Inflammation and stories on maternal health

Antenatal Care in NigeriaMany developing countries have reduced their maternal mortality rates by expanding maternal care through policy innovations. Between 1990 and 2015, maternal mortality has dropped by 44 percent. While this is a considerable amount, maternal mortality remains high in developing countries. For example, in Nigeria, only 61 percent of pregnant women visit a skilled antenatal care provider at least once during their pregnancy. The average rate for similar lower-to middle-income countries is 79 percent.

Maternal health concerns the health of women during pregnancy, childbirth and the postpartum period. During this time, major causes of maternal mortality include hemorrhaging, infection, high blood pressure and obstructed labor.

Every day, 830 women die from preventable causes related to pregnancy and birth. In fact, 99 percent of maternal deaths occur in developing countries. It is necessary for policy innovation in developing countries because sustained use of maternal and antenatal care and increased rates of institutionalized delivery reduce maternal mortality.

Antenatal Care in Nigeria

Of the women who did access and antenatal care, 41 percent did not deliver in a health care facility. Nigeria ranks in the top 16 nations in maternal mortality: 576 deaths per 100,000 births. Containing only 2.45 percent of the world’s population, Nigeria contributes to 19 percent of maternal deaths globally.

There is a stark difference in the number of women who seek antenatal care in urban and rural areas: 75 percent versus 38 percent, respectively. Studies also show that more skilled professionals attended births in urban areas, revealing that 67 percent of women had a trained professional helping them. In rural areas, only 23 percent of women had the help of trained professionals. In these rural areas, only 8 percent of newborns receive postnatal care, whereas 25 percent of children do so in urban environment.

Due to the lack of health coverage and used resources, many of Nigeria’s infants die from preventable causes. Approximately:

  • 31 percent die from prematurity,
  • 30.9 percent die from birth asphyxia and trauma and
  • 16.2 percent die from sepsis.

Ways to Increase Access to Antenatal Care in Nigeria

Improving maternal and antenatal care in Nigeria can encourage women to utilize services such as improved facility infrastructure and amenities. Policy innovation in Nigeria can result in better equipment, more available drugs and an increase in overall comfort for the spaces.

In a study of antenatal patients in Nigeria, women responded positively to increased interpersonal interactions with providers. The study also suggested that improved maternal care should include access to providers who have technical performance skills and experience. Improved maternal care also includes access to providers who display empathy for their patients. Furthermore, policy innovation in Nigeria could improve increased access to facilities for those in rural areas.

Accessed to maternal and antenatal care in Nigeria can be improved with policy innovations made throughout the country. By making health facilities more accessible to more women and giving them the supplies and support they need, Nigeria will be able to decrease its maternal mortality rate and save its families from preventable complications of during pregnancy and infancy.

Michela Rahaim
Photo: Flickr

maternal mortality mozambique

Maternal health in Mozambique is a constant concern as the nation’s maternal mortality rate is one of the highest in the world. While some progress has been made, there is still much that needs to be done to ensure that mothers in Mozambique have to access high-quality healthcare. Recently, two initiatives have been created, the Mozambique-Canada Maternal Health Project and a project by the Maternal and Child Survival Program. They are working to improve maternal health in Mozambique.

The Current State of Maternal Health

In 2015, the maternal mortality rate was 489 deaths per 100,000 live births. Approximately one-fifth of these deaths are women under the age of 20. Maternal mortality has declined since 1990 when there were approximately 1390 deaths per 100,000 live births; however, maternal deaths remain high. It is clear that continued efforts are needed to improve the quality of maternal health in Mozambique. Each day, approximately 800 pregnant women die from preventable causes.

One of the primary factors determining maternal mortality rates is the availability of antenatal care. In regions where more women receive four or more antenatal visits, the maternal mortality rate is generally lower. Globally, 62 percent of pregnant women have at least four antenatal visits with a skilled health professional, while 86 percent of women have at least one. In Mozambique, only 51 percent of expectant mothers have at least four antenatal visits.

