Inflammation and stories on maternal health

Maternal Health in NepalNepal is a landlocked country bordering India and China, with a population of approximately 30 million. With close to 80% of births occurring at home, maternal health in Nepal has become a focal point as mortality rates raised alarmingly.

4 Facts About Maternal Health in Nepal

  1. The maternal mortality rate saw a reduction of about 71% between the years 1990 and 2015. The decline is attributed to free delivery services and transport, access to safe delivery services, and medicines that prevent hemorrhaging.
  2. Midwives are one of the popular professional services for maternal health in Nepal. Fast intervention and postnatal suggestions from a skilled midwife allows for better care for both mother and child after birth. In Nepal, only about 27% of women receive care within 24 hours of giving birth. This makes way for hemorrhaging, heavy-lifting related injuries shortly after giving birth and complications for the baby during and directly after birth.
  3. To ensure that midwives are updated on the most current practices and procedures for successful pregnancy and birthing, midwifery education is imperative. Institutions have partnered with the United Nations Population Fund (UNFPA) to offer combined education for nursing and midwifery. Midwives do not have specific legislation for their work. They are not completely recognized under the law or regulated, creating issues with proper training and resources. Therefore, greater recognition and accessibility will allow midwives the resources, training and encouragement that they need for success.
  4. The National Medical College Teaching Hospital in Nepal published an extensive report of the challenges surrounding maternal health in Nepal. A specific challenge mentioned in this report includes the socio-economic influencers of maternal health. Due to poor nutritional health in women with lower economic status, issues like anemia that cause mortalities. Additionally, rural areas record about 280 birth complications per day.

As maternal health in Nepal becomes more of a focus in the healthcare system, certain policies and programs must be expanded. Midwifery education and access to services are the most important programs for successful maternal health in Nepal. Many experts and those in the field continue to push for individual programs that focus primarily on methods for successful midwives.

– Ashleigh Litcofsky
Photo: Pixnio

Life Expectancy in Timor-Leste
Timor-Leste, also known as East Timor, is a nation that occupies the eastern half of the island of Timor in Southeast Asia. With a population of 1.26 million people, Timor-Leste is one of the least populated countries in Asia. The Portuguese originally colonized the country in 1520. After declaring independence in 1975, Indonesia invaded the nation, which occupies the western half of the island. The Indonesian invasion brought violence, famine and disease to Timor-Leste, resulting in a large loss in population. After a majority of the Timorese population voted to become independent in 1999, Indonesia relinquished control and Timor-Leste moved under the supervision of the United Nations. The nation officially became independent in 2002, making it one of the newest nations in the world. These 10 facts about life expectancy in Timor-Leste outline the rapid improvement the country has made since Indonesian occupation and the issues it still needs to overcome.

