Since the year 2000, Ethiopia has halved its maternal and child mortality rate. While this statistic seems impressive on the surface, the rate of maternal and child mortality in Ethiopia remains one of the highest in the world. The child mortality rate stands at 67 deaths per 1,000 children. The Ethiopian maternal mortality rate (MMR) per 100,000 live births is 412. This number is 25 times the United States MMR.
The Global Context of Maternal and Child Mortality
The rate of maternal and child mortality in Ethiopia is best understood by examining the larger global context of maternal and child mortality. Globally, neonatal mortality remains significantly high, with 7,000 newborn deaths a day. Neonatal mortality comprises 47% of the deaths of children under 5. This number is up 7% from 1990 when it stood at 40%. Furthermore, the greatest number of neonatal deaths occur in sub-Saharan Africa.
Globally, the MMR has dropped 38% from 2000 to 2017, which is the most recent WHO estimate, but it is important to note that even though the overall global MMR has reduced, some regions still disproportionately experience very high MMR rates. The greatest number of maternal deaths occur in Africa, just as with neonatal mortality. In fact, in 2017, 66% of all maternal deaths occurred in Africa.
A key cause of maternal and newborn mortality is malnutrition. Due to COVID-19, the World Food Programme predicted that the number of food-insecure people in low- and middle-income countries (LMICs) would double to 265 million by the close of 2020. Food insecurity often links to malnutrition or undernutrition. Therefore, this fact has the potential to increase maternal deaths due to a lack of iron and other essential nutrients. The WHO estimates that, as it stands globally, 40% of pregnant women are anemic. Anemia makes these women vulnerable to fatal bleeding and infections during childbirth. Furthermore, while high-income countries have very low anemia figures for pregnant women, in certain LMICs, up to 60% of pregnant women struggle with anemia.
Global Aid Organizations Leading the Battle
Fortunately, during and despite the COVID-19 pandemic, global aid organizations have been collaborating with the Ethiopian Ministry of Health and other regional bureaus to continue to decrease the rate of maternal and child mortality in Ethiopia.
As a major player in combatting maternal and child mortality in Ethiopia, the United States Agency for International Development (USAID) focuses on providing Ethiopian women, children and families, especially those in underserved communities, access to quality healthcare. USAID works with the Ethiopian Ministry of Health and regional bureaus to institute better training so that healthcare workers can improve the care provided at various levels (facility, community and household). USAID ensures access to integrated services such as prenatal checkups, skilled care for labor and delivery, newborn care, preventative care for childhood illnesses and nutritional guidance.
Quality of Care Network
Ethiopia is a member of a 10-country Quality of Care Network created by the WHO, the United Nations Children’s Fund (UNICEF) and the United Nations Population Fund (UNFPA). The Network launched in 2017 with the aim of halving maternal and child mortality by 2022 and improving patient care. In Ethiopia, this commitment involves clinical mentoring and coaching since learning is an essential aspect. Ethiopia chose 17 districts that represent “pastoralist, urban and rural populations” to operate as “learning districts.”
Maternal Mortality Reduction
These coordinated efforts seem to be making headway according to the 2020 Gates Foundation Goalkeepers Report, which tracks progress on SDG goals. In 2019, the Ethiopian MMR was down to 205 deaths per 100,000 live births which would meet the Quality of Care Network goal of halving maternal and child mortality by 2022.
Ethiopian child mortality was down from 66 deaths per 1,000 children under 5 in 2015 to 52 deaths in 2019, which represents more modest progress. However, the Goalkeepers Report warns that COVID-19 could reverse progress made on global goals and asserts that a global collaborative response is essential in all areas.
It is critical to maintain heightened vigilance in coordinating efforts to continue to improve maternal and child mortality rates in Ethiopia despite COVID-19 challenges, so that progress is not lost.
– Shelly Saltzman