Additionally, only 54 percent of births are attended by skilled health personnel. Age is also a factor, with 40 percent of women 20-24 years old reporting that they gave birth before the age of 18. Younger mothers have an increased risk of death during childbirth, particularly if there is not someone with medical training present.

Early marriage logically leads to childbirth at a younger age and improving maternal mortality rates in the nation relies on protecting young women. In response to this, the government of Mozambique created the National Strategy to Prevent and Combat Early Marriage in 2016. This program includes better education about sexual and reproductive rights with the goal of empowering women to seek out appropriate care and understand their legal rights. For poorer women, this knowledge is often not enough, however, as they may not have the autonomy to make a legal case or have a healthcare facility readily available to them.

Maternal and Child Survival Program (MCSP)

The Maternal and Child Survival Program (MCSP) has launched a project in Mozambique’s Zambézia Province focused on treating pregnant women with malaria. Malaria currently accounts for 9.6 percent of deaths in the nation, and the rate in the Zambézia Province higher than the average. This project seeks to improve maternal health in Mozambique by tackling maternal and newborn deaths due to malaria.

Malaria during pregnancy has many consequences, including higher rates of maternal anemia and low birthweight babies. These factors increase the likelihood of maternal death as well as stillbirth. A treatment known as IPTs-SP exists that can prevent malaria in expectant mothers, but fewer than 22 percent of women in Mozambique receive adequate dosages during their pregnancy.

The MCSP project is empowering healthcare providers in Mozambique to treat malaria cases in pregnant women regardless of their complexity. For example, a young pregnant woman who had malaria but was also HIV-positive could not receive IPTp-SP treatments because the drug is incompatible with her HIV treatment. However, a different medication was able to be prescribed by an MCSP-trained nurse who had been trained on how to handle a variety of malaria cases.

The project also implemented a Standards-Based Management and Recognition for Malaria program in 58 health facilities in the Zambézia Province. This program is working to collect better data about malaria cases and more effectively implement initiatives for prevention and treatment.

Mozambique-Canada Maternal Health Project

Improving maternal health in Mozambique is a priority for the University of Saskatchewan as well. Researchers from the university are working with Mozambique’s health ministry and the NGO Women and Law in Southern Africa (WLSA) to empower women in 20 different communities through the Mozambique-Canada Maternal Health Project.

Education is a key piece to this project, providing information on maternal, reproductive and sexual health to community members in a way that is participatory and engaging for adolescents and adults. The project is also prioritizing the education of health practitioners to improve the quality of care for mothers in Mozambique.

Additionally, the project seeks to improve resources in the community that can improve maternal and newborn health. They intend to provide local ambulances, establish maternal waiting homes nearby to clinics and support local midwives. The latter is the most important, as having locals who are trained health personnel can greatly benefit rural women who may not have the time or financial resources (particularly in situations of poverty) to travel to a clinic.

These efforts indicate that maternal health in Mozambique is continuing to be a priority. The work that these organizations are doing is focused on empowering women to make their own decisions about their sexual and reproductive lives, ensuring health personnel are properly trained and accessible and meeting the needs of poorer women.

Sara Olk

Photo: Flickr

maternal mortality rates tajThe Republic of Tajikistan is a country located in Central Asia. In 1991, when Tajikistan became independent it was the most poverty-stricken country of the Central Asia republics. A civil war hurt Tajikistan’s economic and social growth, which led to a decline in overall health in the region. One of these health issues is that Tajikistan has had a very high maternal mortality rate. However, in the last decade progress has been made and maternal mortality rates for women in Tajikistan are dropping.

Tajikistan currently has a rate of 32 maternal deaths for every 100,000 live births. This number has significantly decreased since 1990 when the rate was 107. There are multiple factors that are responsible for the decline in maternal mortality rates. One of the dangers had been the fact that many women have their babies at home. In fact, at least 15 percent of women still give birth without a doctor or midwife present.