10 Facts About Life Expectancy in Timor-Leste

  1. Life expectancy in Timor-Leste increased from 32.6 years in 1978 to 69.26 years in 2018, matching that of South Asia. The consistent improvement in life expectancy in the past decade is primarily due to the Ministry of Health’s public health interventions. Such interventions include the reconstruction of health facilities, expansion of community-based health programs and an increase in medical graduates in the workforce.
  2. Life expectancy in Timor-Leste increased despite a drop in GDP, which decreased from $6.67 billion in 2012 to $2.6 billion in 2018. However, Timor-Leste’s GDP rose by 2.8% from 2017 to 2018. Continued improvement in GDP and economic progress in the nation will only serve to increase life expectancy by providing more opportunities for employment, education and improved quality of life.
  3. Tuberculosis was the highest cause of death in 2014, causing 14.68% of deaths. In 2014, estimates determined that Timor-Leste had the highest prevalence of tuberculosis in Southeast Asia, and 46% of people with tuberculosis did not receive a diagnosis in 2017. Maluk Timor, an Australian and Timorese nonprofit committed to advancing primary health care, provides a service through which team members visit Timorese households to locate undiagnosed patients and raise awareness about the severity of tuberculosis in the community. The organization collaborates with the National TB Program and aims to eliminate suffering and deaths in Timor-Leste due to diseases that Australia, which is only one hour away, had already eliminated.
  4. Communicable diseases caused 60% of deaths in 2006 but decreased to causing 45.6% of deaths in 2016. While diseases such as tuberculosis and dengue fever remain a public health challenge, the incidence of malaria drastically declined from over 200,000 cases in 2006 to no cases in 2018 due to early diagnoses, quality surveillance, funding from The Global Fund to Fight AIDS, Tuberculosis and Malaria and support from the World Health Organization.
  5. The adult mortality rate decreased from 672.2 deaths per 1,000 people in 1977 to 168.9 deaths per 1,000 people in 2018. Additionally, the infant mortality rate decreased from 56.6 infant deaths per 1,000 live births in 2008 to 39.3 infant deaths per 1,000 live births in 2018. While public health interventions and disease prevention contributed to the decrease in the adult mortality rate, Timor-Leste needs to expand access to maternal health services in rural areas to continue to improve the infant mortality rate.
  6. Maternal mortality decreased from 796 deaths per 100,000 live births in 1998 to 142 deaths per 100,000 live births in 2017. The leading cause of the high maternal mortality rate is poor access to reproductive health services, as only 43% of women had access to prenatal care in 2006. While the Ministry of Health continues to expand access to maternal health care through mobile health clinics that reach over 400 rural villages, only 30% of Timorese women gave birth with a health attendant present in 2013. Even as access increases, challenges such as family planning services, immunization, treatment for pneumonia and vitamin A supplementation remain for mothers in rural communities.
  7. The violent crisis for independence in 1999 destroyed more than 80% of health facilities. Despite rehabilitation efforts to rebuild the health system, many facilities at the district level either have limited or no access to water. However, the number of physicians per 1,000 people improved from 0.1 in 2004 to 0.7 in 2017. The capacity of the health care system is also improving, as UNICEF supports the Ministry of Health in providing increased training for health care workers in maternal and newborn issues and in striving to improve evidence-based public health interventions.
  8. Timor-Leste has one of the highest malnutrition rates in the world. At least 50% of children suffered from malnutrition in 2013. Additionally, in 2018, 27% of the population experienced food deprivation. USAID activated both the Reinforce Basic Health Services Activity and Avansa Agrikultura Project from 2015-2020 to address the capacity of health workers to provide reproductive health care and the productivity of horticulture chains to stimulate economic growth in poor rural areas. Both projects aim to combat malnutrition by addressing prenatal health and encouraging a plant-based lifestyle that fuels the economy.
  9. Motherhood at young ages and education levels are key contributors to malnutrition, as 18% of women began bearing children by the age of 19 in 2017. Teenage girls are far more likely to experience malnourishment than older women in Timor-Leste, contributing to malnutrition in the child and therefore lowering life expectancy for both mother and child. As a result of malnutrition, 58% of children under 5 suffered from stunting in 2018. Additionally, findings determined that stunting levels depended on the wealth and education level of mothers. In fact, 63% of children whose mothers did not receive any formal education experienced stunting, while the number dropped to 53% in children whose mothers received a formal education.
  10. Education enrollment rates are increasing, as the net enrollment rate in secondary education increased from 40.5% in 2010 to 62.7% in 2018. Completion of secondary education links to higher life expectancy, especially in rural areas. Since 2010, Timor-Leste has increased spending on education. Additionally, local nonprofit Ba Futuru is working to train teachers to promote quality learning environments in high-need schools. After Ba Futuru worked with schools for nine months, students reported less physical punishment and an increase in innovative and engaging teaching methods in their classrooms. The organization serves over 10,000 students and provides scholarships for school supplies for hundreds of students. With more programs dedicated to increasing enrollment and the classroom environment, students are more likely to complete secondary education and increase both their quality of life and life expectancy.

These 10 facts about life expectancy in Timor-Leste indicate an optimistic trend. Although malnutrition, disease and adequate access to health care remain prevalent issues in Timor-Leste, the nation’s life expectancy has rapidly increased since Indonesian occupation and has steadily improved its education and health care systems since its founding in 2002. To continue to improve life expectancy, Timor-Leste should continue to focus its efforts on improving public health access and community awareness in poor rural areas, and particularly to emphasize maternal health services to reduce both maternal and infant mortality rates. Despite being one of the newest nations in the world, Timor-Leste shows promise and progress.

Melina Stavropoulos
Photo: Flickr

Maternal health in Nepal Nepal, a landlocked country bordering India and China, has a population of approximately 30 million. In 2015, close to 41 percent of births occurred at home in Nepal. Of those home births, just under half were carried out without a trained professional. Due to the alarming rate of maternal deaths seen in the early 2000s, maternal health in Nepal has been a focal point for many years. Even though complications during births at health centers still occur, the presence of trained professionals during birth remains the best way to avoid preventable deaths. Many organizations have partnered with the Nepalese government and are working hard to bring these numbers down even further every year.

