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Maternal healthcare in Algeria
Algeria, a large country in North Africa, bordering the Mediterranean Sea. The country is known for its rich history and culture, as well as its scorching temperatures. Like many nations in Africa, Algeria struggles to combat maternal mortality – a long-standing, persistent issue for many women in the country. However, in the last several years, Algeria has taken numerous steps to expand maternal healthcare and reduce pregnancy and labor complications. Here are four facts about maternal healthcare in Algeria.

4 Facts About Maternal Healthcare in Algeria

  1. According to recent updates on the maternal mortality ratio in Algeria — it has gradually dropped from 179 deaths per 100,000 live births in 1998 to 112 deaths per 100,000 live births in 2017. Much of the success in lowering the number of deaths is attributed to a multitude of factors such as increased medical training, investments in healthcare and specific government initiatives aimed at reducing maternal deaths. During the years 2009–2017, Algeria trained about 900 professionals from university hospitals such as, Benni Messous, Kouba, Oran and Bab El Oued on multidisciplinary management of pregnancy.
  2. Within the last couple of years, Algeria has managed to make major investments in healthcare. Algeria managed to increase expenditures in healthcare as a share of GDP from 3.6 % in 2003 to 6.4 % in 2017 — growing at an average annual rate of 4.57%. This is an impressive number when compared with Algeria’s neighboring countries. Moreover, these investments have also helped to establish successful disease detection programs and allowed for improved medical facilities.
  3. In 2015, the Ministry of Health in Algeria began to work in collaboration with UNICEF in an attempt to implement a neonatal and maternal mortality reduction plan. This plan was implemented with the intention of reducing as many preventable, maternal deaths as possible, with a target of 50 deaths per 100,000 live births by 2019. Additionally, in 2016 the Ministry of Health put forward an emergency maternal mortality rate (MMR) reduction plan. “The goals set by the plan relate to strengthening family planning, improving the quality of healthcare during pregnancy, birth and postpartum.”
  4. In order to continue the reduction of the maternal mortality rate, the Health Ministry of Algeria held a survey to consolidate the maternal death rate with the technical and financial collaboration of the three U.N. agencies: (UNFPA, UNICEF and the WHO). The objectives of this survey were to reach a consensus on connections between frequent causes of maternal death, update the maternal death rate and cultivate reliable data “for the readjustment of national programs on maternal health and the reduction of preventable maternal deaths for the implementation of Algeria’s ICPD commitments.”

A Leader in Maternal Healthcare

Much work remains in order for Algeria to be able to effectively put an end to preventable, maternal deaths. However, the measures put into practice within the last several years have already proven to be a success. Thanks to these policies, Algeria has become known as a leader in maternal healthcare in North Africa and the country continues to build a strong momentum and infrastructure to fight this problem.

Shreeya Sharma
Photo: Flickr

Health Care in Sudan
Sudan is rich in natural and human resources; however, it is poverty and conflict-stricken. Agriculture is an income provider for 70 percent of the populace. Due to a lack of resources and training availability, the health care sector of the country remains underfunded and understaffed. Here are ten facts about health care in Sudan.

10 Facts About Health Care in Sudan

  1. Approximately 14 percent of Sudanese do not have access to health care. This is largely due to the fact that Sudan has a critical shortage of health care workers. According to the World Health Organization, there are 23 qualified health care workers per 10,000 members of the population.
  2. Sudan’s maternal mortality rate has improved, but it varies by region. In 2015, the maternal mortality rate was 311 per 100,000 live births. This was a significant improvement from 744 per 100,000 live births in 1990. Unfortunately, these rates are not consistent across the country. While more recent data is not available, in 2006, the maternal mortality rate in Southern Kordofan was 503 per 100,000 live births. In the Northern state, however, the rate was only 91 per 100,000 live births.
  3. Approximately 32 percent of Sudan’s population is drinking contaminated water from untreated water sources. This is a result of chemical and bacterial contamination from industrial, domestic and commercial waste that degrades the water quality. There are acts at the state and national levels to help prevent this washing and injection; however, these acts need activation. UNICEF is working with the Sudanese government to increase access to basic treated water supplies for the people of Sudan, with a focus on women and children.
  4. Sudan suffers from outbreaks of cholera, dengue fever, Rift Valley fever (RVF), chikungunya and malaria. Increased outbreaks in 2019 were, in part, a result of heavy rainfall during the rainy season. Consequently, this rainfall left behind stagnant pools which were breeding grounds for mosquitos, contributing to the spread of infection. Government authorities and their humanitarian partners worked to respond to outbreaks across the country. The Kassala and North Darfur Ministries of Health launched weekly response task force meetings and developed state-level plans to mitigate the outbreak.
  5. Sudan has widespread micronutrient deficiencies. This is partially due to insufficient levels of crop growth. Only 14 percent of 208 cultivable acres are being cultivated. Drought, pests and environmental degradation also contribute to widespread malnourishment. However, vitamin A deficiency decreased due to repeated vitamin A supplementation given during National Immunization Day campaigns.
  6. Many Sudanese women and girls lack adequate health care and resources. Women and girls living in the rebel-held areas of Southern Kordofan or the Nuba Mountains of Sudan have very limited or no access to contraception. Human Rights Watch found most of the women interviewed did not know what a condom was and was unfamiliar with other common contraceptive practices. This lack of education and the low availability of condoms are why there are high percentages of women testing positive for hepatitis B. Consequently, gonorrhea and syphilis are on the rise in Sudan.
  7. The National Expanded Program on Immunization in Sudan supports an increase in routine immunization coverage. In addition, the government’s financial investment to EPI and polio eradication program is 15 million USD. Challenges the program faces include poor service delivery and a lack of resources and skilled staff.
  8. Sudan spends 6.5 percent of its gross domestic product and 8.3 percent of government spending on health care. Before the 1990s, receiving care at public health care facilities was mostly free. However, the structural reforms of 1992 introduced user fees. Now, out-of-pocket expenses for patients hover in the 70 percent range.
  9. There are 75 degrees and diploma-granting health institutions in Sudan. About 28 of these institutions offer diplomas and 47 of these schools offer degrees. There are 14 private institutions, while the others belong to agencies such as the Federal Ministry of Health and other government agencies. In 2001, the Federal Ministers of Health and Higher Education signed a Sudan Declaration and Nursing and Allied Health Workers in 2001. The goal of the declaration was to improve nursing and other health care education. The Academy of Health Sciences was established in 2005 to help implement this goal.
  10. The Sudanese government is working to rebuild and reform the health care system. A 25-year plan spanning from 2003 to 2027 was created in the early 2000s. This plan focuses on ensuring health care services are accessible and high quality, particularly for impoverished and vulnerable populations.