Hospitals and Healthcare Facilities

A project by the name of Feed the Future Tajikistan Health and Nutrition Activity (THNA) is spreading information about the dangers of giving birth at home. They also teach women in the country about the benefits of delivering in a hospital or other health care setting. Funded by USAID, THNA is working alongside hospitals and healthcare centers in different locations throughout the country to talk about the three main factors that lead to increased chances of maternal mortality, also known as the three delays:

  1. Seeking maternity care
  2. Reaching a healthcare facility
  3. Receiving high-quality care once at a healthcare facility

In 2016, THNA partnered with the Ministry of Health and Social Protection of the Population to further understand the problem. The duo conducted 14 in-depth assessments of hospitals in the region. They found out that many healthcare facilities did not have proper medical supplies, lacked adequate equipment and were understaffed. The duo worked together and provided the healthcare centers with new equipment and supplies.

The partnership also taught more than 1,400 people in the community to be health educators. The health educators, in turn, taught women about prenatal care and when they should go to a hospital. These changes are a major reason why maternal mortality rates in Tajikistan are declining.

Midwifery Services

Families in Tajikistan who cannot afford healthcare facilities often turn to alternatives such as midwifery. It is challenging to find a good midwifery service in the country. However, the United Nations Population Fund (UNFPA) is working with the Ministry of Health to increase the quality of midwives in the region. They supply midwives with education, capacity building and medical equipment. Furthermore, the UNFPA trains midwives on effective perinatal care.

UNFPA also provides technical help in improving training curriculums at schools throughout the country. Nargis Rakhimova, the UNFPA National Program Analyst on Reproductive Health in Tajikistan said, “This initiative is considered a breakthrough as it raises educational programmes to the level of internationally agreed standards.” Improved midwifery services are another factor why maternal mortality rates for women in Tajikistan are dropping.

Even though it is easy to recruit young women into midwife training programmes, it is not easy to keep them in the profession. Midwives do not make a lot of money and there is no official certification for midwifery, which may lower the standards of services in the region. Rakhimova said, “Though the midwifery situation in Tajikistan is improving, midwifery needs to be developed as a separate profession complementary to medicine.” Improving compensation for midwives will help continue to lower maternal mortality rates in Tajikistan.

Continuing to Improve

The poverty Tajikistan faced when it gained its independence led to a number of health crises in the region. Maternal mortality rates are one of these issues. Even though the country still faces problems with maternal mortality, the conditions are improving. The combination of advancements in healthcare facilities and midwifery services are a big reason for the improvements. These are the two main contributors as to why maternal mortality rates for women in Tajikistan are dropping.

Nicolas Bartlett
Photo: Flickr

antenatal care in IndiaIndia is home to one-fifth of all births but has no monitoring systems for basic maternal health and nutrition. A research brief published by the rice institute finds that India has far worse maternal nutrition rates than sub-Saharan Africa – a region much poorer with higher fertility rates. With improper antenatal care being linked with long term effects on the height, weight, cognition and productivity of a child, global attention has been brought to the antenatal care inequalities found in India.

Antenatal Care in India Today

Access to antenatal care in India depends strongly upon the geographic location and socioeconomic status of expectant mothers. Between 50 and 74 percent of expectant mothers in India receive prenatal care services – with a large gap in the distribution of these services.

According to a study done in 2011, 357,777 women in Delhi received at least three antenatal care check-ups, more than the entire state of Uttarakhand which had 153,202 women receive the same level of care.

Further studies showed that  “some states, such as Kerala and Goa, more than 93 percent of women used ANC [Antenatal Care] four times or more, while in Bihar and Nagaland, this figure was less than 17percent,” highlighting the substantial inequalities of access to antenatal care in India.

Current Government Initiatives

Currently, several government programs are in place to increase access to antenatal care services throughout India but have not shown largely promising results. India’s largest program for improving neonatal health, Janani Suraksha Yojana (JSY), uses cash incentives to encourage birthing in hospitals.