4 Facts About Maternal Health in Nepal

  1. Nepal’s maternal mortality rate decreased about 71 percent between 1990 and 2015. The decline is attributed to free delivery services and transport in rural areas, access to safe delivery services and medicines that prevent hemorrhaging. In rural parts of Nepal, it has historically been much more difficult to receive proper healthcare. Through the combined efforts of various organizations and the Nepalese government, the number of facilities in remote areas has increased. Additionally, the incentive to travel to these facilities has risen. In 2005, the government began giving stipends to pay for transportation costs. Four years later, the government passed the Safe Motherhood Programme, which allowed free delivery services to pregnant women. In 2011, the government continued to promote safe pregnancies by adding another incentive of $5 for attending antenatal checkups. Through these efforts, the government has had an enormous impact on the development of maternal health in Nepal.
  2. Midwifery is one of the most important services for maternal health in Nepal. Fast intervention and postnatal suggestions from a skilled midwife allows for better postnatal care for both mother and child. In Nepal, only about 27 percent of women receive care within 24 hours of giving birth. This increases risk of hemorrhaging and heavy-lifting related injuries shortly after giving birth. It also increases risk of possible complications for the baby during and directly after birth.
  3. Midwifery education ensures that midwives are up to date on the most current practices and procedures for successful pregnancy and birthing. Institutions have partnered with the United Nations Fund for Population Activities (UNFPA) to offer combined education for nursing and midwifery. In 2011, Nepal and the UNFPA committed to training 10,000 birthing attendants. However, in a report about midwifery authored by the UNFPA, midwives do not have specific legislation for their work. Midwives are not completely recognized under the law nor are they regulated, which results in issues with proper training and resources. Therefore, greater recognition and accessibility will allow midwives the resources, training and encouragement that they need for success.
  4. Women of lower socioeconomic status have more complications surrounding maternal health. The National Medical College Teaching Hospital in Nepal published an extensive report of the challenges surrounding maternal health in Nepal. A specific challenge mentioned in this report includes the socioeconomic influencers of maternal health. Due to poor nutritional health in women of lower economic status, issues such as anemia can cause mortalities. Additionally, rural areas record about 280 birth complications per day. Although there has been significant work since then to expand access to cesarean sections and birthing centers in rural areas, there are still around 258 women dying per 100,000 live births.

As maternal health in Nepal becomes more of a focus in the healthcare system, there are certain policies and programs that must be expanded upon. Midwifery education and access to services are the most important programs for successful maternal health in Nepal. Many experts in the field continue to push for individual programs that focus primarily on methods for successful midwifery education and overall increased care for maternal health in Nepal.

– Ashleigh Litcofsky

Photo: Flickr

Maternity Crisis in Sierra Leone
There is a maternity crisis in Sierra Leone. The country has the highest maternal death rate in the world, with one in 17 women dying from pregnancy or birth complications. This number could be even higher, as Sierra Leone’s 2017 Maternal Death and Surveillance Report estimated that seven in 10 maternal deaths go unreported. Below are seven facts about the maternity crisis in Sierra Leone.

