNICEF; 2010. 2. Hogan MC, Lopez AD, Lozan R, Murray CJ, Naghavi M, Rajaratnam JK. Building momentum: global progress toward reducing maternal and child mortality. Seattle: Institute for Health Metrics and Evaluation; 2010. 3. WHO, UNICEF, UNFPA, World Bank. Trends in maternal mortality: 1990 to 2008. Geneva; 2010. 4. WHO. Women and health: today's evidence, tomorrow's agenda. Geneva: WHO; 2009. 5. World Health Organization, UNICEF. Countdown to 2015 decade report (2000-2010):taking stock of maternal, newborn and child survival. Washington DC: World Health Organization, UNICEF; 2010. 6. Childinfo. Statistics by area: child survival and health. 2010 [cited 26 July 2010; Available from: http://www.childinfo.org/ mortality_overview.html 7. Black R, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. The Lancet. 2010;375:1969-87. 8. Yusuf HR, Atrash HK. Parents' death and survival of their children. Lancet. 2010;375:1944-5. 9. UNAIDS. 2009 AIDS Epidemic Update. Geneva: UNAIDS; 2009. 10. Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371:243-60. 11. Singh S, Darroch JE, Ashford LS, Vlassoff M. Adding it up: the costs and benefits of investing in family planning and maternal and newborn health New York: Guttmacher Institute and United Nations Population Fund; 2009. 12. Abdool-Karim Q, AbouZahr C, Dehne K, Mangiaterra V, Moodley J, Rollins N, et al. HIV and maternal mortality: turning the tide. Lancet. 2010;375:1948-9. 13. Kinney MV, Kerber KJ, Black RE, Cohen B, Nkrumah F, Coovadia H, et al. Sub-Saharan Africa's mothers, newborns, and children: where and why do they die? PLoS Medicine. 2010;7(6).
1111 19th Street NW Suite 1120
Washington DC
20036
202.833.5900