However, a study done in 2014 found that the cash transferred to new mothers is much less than advertised, due to how much of it goes towards paying for delivery services – which are meant to be free. In addition, this program only encourages women to give birth in hospitals, rather than address pressing maternal health problems in India – such as maternal nutrition and low birthweight.

Meanwhile, the Pradhan Mantri Matru Vandana Yojana (PMMVY) government program dispenses 5,000 rupees for expecting and lactating mothers. However, this is only available to first-time mothers.

The Integrated Child Development Services (ICDS) is intended to give food to expectant mothers and their children but is poorly implemented – with less than 30 percent of women having received food the ICDS program during their last pregnancy.

Looking Ahead

In order to improve access to antenatal care in India, studies suggest “policy and programme managers should shift from improving the ‘average figures’ to the ‘distribution’ of programme/health care indicators across the sub-groups of populations which need them most.”

The rice institute also notes that rather than rely on outdated surveys for indicators of maternal health, the government finally establish a national monitoring system allowing policymakers to view changes in maternal health over time.

With proper government oversight, the future of antenatal care in India looks promising, as suggested by a study published in The Lancet found that mortality rates for neonates declined by 3.3 percent annually between 2000 and 2015 due to government intervention.

– Shreya Gaddipati
Photo: Unsplash

Maternal Healthcare in Belarus
Fewer than 30 years ago, maternal health care in Belarus was not treated as a top priority in the country and the numbers show it. In 1990, 33 out of every 100,000 live births resulted in the death of the mother. By 2015, that number had decreased to four out of every 100,000.

Reasons for Bad Maternal Health Care in Belarus

The reasons for this precipitous drop are numerous, but some stand out more than others. For a long time, public health in Belarus revolved around containing the fallout from two momentous events. One was the Chernobyl disaster in 1986 that directly affected more than 2.2 million people in Belarus, half a million of whom were children. Charities, nongovernmental organizations and United Nations system organizations focused on providing emergency care to those who had been exposed to dangerous amounts of radiation.

The other event was the breakup of the Soviet Union in 1991. According to the World Health Organization (WHO), health care in Soviet-era Belarus was centered on the Semashko system. In this system, industrial workers, believed to be the source of productivity and prosperity for the Soviet Union, were essentially considered more important than the rest of the population. This resulted in addressing their immediate health needs first while overlooking larger public health concerns and it also meant that health care professionals were not as highly regarded as industrial workers. Low pay and little respect for medical workers perpetuated a cycle of subpar health care in Belarus.

Government Initiatives

Independence from Russia brought economic decline for Belarus in the short-term, but it also created an opportunity to revamp the country’s approach to public health. Maternal health care in Belarus received some overdue attention. Between 2005 and 2010, several health resolutions were initiated under the new Government of the Republic of Belarus, including a greater focus on reducing maternal mortality rates.

One such initiative was to build health facilities in rural areas, so that expectant Belarusian mothers in agricultural townships would have the same access to care as their urban counterparts. Another was to create a multileveled perinatal care system, made possible with the support of the head of state who approved the allocation of funds to improve maternal health care in Belarus. This included employing almost 2,700 obstetrician-gynecologists to treat a population of roughly 4.8 million women of fertile age. This initiative was implemented in 2005.

The Progress of Maternal Health Care in Belarus

A doctor visit at the earliest point in a known pregnancy is optimal for the health of mother and child. To ensure that expectant mothers would adhere to this guideline, a monetary allowance was given to them as an incentive for seeing a doctor within the first 12 weeks of their pregnancy. As a result of this bold initiative, prenatal visits within the first trimester increased by approximately 93.5 percent.

Paid maternity leave in Belarus lasts between 126 and 140 days, depending on the difficulty of the labor. Fathers are encouraged to play an active role in the birthing process, with maternity wards made to accommodate families. Today, maternal health care in Belarus ranks 26th in the world. Belarus is a shining example of how a country can evolve over a matter of mere decades and transcend seemingly insurmountable difficulties.