Top 7 Facts About the Maternity Crisis in Sierra Leone

  1. The Majority of Maternal Deaths are Preventable: The top causes of maternal death in Sierra Leone are bleeding, pregnancy-induced hypertension, infection and unsafe abortions, all of which are preventable through adequate medical treatment, according to the World Health Organization. Bleeding is a particularly difficult problem for under-served rural areas where mothers do not have access to health care facilities. Another issue facing mothers is infrastructure. People poorly maintain many roads between towns and clinics and these make for a difficult journey for sick and laboring women. Again, road maintenance is a simple problem that can help reduce maternal death in Sierra Leone.
  2. The Majority of Mothers are Under 20: One hundred and twenty-five out of 1,000 mothers in Sierra Leone are under age 20 according to a 2017 United Nations Population Fund (UNFPA) study. Maternity in Sierra Leone is particularly dangerous for adolescent mothers and 20 percent of maternal deaths in Sierra Leone were among teenagers. Beyond maternal death, pregnant teenagers in Sierra Leone lose out on life prospects – a 2015 law banned pregnant girls from attending school, and parents describe teenage pregnancy as the “ultimate shame” for a family.
  3. The 2014-2015 Ebola Crisis Halted Progress: Before 2014, Sierra Leone was making progress in reducing maternal death – from 2000 to 2015, maternal deaths dropped by 4.4 percent. However, the Ebola epidemic caused an immediate increase in maternal death through 2015. Sierra Leone planned to meet many Millennium Development Goals by 2015, but the May 2014 Ebola outbreak reversed progress, particularly in maternal health. Not only did Ebola put a strain on general health care in Sierra Leone, but it also dramatically reduced the number of health care workers in the country. A 2016 World Bank report estimated that maternal death could increase by 74 percent due to the extreme shortage of health care workers in the country.
  4. Programs for Maternity Care Still Need Funding: There is a dearth of doctors in Sierra Leone. For example, in the district of Bonthe, there are nine doctors for 220,000 patients and only 44 percent of births receive support from a nurse or midwife. Unfortunately, between the civil war from 1991 to 2001 and the 2014 to 2015 Ebola outbreak Sierra Leone, the burgeoning health care system in Sierra Leone lost momentum. The E.U., the U.N. and UNICEF have all devoted funds to maternity in Sierra Leone in addition to Partners in Health and other nonprofit organizations. Donations are critical to moving forward with maternal health.
  5. Sierra Leone’s Government has Committed Itself: President Julius Maada Bio announced in October 2019 that Sierra Leone increased its health budget from 8.9 percent to 11.5 percent of the country’s national budget to help combat dangerous maternity in Sierra Leone. On October 18, 2019, Sierra Leone opened a $1.6 billion maternity facility in Freetown to better serve the country’s largest city. Sierra Leone also launched a free health initiative in 2010 to help improve pre- and post-partum care. The government’s goal for maternity in Sierra Leone is to meet Millennium Development Goals by 2030, reducing the global maternal mortality ratio to less than 70 per 100,000 live births.
  6. Nonprofits are Deeply Involved: Multiple nonprofit organizations, including UNICEF, Partners in Health and the Borgen Project have covered issues with maternity in Sierra Leone. Partners in Health has been particularly successful, building a maternal waiting home and opening a health clinic in Kono in 2018. UNICEF provided safer water for mothers to help with illness and sanitation. These nonprofits prove that the crisis is not insurmountable.
  7. Celebrities are also Getting Involved: In October 2019, vlogbrothers, run by Hank and John Green, pledged $6.5 million to Partners in Health as part of his family’s initiative to bring awareness to maternity in Sierra Leone. John Green discussed how he traveled to Sierra Leone and saw first-hand the lack of hospital electricity, medical equipment and transport. He praised the efforts of the Partners in Health in developing a large-scale hospital system and making systematic changes and he asked anyone who can donate to do so. Currently, the vlogbrothers have a goal of $240,000 per month in donations – so far, they have approximately $194,000. The vlogbrothers are also providing updates on their donations and work with Partners in Health in Sierra Leone.

Motherhood should not be a gamble. Families around the world deserve to look forward to pregnancy and birth and not feel distressed. Multiple organizations are pushing for progress, but more is necessary. Support in any form, from awareness to donations, can only help the crisis of maternity in Sierra Leone.

Melanie Rasmussen
Photo: Flickr

Life Expectancy in Georgia 

Georgia, located between Western Asia and Eastern Europe, has made significant progress over the past several decades when it comes to the life expectancy of its nearly 4 million citizens. Since around the 1990s, the country has experienced many health reforms that helped to improve the general health of its population as well as lower maternal and infant mortality rates. However, despite these improvements, Georgia still faces multiple health-related challenges that pose a threat to the life expectancy of its citizens. Listed below are five facts about life expectancy in Georgia.

5 Facts About Life Expectancy in Georgia

  1. According to a survey carried out by the United Nations in 2012, the average lifespan for Georgian women stood at 79 years, while the average life span for men was lower, at around 70 years. The average lifespan in Georgia is expected to increase to 80.6 years for women and 74.1 years for men by 2035. 
  2. As of 2019, the life expectancy in Georgia at birth is approximately 73.66 years. This marks a percentage increase of approximately 20 percent over 69 years. Back in 1950, the U.N. estimated that the life expectancy in Georgia at birth was less than 60 years in total. 
  3. According to the World Health Organization (WHO), the probability of death for people between ages 15 and 60 stands at 238 for males and 83 for females. The probability of children dying before the age of 5 per 1,000 births was around 11 in 2017.
  4. Georgia developed the Maternal and Newborn Health Strategy, as well as a short term action plan in 2017 to provide direction and guidance in improving maternal and newborn health. According to UNICEF, the three-year initiative “envisages that by 2030, there will be no preventable deaths of mothers and newborns or stillbirths, every child will be a wanted child, and every unwanted pregnancy will be prevented through appropriate education and full access for all to high quality integrated services.”
  5. In 2010, the leading causes of premature death in Georgia were cardiovascular and circulatory diseases, including ischemic heart disease and cerebrovascular disease. It was reported that in 2010, the three most prominent risk factors for the disease burdened people in Georgia were related to diet, high blood pressure and tobacco smoking. It was also reported that the leading risk factors for children who were younger than 5 and people between ages 15 to 49 were suboptimal breastfeeding and the aforementioned dietary risks.