These ten facts about health care in Sudan illuminate some of the struggles the nation has faced, as well as improvement efforts by the Sudanese government and other humanitarian organizations. It is imperative that these efforts continue in order for health care to continue to progress in Sudan.

Robert Forsyth
Photo: Flickr

Healthcare in Nepal
Nepal remains one of the world’s poorest countries as well as one of the most prone to natural disasters. The country suffers from the effects of climate change and population increase, which further increases the damage caused by natural disasters. Landslides and floods are particularly common, especially during the monsoon season. These catastrophes kill more than 500 people a year. The healthcare in the country is often unequally distributed, with healthcare resources centralized around the country’s major urban centers. This unequal distribution hinders the quality and accessibility of healthcare provided in Nepal. Here are 10 facts about healthcare in Nepal.

10 Facts About Healthcare in Nepal

  1. The 1978 Alma Ata Declaration: In an effort to improve healthcare, Nepal was influenced by the 1978 Alma Ata Declaration. The declaration emphasized community-oriented preventive, promotive and curative healthcare services. Nepal also took steps to improve the lives of its citizens by establishing a network of primary healthcare facilities. In addition, the nation deployed community healthcare workers to provide healthcare at the community level.
  2. Life expectancy: As a result of improving healthcare in Nepal, life expectancy has seen a dramatic increase. According to the Nepali Times, life expectancy went up 12.3 years between 1991 and 2011. Currently, the country has the second-highest life expectancy in South Asia, largely due to the fact that the country has seen a sharp decrease is birth rate mortality. The Central Bureau of Statistics reported that 295,459 Nepalis were more than 75 years old in 2001 and in 2011 that number increased to 437,981.
  3. Accessibility: Most of Nepal’s healthcare resources are located in or around Kathmandu, the capital city of Nepal. This centralization leads to other areas of Nepal being neglected. In 2015, however, Nepal’s government formed a Social Health Security Development Committee as a legal framework in an effort to start implementing a social health security scheme. The program’s goal was to increase the accessibility of healthcare services to Nepal’s poor and marginalized communities. It was also aimed to increase access to people who live in hard to reach areas of the country. Problems, however, remain with financing the effort.
  4. Healthcare as a human right: In 2007, the Nepalese Government endorsed healthcare as a basic human right in its Interim Constitution. Despite this, only 61.8 percent of Nepalese have access to healthcare facilities within a 30-minute radius. Nepal also suffers from an inadequate supply of essential drugs and poorly regulated private healthcare providers. Statistically, Nepal also only has 0.67 doctors and nurses per 1,000 people. This is less than the World Health Organization’s recommendation of 2.3 doctors, nurses and midwives per 1,000 people.
  5. Lack of basic health facilities: Around 22 percent of Nepalis do not have access to basic health facilities. The groups who lack healthcare in Nepal tend to be the Dalits from Terai and Muslims. However, there has been a 19 percent increase in the usage of outpatient care by Dalits.
  6. Common diseases in Nepal: The top diseases in Nepal are ischemic heart disease, COPD, lower respiratory infection, diarrheal disease, stroke and diabetes.
  7.  Oral health: More than half of adults in Nepal suffer from bacterial tooth decay. Bacterial tooth decay can lead to chronic pain, heart disease and diabetes. Many in rural villages do not have access to tooth filling, toothpaste or water. There is a belief among some Nepalese that tooth extraction causes blindness.
  8. Maternal and child mortality rates: There has been a reduction in maternal and child mortality rates.  The rates have decreased from 539 per 100,000 to 281 per 100,000 live births in 2006, according to the DHS survey. The 5 and under mortality rate decreased in rural areas from 143 per 1000 to 50 per 1000 live births in 2009.
  9. Earthquakes: The earthquakes that hit Nepal in April of 2015 are one of the greatest natural disasters in Nepal’s modern history, destroying over 1,100 healthcare facilities. Possible Health.org, a global team of people committed to the belief that everyone deserves access to quality healthcare without financial burden, signed a 10-year agreement with their government partners to attempt to rebuild the healthcare system in the Dolokah district, which suffered the destruction of 85 percent of their healthcare facilities.
  10. Government corruption: While there are efforts to improve the lives of Nepalis, corruption exists, according to the Himalayan Times. The Corruption Perceptions Index ranks Nepal 124 out of 175 countries worldwide. This corruption leads to a lack of resources dedicated to healthcare. The Nepali government only allocations 5 percent of its national budget toward healthcare, not enough to create significant improvements.