With a maternal mortality rate among the lowest in the world and a compassionate and comprehensive maternal health care system, Belarus has defied expectations across the board. The aid provided to the country during the low points in Belarusian history following the Chernobyl disaster and the fall of the Soviet Union was an important stepping stone toward a healthier and more independent Belarus. The state of maternal health care in Belarus is a magnificent reflection of that.

– Raquel Ramos

Photo: Google

Maternal Health Program for Low-Income Families
Since 2001, the province of Manitoba, Canada, has provided 63,000 pregnant and low-income women with cash supplements to help them take care of themselves and their families. The program is called the Healthy Baby Prenatal Benefit.

The supplements are “financial cushions” meant to provide women with the money they need to get health care, healthy food and nutritional supplements. Researchers who have worked with the program say that it has provided a blueprint for other provinces in Canada to follow. If this maternal health program for low-income families works well on a cross-country scale, it could possibly be further developed to help other countries as well.

Maternal Health Program

The money is not the most important part of this project, though. Because the cash supplement was only around $62 per month, the mothers cannot afford many things with it. However, the financial cushion encouraged women to seek healthier food, better transportation options and other things they might not splurge on.

Also, this was a gateway for ensuring that women get into prenatal care as soon as possible. Along with the stipend comes a community. There are approximately 70 prenatal and postnatal support groups across Manitoba that educate women about their future children, what they need to know during pregnancy, and other tips and tricks they may not have received otherwise. All in all, it has been a successful maternal health program for low-income families.

Impact of the Program

Women who have participated in the Healthy Baby Prenatal Benefit program said they felt like confident mothers after going to support groups and using their supplements to better their lives. The program drew inspiration from France, the country that is touted as one of the best countries in the world to raise children. Programs like the Healthy Baby Prenatal Benefit are inspiring others around the world as well.

Cambodia has set up a UNICEF funded pilot project that gives stipends to women if they follow up on their prenatal checks. It was relatively successful, which gives hope to the government and other nongovernmental organizations that funding projects like this are important in the long term. Taking care of the mother’s body while pregnant not only helps the future child but also helps the mother. It decreases the death rate among pregnant women, which can drastically change a child’s future.

According to the World Health Organization (WHO), 830 women die every day from preventable issues related to pregnancy and childbirth and 99 percent of those women come from developing countries. Women in rural areas are affected the most because they do not have access to adequate health care. The most interesting thing that can be concluded from these facts is that skilled care before, during and after childbirth can save the lives of women and newborn babies. This directly relates to the cash programs in countries like Canada, France and Cambodia.

Other Countries That Need Similar Programs

There are a lot of countries that could benefit from the programs such as the Healthy Baby Prenatal Benefit program and that can develop their own maternal health programs. In this article, three of such countries are listed.

Sierra Leone is the first country on the list that could improve maternal health care. There are around 1,360 deaths per every 100,000 live births in the country, which makes the situation urgent. The second on the list is Chad, a country that has approximately 856 deaths per every 100,00 live births. Children make up for 57 percent of Chad’s population and this dangerous trend could potentially leave many of them without mothers. In Nigeria, there are approximately 814 deaths per every 100,000 live births. Nigeria has looked into cash supplement programs before, but creating one specifically for pregnant women would create a great and much-needed change.

Developing countries can and should follow Canada’s example and success with a maternal health program dedicated specifically to low-income families. There is a successful blueprint in the world and it just needs to be adapted to each country that needs it.

– Miranda Garbaciak
Photo: Flickr

Every Mother CountsChristy Turlington is a world-famous model. Those in the fashion world know her from Calvin Klein, Maybelline and Versace, just to name a few of her modeling platforms. However, in addition to her modeling career, Christy Turlington helps poor pregnant women avoid death from dangerous complications during birth. Not only does she enjoy doing this more than she ever enjoyed modeling but she has also saved the lives of thousands of women who could then live their lives and care for their babies.