As a whole, life expectancy in Georgia has improved significantly compared to the mid 20th century. With that being said, there is no denying that there is still work that needs to be done in a number of areas including maternal health. Hopefully, with strong investments from the government, life expectancy in Georgia will continue its upward trajectory. 

Adam Abuelheiga
Photo: Flickr

Women’s Health in IndiaWomen’s health in India is still vulnerable to several risks such as high maternal mortality rates, lack of preventative care and misinformation about family planning and contraception. Despite this, India has proven itself a pioneer in technological innovation among developing countries and it is putting its new innovations towards improving women’s healthcare. 

Maternal Health and Newborn Development

Although maternal mortality rates in India have declined substantially in the last decade, the number of recorded deaths related to pregnancy complications in the country is still remarkably high. A report by UNICEF estimates that 44,000 women die due to preventable pregnancy-complications in India yearly. These complications often stem from a lack of knowledge and inherently the inability to understand that their baby isn’t developing correctly. This lack of knowledge results in fewer women seeking treatment that could save their lives. To combat this, organizations are developing innovative mobile apps to help women stay proactive and educated about the health of their babies and the status of their pregnancies. 

For example, in 2014, MAMA (Mobile Alliance for Maternal Action), an organization dedicated to women’s maternal health in developing countries, developed a digital service called mMitra. The service sends recordings and SMS messages to new and expectant mothers with crucial information about the early stages of pregnancy and child development within the first year of life. The app, which collected 50,000 subscribers within months of its launch, sends educational content to women in their native languages and at times of their choosing. The app,  mMitra ultimately aims to help women pick up on pregnancy and child development issues early and seek treatment before symptoms escalate or endanger the mother and child. 

Breast Exams and Preventative Care

Mammograms are an essential part of preventative care for women globally. Despite this, it is estimated that over 90 percent of women in the developing world go without this essential screening examination. Particularly, in India, high-costs, unsustainable electricity and lack of properly trained radiologists are major causes for the inaccessibility to mammograms and other procedures like it. More women die of breast cancer in the country than anywhere else in the world (around 70,000 women annually). While these high death rates due to inaccessibility to preventive care are tragic, they’ve inspired innovative medical devices that have revolutionized women’s health in India. 

One such device, known as iBreastExam was invented by computer engineer Mihir Shah. Shah invented the device to ensure that women in even the most rural parts of India could get affordable, accurate breast exams and seek treatments as needed. The battery-operated wireless machine is designed to record variations in breast elasticity and performs full examinations in five minutes, posting and recording results through a mobile app. Not only that, the exams are painless, radiation-free and are extremely affordable at $1 to $4 per exam.

Family Planning and Contraceptive Options

Lack of family planning and knowledge of contraceptive options is another challenge in improving women’s health in India. Many Indian women shy away from modern family planning and contraception due to things like familial expectations, cultural influence and a general fear stemming from misinformation from disreputable resources. Family planning and the use of contraception could reduce India’s high maternal mortality rates. However, without proper education on these matters, it is difficult for young Indian women to make informed decisions about what options are best for them. But, in the midst of India’s technological revolution, an increase in accessibility to mobile devices is steadily transforming the way women are gaining health awareness in India. 

There is a particular mobile app that is playing a huge role in improving women’s health awareness in India. Known as Gyan Jyoti, the mobile app provides credible information through educational films, TV advertisements and expert testimonials from doctors. It also acts as a counseling tool for ASHAS (appointed health counselors). The app allows ASHAS to expand their knowledge of family planning through an e-learning feature, customize their counseling plan according to the needs of clients and monitor and store client activity in order to provide the best information possible. 

Overall, while there are still many challenges in improving women’s health in India, the country has proven itself to be a pioneer in technological innovation. Just as well, it’s proven that transformation is possible by putting its innovations towards women’s health awareness through mobile apps, life-saving hand-held devices, and educational platforms that can be accessed at the click of a button. 

Ashlyn Jensen
Photo: Flickr

 

Effects of Poverty While PregnantWomen represent more than half of the world’s poor and make only a small percentage of the world’s income. This is influenced by various factors, including lack of access to education, abuse and gender inequality. Because women are already at a higher risk of facing the crippling effects of poverty, their situation becomes more precarious when they are pregnant or new mothers. It is estimated that 99 percent of all maternal deaths occur in developing countries.

