Fertility Rates in Developing CountriesReducing fertility rates in developing countries is critical for ending global poverty. Common methods of doing so include education, contraception and women’s empowerment. However, another important factor affecting fertility rates is child survival.

There are many biological and behavioral factors that affect women and families when children die early. Physiologically, the early death of an infant triggers the resumption in ovulation, leaving the mother at early risk of conceiving again. Additionally, parents who lose children early are more likely to attempt to replace lost children or have extra children as insurance or compensation.

To fight high fertility rates in developing countries and around the world, it is important to understand the rates, causes and prevention efforts of stillbirths and under-five mortality.

The World Health Organization (WHO) defines a stillbirth as “a baby born with no signs of life at or after 28 weeks’ gestation.” There are an estimated 2.6 million stillbirths per year across the globe, which equates to more than 7,178 occurring daily.

The majority of stillbirths happen in developing countries with little or no access to skilled health professionals during pregnancy and labor. The WHO estimates that of the 2.6 million yearly stillbirths, 90 percent occur in low and middle-income countries, 75 percent occur in South Asia and sub-Saharan Africa, and 60 percent occur in rural areas of those Asian and African regions.

Stillbirths are caused by child birth complications, post-term pregnancy, maternal infections during pregnancy (such as malaria, syphilis and HIV), maternal disorders (such as hypertension, obesity and diabetes), fetal growth restrictions and congenital abnormalities.

Most stillbirths can be prevented with improved access to maternal healthcare. The Every Newborn Action Plan (ENAP) aims to prevent these avoidable deaths and has a target of 12 stillbirths per 1,000 live births by 2030. To compare, today, the stillbirth rate in sub-Saharan Africa is 29 per 1,000 live births and, in developed countries, is three stillbirths per 1,000 live births on average.

An estimated 5.9 million children under five die every year around the world. However, instances in developing countries are higher. In low-income countries, the under-five mortality rate is about 76 deaths per 1,000 live births. To compare, in high-income countries, the under-five mortality rate is about seven deaths per 1,000 live births. Seventy percent of these deaths in developing countries are preventable and caused by acute lower respiratory infections (such as pneumonia), diarrhea, malaria, measles, HIV/AIDS, malnutrition and neonatal conditions.

About 2.7 million children die annually during the first month of life. Seventy-five percent of these newborn deaths happen during the first week and up to 50 percent during the first 24 hours. Causes of neonatal and infant mortality include prematurity, low birth weight, infections, birth asphyxia, HIV-infected mothers and birth trauma.

The majority of these infant deaths are preventable with health measures and care during and after birth, particularly during the first week of life. Additionally, most deaths under the age of five can be prevented with access to basic goods and services such as nutrition, water, sanitation, shelter, education, healthcare and information. Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs) aim to decrease instances of under-five mortality as well as stillbirths. Part of SDG goal three is to end preventable infant and child mortality by 2030.

Improving fertility rates has positive effects on economics, health, environment and education. And, contrary to a popular foreign aid myth, improving child survival rates can actually decrease population growth rates around the world. Ironically, fertility rates in developing countries and around the world can, in turn, affect stillbirth and under-five mortality rates. Addressing this perceivably unending cycle is critical to ending global poverty.

Francesca Montalto

Photo: Flickr

progress of teh MDGs
The countdown has begun: there are less than 500 days until the December 31, 2015 deadline for the eight Millennium Development Goals to be accomplished. But before global leaders can agree upon a new set of goals to take up after 2015, the progress of the MDGs must first be analyzed.

Organized by The Partnership for Maternal, Newborn & Child Health, the 2014 Partners Forum met from June 30 to July 1 at the Sandton Convention Centre in Johannesburg, South Africa to discuss the various successes and failures on the achievement of the MDGs.

The eight MDGs were created by the U.N. in 2000 with the purpose of alleviating global poverty by 2015. Since the issue of global poverty is such a complicated and multi-layered issue, the MDGs focus on addressing both health and societal concerns.

As 14 years have now passed and the deadline is quickly approaching, about 800 representatives from health, gender and development, nutrition, education, private and public communities attended the 2014 Partners Forum to outline the progress that remains to be seen by the end of next year. As the PMNCH Chair and African Ambassador for A Promised Renewed, Graça Machel, said, “We have 500 days, every day counts, every action counts and every life counts.”