How It All Started

It all started in the birthing center in New York City’s St. Lukes-Roosevelt Hospital. Christy and her husband, Edward Burns, arrived at the center not long after her water broke. The pregnancy had been normal up to this point, and the birth of their child, Grace, seemed to go off without a hitch. She did not even need pain medication.

However, the placenta had become embedded into Christy’s uterine wall, causing her to bleed heavily. This is known as postpartum hemorrhage (PPH), and it kills 1,000 women around the world every day. The midwife began to suspect this was happening when Christy had not passed the afterbirth after 45 minutes. (Normally, it takes less than 20 minutes.) After another 25 minutes, the doctor had to come in and remove the placenta manually.

The following day, the excessive bleeding had stopped. Christy, knowing that the doctors would likely be able to save her life again, decided to get pregnant again. While carrying her second child, Finn, she and her mother took a trip to the latter’s hometown, San Salvador, the capital of El Salvador. Once there, Christy learned that PPH causes the majority of postpartum deaths not only there, but all over the developing world.

Turlington also learned that many pregnant women in the developing world have to walk to hospitals instead of driving; as a result, many simply choose to give birth at home, without any access to medical care. Learning this inspired Christy to found Every Mother Counts, a foundation that helps cut down on the maternal death rate.

The Charity and the Documentary

Every Mother Counts started out as an advocacy organization that simply aimed to make people aware of worldwide maternal deaths so that they could help. Their first act, spurred by Christy, was to make the documentary No Woman, No Cry. It was filmed in Tanzania, Bangladesh, Guatemala, and The U.S. over the span of a year and shows what birth is like in each country. The bottom line is that The U.S. is disproportionately better at helping women survive childbirth.

While advocacy remains a large part of Every Mother Counts’s overall mission, the organization has branched out over time to include other avenues to help. They sell several products, mostly clothing, and use the profits to help have a greater impact on the lives of the women they are helping. They host running events to raise even more donation money for their cause.

Their website contains forms that allow people to call, email or tweet their congressional leaders to get them to support bills that will help poor mothers survive childbirth. Every Mother Counts has had an impact on more than 680,800 individuals, including mothers, babies, and health care providers.

The Success of Every Mother Counts

Using only donation money, Every Mother Counts funds grants for projects that improve and save the lives of pregnant women in poor countries around the world. For example, in Malawi, they spent $113,740 to give portable solar suitcases to 40 rural clinics, which provided them with a reliable source of electricity with which to run their equipment.

In Syria, $40,350 was spent to help train and equip six midwives to deal with life-threatening emergencies, including giving them home visit kits, medicines, cell phones and more. In the Democratic Republic of the Congo, $10,000 went to giving clinics delivery and postpartum beds, emergency supplies and incinerators to get rid of medical waste. All of these efforts and more have saved the lives of over 400,000 women worldwide.

Christy Turlington has had a huge impact on women’s lives as the founder and CEO of Every Mother Counts. She has saved thousands of lives, made many U.S. citizens aware of postmortem deaths in the developing world and given health centers the equipment that they need to prevent many birth-related tragedies. Although she continues to accept modeling jobs, they barely matter to her anymore. The fact of the matter is that Christy Turlington helps poor pregnant women around the world avoid becoming another health statistic.

– Cassie Parvaz
Photo: Flickr

Maternal Mortality in ChadChad has one of the highest rates of maternal mortality in the world. Out of 15 women in Chad, one will die due to complications while giving birth. This makes a rate of 6.7 percent, which is dangerously high. In 2010, only 23 percent of women had help from someone medically qualified to do so while giving birth. Every couple of minutes, a woman in Chad dies due to birth complications.