Furthermore, in food insecure and unstable countries, adolescent pregnancy is the leading cause of death in young women, ages 15-19. Some of the leading causes of maternal death include severe bleeding, infection and delivery complications due to a lack of proper health care facilities.

Physical Effects of Poverty While Pregnant

In developing countries, where there is often little access to high-quality food and water, one of the most common effects of poverty while pregnant is malnutrition. Underweight and malnourished mothers are at an increased risk of mortality, miscarriage and preterm labor. Because they lack proper access to antenatal care, they are prone to infection and morbidity.

The WHO Millennium Goals Progress Report showed that 60 percent of women in Africa give birth without the presence of a skilled attendant. In addition, nearly 50 percent in Africa lack any antenatal care.

As it relates to malnutrition, more than half of all pregnant women in developing countries suffer from anemia. In South Asia, for instance, 75 percent of pregnant women have anemia versus 18 percent in developing countries. Aside from the low energy levels associated with anemia, anemic pregnant women face a heightened risk of death from bleeding during childbirth.

Malnourished mothers are also at risk of developing hypertension. Although hypertension is associated with higher risks of preterm birth and lower child birthweights, the most severe risks include preeclampsia and placental abruption. The former can cause kidney, liver and brain damage for the mother. Although this is a treatable condition if caught early, many women in developing countries have little access to health care that would offer a proper diagnosis or treatment.

With regard to placental abruption, the placenta separates from the wall of the uterus and can cause severe bleeding for the mother and prevent the baby from receiving enough oxygen. Like anemia, hypertension is a severe physical side effect directly correlated with higher rates of poverty that puts malnourished mothers and babies at great risk.

Emotional Effects of Poverty While Pregnant

In many developing countries, women do not have equal access to education or career opportunities, making them dependent upon their spouses or families. Such dependency can lead to feelings of helplessness that can affect the health of pregnant women. Evidence suggests that pregnant women who face extreme poverty are more likely to face inequality and develop mental illness.

Furthermore, humanitarian crises, such as conflict and post-conflict situations, can increase the risk of violence against women. It is estimated that 35 percent of women worldwide have experienced physical and emotional violence. In places such as West and Central Africa where child marriage still exists, women are more likely to face violence and domestic abuse.

In sub-Saharan Africa, Intimate Partner Violence (IPV) has a 61 percent prevalence in some areas. Abuse in any form, physical, psychological or sexual, can have dire consequences on women and their health during pregnancy. Victims of abuse often face physical harm and mental health issues, such as depression, post-traumatic stress and anxiety. Some victims turn to alcohol or drugs. In addition, women who suffer abuse often face unwanted pregnancies and unsafe abortions. The stress of abuse can affect many aspects of a person’s life but puts pregnant women at a much greater risk due to their already vulnerable physical state.

Efforts to Lessen the Effects of Poverty While Pregnant

Programs such as the U.N.’s Global Strategy for Women’s, Children’s and Adolescent’s Health, the U.N. Millennium Development Goals and WHO Global Action Plan have made strides in reducing the effects of poverty while pregnant. Between 1990 and 2013, the global maternal mortality rate has decreased by 50 percent.

Although maternal mortality rates remain high in developing countries, programs such as the U.N.’s Agenda for Sustainable Development and numerous nonprofit organizations are working to provide access to antenatal care and technology that would assist in identifying health problems for pregnant women. With increased food security, access to antenatal care and an increase in education and gender equality, the U.N. Agenda For Sustainable Development hopes to decrease the maternal mortality rates by at least two-thirds by 2030.

In keeping with this sustainable development agenda, the Reach Every Mother and Child Act (S.1766) is a bipartisan bill that would allow for mothers and children in these impoverished nations to receive the care they so desperately need while also providing a foundation for them thrive and contribute to the global economy. Because the U.S. already has the expertise in ending preventable maternal and child deaths, we must play a larger role in this global fight to help mothers and their children.

 

Send an email to your Senators today asking them to support the Reach Every Mother and Child Act.

 

In addition to increasing access, a greater focus is being placed on the quality of care for these vulnerable groups led by the WHO and UNICEF. The two organizations recently launched a Network for Improving Quality of Care for Maternal, Newborn and Child Health to “cut preventable maternal and newborn illness and deaths, and to improve every mother’s experience of care.” In 2017-2019, Bangladesh, Côte d’Ivoire, Ethiopia, Ghana, India, Malawi, Nigeria, Tanzania and Uganda signed on as partners and more countries are expected to join this effort in the future.