The 2014 Partners Forum also released long-awaited reports focusing on the fourth and fifth MDGs of improving maternal and newborn health. The World Health Assembly’s “Every Newborn Action Plan” and the “Success Factors for Women’s and Children’s Health Report” both provided information on the progress made towards these two goals, but also gave statistics proving that maternal and child mortality rates are still too high.

Many agree that the MDGs have had mixed results since the success rate of each goal varies according to a specific region or country. At the Beijing+20 Conference held at the U.N. Headquarters in New York, the Executive Director of the U.N. Entity for Gender Equality and the Empowerment of Women, Phumzile Mlambo-Ngcuka, called the progress of the MDGs a “mixed bag” since the results have been so inconsistent. According to Mlambo-Ngcuka, education “is probably the closest thing the world has to a silver bullet.”

Countries that are finding it more difficult to achieve these goals are now looking to countries that have made significant progress in the fight against global poverty since 2000. According to the 2014 Success Factors for Women’s and Children’s Health report, Peru, Egypt, Nepal, Vietnam, China, Rwanda, Ethiopia, Lao PDR, Bangladesh and Cambodia are the top ten countries that have not only progressed, but are also on-track to achieving the fourth and fifth MDGs.

Although the post-2015 Sustainable Development Goals will not be agreed upon until later this year, this new set of goals is expected to both revise and expand on the current MDGs to continue the fight against global poverty. Despite the various setbacks countries and regions have faced in achieving the MDGs, the fact that some progress has been recognized proves that establishing an official list of goals is an effective way to alleviate global poverty.

-Meghan Orner

Sources: The Partnership for Maternal, Newborn & Child Health 1, The Partnership for Maternal, Newborn & Child Health 2,, Global Post
Photo: GBCHealth

every newborn action plan
Five babies are born every second, and every day over 400,000 women around the world facilitate the miracle of life. Many of these children, however, are given poor chances of survival. 44 percent of children who die before their fifth birthday are taken from the world within their first month of life. 2.9 million babies die within the first month, and an additional 2.6 million babies are stillborn. Arguably more alarming than the statistics is that these deaths are typically preventable.

That’s where the Every Newborn Action Plan (ENAP) comes in. Endorsed in May and launched on June 30, ENAP is an initiative aimed at accelerating action to prevent the numerous newborn deaths around the world. USAID, the UN and other global organizations have banded together to support and promote this plan.

Children are at their most vulnerable during the child delivery process and the first few months of life. Prematurity, asphyxiation and infection are among the serious threats to newborn survival, but they can be minimized with the right steps. Training doctors and nurses to anticipate and prevent these possibly fatal conditions is a vital step in minimizing newborn deaths, and ENAP aims to address this.

ENAP was launched in Johannesburg, South Africa, where the UN Secretary General, Ban Ki-Moon spoke. He said, “If we increase investments, focus on equity and promote human rights, we can create a world free of preventable maternal and child deaths in just one generation.”

The plan has a timetable, hoping to reduce the neonatal mortality rate per 1000 live births from 15 to 7 by 2035, with less extreme mile markers between now and then. To achieve these goals, over 90 countries have to get behind the movement and accelerate their progress and 29 of these countries will have to “more than double current rates of progress in policy and private sector commitments to save newborn lives.” ENAP outlines how this can be achieved.

ENAP focuses on improving healthcare across myriad specialties including prenatal, pregnancy, postnatal and infant care. It emphasizes thoroughness at every stage, beginning with early pregnancy and not ending until the child and the mother are experiencing stable health. Their plan includes a checklist of criteria for improved pregnancy healthcare, including points like “early initiation of breastfeeding” and “birth companion of choice and skilled attendant at birth.” These things are often a given in the U.S., but are sometimes a luxury in impoverished countries.

Higher survival rates for newborns and mothers would mean great things for fighting global poverty. Population growth is often uncontrollable in impoverished areas because, without a guarantee that children will survive, families often have more children than they can support. This puts strain on communities and lowers quality of life standards significantly. As ENAP reduces newborn deaths, population growth can transition to a steadier rate that can be more easily supported by countries, which will lead to more stable economies and happier people.

With the backing of countries worldwide, the support of institutions such as USAID and the UN and effective implementations of the guidelines of the plan, Every Newborn Action Plan has the potential to save millions of lives in just over two decades.

– Magdalen Wagner

Sources: United Nations, World Health Organization, GhanaWeb, Huffington Post, Mail Online
Photo: IBTimes