Maternal mortality rates, along with child mortality are a good indicator of the status of health care in the country. Higher rates imply the lower quality of and access to health care. Lack of personnel and training prevents women from getting the help they need during childbirth. An increase in health care professionals and proper training will raise the likelihood of saving the lives of the mother and the child.

Chad Mother and Child Health Services Strengthening Project

In 2014, The World Bank approved funding of almost $21 million for the Chad Mother and Child Health Services Strengthening Project. The money comes from the Health Results-Based Financing Fund that is supported by the U.K. and Norway.

The Project targets regions that have particularly high rates of child and maternal mortality in Chad. Increased funding will go to health care services in the areas with low access to resources and higher indicators of maternal mortality. The Project provides care for the woman throughout her pregnancy, helps with deliveries by professionals and even immunizations for the newborn.

The Services Strengthening Project is set to conclude its goals by 2020. The Project is trying to reach 80,000 pregnant women and provide them with antenatal care during a health care visit. This number was exceeded in 2018 since the people of the Project reached 82,117 women by this year. Additionally, they are hoping to achieve 35,000 births with the help of skilled medical professionals by 2020. As of 2018, they are well on their way with 29,500 births. As for its other goals, that include child immunization and health personnel training, the Project is also right on track.

Education of Mothers in Chad

Community awareness is just as important in preventing maternal mortality in Chad as providing access to services. Women have extremely limited opportunities when it comes to education, and four out of five women in Chad between the ages of 15 and 24 are illiterate. Having limited knowledge of antenatal care, hygiene and disease greatly influence the likelihood that a mother or child will not survive the pregnancy.

Levels of HIV in women also contributes to maternal mortality in Chad. Only 10 percent of women aged 15-24 have a thorough knowledge of HIV prevention. Without education on HIV, women easily contract it and spread it to their children. Training provided by programs like the Chad Mother and Child Project can significantly mitigate this issue simply through education and increase of awareness.

Training for health care professionals and midwives in the region, in addition to education for the mothers, lays the foundation for a long-term solution to maternal mortality in Chad. Lack of proper care for expecting mothers not only leads to deaths, but to abandoned families and children without mothers. This repercussion leads to an even longer lasting impact on communities as a whole.

Chad, in particular, is in desperate need of change and improvement in its health care for mothers. Many developing countries have improved their rates of maternal mortality in recent decades, but Chad’s only increased by 10 percent between 1980 and 2010. One of the Millennium Development Goals was to see a 75 percent decrease in pregnancy and childbirth-related deaths, but Chad has yet to reach this goal.

Trained staff on hand, proper medical tools and educated mothers can make the world of difference in decreasing the deaths of maternal and child mortality in Chad.

– Amelia Merchant
Photo: Google

postpartum hemorrhagingIn the advanced world, a postpartum hemorrhage is a very manageable and preventable condition; however, postpartum hemorrhaging is a leading cause of maternal mortality. A staggering 99 percent of all deaths resulting from postpartum hemorrhaging occur in lower income countries. Postpartum hemorrhaging is responsible for 59 percent of maternal deaths in Burkina Faso, 43 percent in Indonesia and 52 percent in the Philippines.

Why Postpartum Hemorrhaging Is Common

In these developing countries, the increased frequency of postpartum hemorrhages is due to a lack of experienced obstetricians and caregivers who can properly treat the condition. There is also a lack of access to proper medications as well as care for those medications.

Oxytocin is currently the most common drug prescribed for preventing postpartum hemorrhages. The World Health Organization recommends that oxytocin be routinely administered and actively managed; however, oxytocin must be stored and transported at two to eight degrees Celsius, two conditions of which developing countries cannot accommodate.

A Possible Solution

A rival drug has been in the works to be as efficient as oxytocin in preventing excessive bleeding post childbirth as well as be more manageable in the living conditions of developing countries. The drug is a heat-stable carbetocin. This type of drug does not need refrigeration and can maintain its efficacy for at least three years when stored at 30 degrees Celsius. These requirements are far more realistic and achievable in developing communities.