– Christina Laucello and Kim Thelwell
Photo: Flickr

Maternal health in Guinea

Guinea, officially known as the Republic of Guinea, is a country in West Africa with a significant amount of natural resources, such as bauxite and iron ore as well as gold and diamond mines that could bring the country immense wealth. However, due to its reliance on agriculture and the Ebola outbreak of 2014, the country remains in poverty and has some of the lowest health rates in the world. The philanthropic focus on eradicating Ebola has shifted funds from maternal health to ending the Ebola crisis, endangering the lives of women and children. Improving maternal health in Guinea needs to become a priority.

Maternal Health in Guinea

Of the numerous social problems facing Guinea, maternal health is one of the most detrimental to the country. The neonatal mortality rate in Guinea is 25 deaths per 1,000 live births. The maternal mortality rate is 679 women out of 100,000 live births. This compared to a global neonatal mortality rate of 18 deaths per 1,000 live births depicts a country struggling with maternal health development. Throughout the country, only 36.1 percent of children are vaccinated and approximately 31 babies die each day while 21 babies are stillborn.

One aspect of maternal health that could use improvement is prenatal care and scheduled doctor visits. In rural areas, fewer than 40 percent of women receive prenatal treatment while 71 percent of women in urban areas attend doctor visits before the birth of their child. These low percentages of prenatal care correspond to equally low rates of women who give birth in facilities with trained personnel. The main reason women do not want to give birth in facilities is the mixed-gender wings. Women feel uncomfortable giving birth where men are present.

Global Funding to Reduce Maternal Mortality

To combat these statistics, the government of Guinea and various non-profit organizations are implementing programs to help improve the health and mortality of infants and mothers. In 2018, the World Bank approved $55 million in funding for the two poorest regions of Guinea, Kindia and Kankan. This money will go to improving reproductive, maternal, newborn and child health.

The grant was distributed to two different associations. The International Development Association will receive $45 million to provide low to zero-interest rates for programs that improve economic growth and reduce poverty. The Global Financing Facility will receive $10 million to prioritize underinvested areas of maternal and infant health.

In 2015, the USAID began the Maternal and Child Survival Program in Guinea, which improves the quality and availability of maternal and infant services. The goal of this program is to empower district-level lawmakers to strengthen local centers through a bottom-up approach. Through this initiative, MCSP has established seven healthcare facilities with 42 healthcare providers and 125 healthcare educators.

Focusing on Maternal Health

In 2015, the IDA approved a grant to implement the Primary Health Services Improvement Plan as part of a five-year plan to improve maternal health, child health and nutrition in Guinea. The grant specifically targets health centers by increasing the number of health centers and the availability of equipment and supplies in these centers.

Due to many centers focusing on fighting Ebola, this plan improves the availability of medicines in health centers, restores drug funds within health facilities, supports training in financial drug fund management and covers any financial gap to produce medicines in subsequent years. Additionally, the grant provides three-year training and continuous mentoring for nurse assistants. Furthermore, it recruits unemployed nurse assistants to work at these health centers.

Improvements Made

Since these initiatives began, there has been a significant improvement in developing maternal health in Guinea. The number of births attended by trained health professionals between 2016 and 2018 improved from approximately 27,000 personnel to 44,000. There were also 8 percent more women who received prenatal care by attending at least four doctor visits before the birth of their babies.

Similarly, the Ebola Response Project, although meant to target people affected by the Ebola breakout, has positively affected maternal health development in Guinea by helping fund a new maternity center in Koba. This center helps women attain the privacy they desperately desire by providing two separate wings for men and women. At this center, specifically, a program was initiated to distribute clothes, mosquito nets and soap to expecting mothers to encourage visiting the center.

Maternal health development in Guinea has been steadily improving through programs and governmental plans; however, there is still much work to be done. Although infant and maternal mortality rates are dropping due to an increase in health centers and personnel, a continued increase in funding and a restructuring of fund management is necessary to continue to improve maternal health in Guinea.

Hayley Jellison
Photo: Flickr

Urban and Rural Voucher Systems

Each year, millions of pregnant women give birth without access to proper health care services. Countries such as Ethiopia, Laos and Yemen are just a few parts of the world where this is a major problem. For example, in Ethiopia, 59 percent of women do not receive care by a medical professional during pregnancy. In Zimbabwe, however, access to prenatal care has drastically improved since the 2014 implementation of the Urban and Rural Voucher Systems (UVS and RVS, respectively). These systems allow for low-income pregnant women to receive the healthcare that they need. They have already had incredible benefits on thousands of pregnant women. Additionally, they set a great precedent for governments and NGOs to come together to find solutions to pressing maternal health issues.