The World Health Organization conducted a comparative study between the heat-stable carbetocin and oxytocin for prevention of postpartum hemorrhages. Approximately 30,000 women were sampled and given either drug to study the effects each had on prevention. It was concluded that the heat-stable carbetocin was not inferior to oxytocin.

Saving Mothers’ Lives

With such a high rate of deaths from postpartum hemorrhaging in developing countries due to the strict requirements for oxytocin that cannot be met, the heat-stable carbetocin will drastically improve the mortality rates. The new drug will be readily available and easily managed where it was once not.

Permitting the usage of the heat-stable carbetocin has many benefits that will better developing countries in a multitude of ways. If used widely, the drug could very possibly put an end to this tragically common occurrence.

– Samantha Harward
Photo: Flickr

Maternal Healthcare in Mexico
Eight years ago, The Economist, a British business publication, described maternal healthcare in Mexico as “a perilous journey.” Although deaths in labor had decreased by over a third in the past 20 years, they still remained among the highest in Latin America. Preventable complications were common among women, especially those of indigenous descent, largely as a result of infrastructural and social challenges.

Maternal Mortality

Since then, substantial effort has been put into solving this problem, especially in anticipation of the 2015 Millennial Development Goals. Globally, maternal mortality is often the result of wider social problems related to extreme poverty. It especially affects poor rural women who lack access to modern medical facilities. Solving maternal mortality in Mexico requires implementing a wider health infrastructure that serves these disenfranchised groups.

In Mexico, one of the groups most vulnerable to labor complications is girls under fifteen years old. This is not a generational issue, but rather a result of the dangers of underdeveloped girls giving birth. Twenty percent of Mexican births annually are a result of teenage pregnancy. Half of the sexually active teenage girls in Mexico become pregnant and 11,000 of Mexico’s births each year are to mothers between 10 and 14 years old.

While a proportion of these teenage pregnancies are the result of consensual encounters, some of them are the result of chronic child sexual abuse. One study found that a third of Mexican girls (and about a fifth of Mexican boys) had experienced sexual assault. Unfortunately, comprehensive statistics on the sexual abuse of children are relatively rare for developing countries, but it is likely that these high rates contribute to the phenomena of teenage pregnancy in Mexico.

Teenage Pregnancy and Healthcare Improvements

Ultimately, the key to achieving better maternal healthcare in Mexico lies in preventing teenage pregnancy and providing healthcare infrastructure. On the latter, the Mexican government has already established several programs targeting the country’s rural poor such as the Oportunidades (Opportunities) program, and additional support from the Mexican social security program. Specific programs, such as PRONTO, train hospital staff to intervene in dangerous labors and have shown to help reduce maternal mortality.

However, the Mexican government has taken little action against ending teenage pregnancy. This represents a major blindspot in the path towards achieving improved maternal healthcare in Mexico.

Maternal mortality and labor complications are especially common among young mothers; mothers under 15 are twice as likely to die in labor as older mothers. Their babies are more likely to die as well. Many of these teenage pregnancies could be prevented with education and awareness programs, but most of Mexico’s initiatives are geared towards older girls.

Supporting Maternal Healthcare

Several NGOs have taken initiative in reducing Mexican maternal mortality both by tackling infrastructure issues and generational sexual abuse. Conferences such as this year’s International Best Practices Meeting bring together experts from various fields and international organizations to discuss the issue.

Specifically, the role of midwives in the prevention of labor complications has also been reinforced in Mexican society. Such a prioritization could increase women’s access to maternal healthcare in Mexico, especially in rural areas.

Ultimately, despite the challenges facing Mexican mothers, there is hope that the danger of pregnancy in the country can be further reduced. Improved maternal healthcare in Mexico can be achieved with infrastructure and education, factors that also help combat extreme poverty in the country; only then, can Mexico truly achieve its development goals.

– Lydia Cardwell
Photo: Flickr