Qualifications

The UVS and RVS service pregnant women whose incomes place them in the bottom 40 percent of households in Zimbabwe. Consequently, women who cannot afford the required $25 co-pay at many clinics can still receive care. Providing women with this essential health care helps to ensure that these women and their babies stay healthy and safe both during and after pregnancy.

Funding

The government of Zimbabwe, the World Bank and Codaid are the main sources of funding for the UVS and RVS. Cordaid is a local NGO that has assisted with much of the program’s implementation. Clinics are subsidized based on their performance. They measure performance on overall range and quality of coverage. This supply-side solution works to help promote jobs and economic growth in local communities, which contributes to the program’s long-term sustainability.

Impact on the Poor

Access to proper care during pregnancy is essential to ensure the health of expectant mothers and their child. In many countries around the world, women do not have access to this care. As a result, the consequences have been horrific.

For instance, there are roughly 3.3 million neonatal deaths recorded per year. Neonatal refers to the first four weeks of a baby’s life. Proper prenatal care can prevent these fatalities. A woman who receives such care is far less likely to give birth to a child with fatal health issues. Proper prenatal care can help identify and fix possible health issues before they become too serious. In addition, receiving prenatal care can offer educational resources. The care can educate a woman about the ways in which they should go about raising a healthy child.

Conclusion

Zimbabwe’s Urban and Rural Voucher Systems have had immense benefits since their implementation. The thousands of women that they have helped to serve reflect such benefits. The programs provide an affordable and accessible option for pregnant mothers to receive the care that they need to ensure both their health and the health of their babies. Also, the UVP and RVP supply-side design ensure that the programs are helping to stimulate local economies and bring communities together. All in all, while much progress must still be made towards increasing access to prenatal care for pregnant women around the world, Zimbabwe has taken an important first step with its Urban and Rural Voucher Systems.

– Kiran Matthias
Photo: Flickr

Child Health Care in Ethiopia

Ethiopia is a fascinating case study relating to the mission of downsizing poverty. Although many Ethiopians do struggle, the country has made significant improvements in recent years. For example, 30 percent have fallen below the poverty line as of 2011. The poverty rate decreased from 44 percent in 2000 to 30 percent in 2011. During that time, the percentage of Ethiopians who are uneducated decreased from 70 to 50 percent. Additionally, the average life expectancy rose by 10 years. Maternal and child health care in Ethiopia has been on a similar trend of improvement.

Maternal Care

In 2000, only 22 percent of mothers saw a doctor for an antenatal check-up before having their baby. This rate reportedly increased to 37 percent in 2011. Although this progress is promising, one in 52 women in Ethiopia die due to childbirth-related causes every year. Furthermore, 257,000 children in this country will die before reaching age 5. Fortunately, many organizations remain committed to improving maternal and child health care in Ethiopia through a variety of methods.

Organizations Dedicated to Improving Ethiopia’s Maternal and Child Care

USAID has worked alongside the Bill and Melinda Gates Foundation to bring change to Ethiopia. They have been working to improve coverage of universal family health care plans across the country. These plans include accessible prenatal care for
mothers. They also include increased immunizations and community-based management plans for childhood illnesses.

These two organizations focus on policy and advocacy to achieve their goals. Their success is shown in how poverty has decreased by 45 percent since the Bill and Melinda Gates Foundation first established a grant in Ethiopia in 2002. They cannot take all the credit for this improvement, however, as other organizations have joined them in the fight for better maternal and child health care in Ethiopia.

The World Health Organization (WHO), with the support of the Children’s Investment Fund Foundation and the Ethiopian Federal Ministry of Health, has approached this issue from a different direction. In 2015, the WHO launched a program to monitor and improve the quality of health care in Ethiopian hospitals. In 2015, WHO collected baseline data. This was in addition to training and suggestions for improvement of labor and care in the hospitals.

Improving the Safety of Deliveries

One change implemented by many hospitals was the adaptation of the Safe Childbirth Checklist. The checklist presented 29 essential activities for doctors to perform during childbirth to ensure the safety of the mother and the newborn. The follow-up data collected in 2016 found significant change had been made after the initial visits. This resulted in an improvement in the quality of maternal and child health care in Ethiopia.

This is, as the Gates Foundation puts it, a story of “progress, not victory.” Many Ethiopians continue to struggle, particularly in the realm of maternal and child health. However, the past twenty years of Ethiopia’s history remains hopeful and inspirational, not only for the country’s future but also as an example of the change that is possible. The impact of these organizations on the situation in Ethiopia should serve as a reminder of the potential for positive change.

– Madeline Lyons
Photo: Flickr