These 10 facts about healthcare in Nepal illustrate the challenges the nation has faced, as well as the progress that has been made. To help improve healthcare, the European Union provides continual support. In 2019, they gave 2 million pounds of assistance to the country. Moving forward, continued work by humanitarian organizations and the Nepali government is needed to continue improving healthcare in Nepal.

Robert Forsyth
Photo: U.N. Multimedia

10 Facts About Life Expectancy in Kyrgyzstan
Kyrgyzstan is a landlocked country in Central Asia with a population of 6.4 million. Since its independence from Russia in 1991, Kyrgyzstan has had unstable political conditions, leading to poor health conditions. Here are 10 facts about life expectancy in Kyrgyzstan.

10 Facts About Life Expectancy in Kyrgyzstan

  1. The average life expectancy in Kyrgyzstan is 71 years. For men, life expectancy is around 68 years, while women generally live 75 years. This represents a significant increase over the last 10 years, rising from an average of 67.7 years in 2010. However, the life expectancy in Kyrgyzstan still remains below the average in Asia, which is 79 years. It also falls behind other Central Asian countries, as the average life expectancy in Central Asia is 70 years for men and 76 years for women.
  2. The mortality rate for children under 5 in Kyrgyzstan is 20 per 1,000 live births. Comparatively, the average mortality rate for children under 5 in developing countries in Europe and Central Asia is 11 per 1,000 live births. Still, Kyrgyzstan has made much progress on reducing the mortality rate for young children over the past 20 years; in 1990, the mortality rate for children under 5 was 65 per 1,000 live births.
  3. Ischemic heart disease is the leading cause of death and disability in Kyrgyzstan. The rate of ischemic heart disease in Kyrgyzstan is significantly higher than the rates in other low-and-middle-income countries. In fact, 4,628.7 per 100,000 deaths in Kyrgyzstan are caused by ischemic heart disease, while the average rate for other low-and-middle-income countries is 3,036.7 per 100,000 deaths. The second most common cause of death in Kyrgyzstan is stroke.
  4. Kyrgyzstan’s sanitation and drinking water services have a significant impact on the health of its population. Around 93 percent of the population has access to basic sanitation services and piped water services reach 58 percent of the nation. Additionally, the practice of open defecation is not found in the country, contributing to more sanitary conditions.
  5. As of 2015, the maternal mortality rate in Kyrgyzstan is 76 per 100,000 live births. Maternal mortality has remained high in the nation for the past two decades, barely decreasing from 1990 when the maternal mortality rate was 80 per 100,000 live births. This is in spite of the fact that 99 percent of all births in Kyrgyzstan are attended by a skilled professional.
  6. In Kyrgyzstan, there are approximately 1.9 doctors and 6.4 nurses per 1,000 people, according to World Bank data from 2014. This is lower than the average for low-and-middle-income countries in Europe and Central Asia, which is approximately three physicians per 1,000 people. Kyrgyzstan has made improvements, however, as the rate was approximately 2.5 doctors per 1,000 people in 2008.
  7. Kyrgyzstan has made reforms to its health care system three times since 2001, with the goal of improving the availability and quality of medical services. A mandatory health insurance fund has been in place since the 1990s and on average people in Kyrgyzstan pay 39 percent of the total cost of their health services. However, a lack of pharmacy price regulation and the devaluation of the national currency led to a 20 percent increase in co-payments for reimbursed medicine in outpatient care increased between 2013 and 2015, driving up out-of-pocket costs.
  8. Kyrgyzstan’s Ministry of Health and Mandatory Health Insurance Fund will implement a new Primary Health Care Quality Improvement Program between 2019 and 2024. This program is largely funded by the World Bank, which is contributing nearly $20 million. Alongside this program is the country’s new health strategy for 2019-2030: “Healthy Person – Prosperous Country.” The government of Kyrgyzstan recognizes that strengthening the primary health care system is essential to improving lives, particularly for the impoverished.
  9. The impoverished — which account for 25.6 percent of the population — and those living remotely in the mountains are most likely to experience malnutrition in Kyrgyzstan. UNICEF estimates that 22 percent of all child deaths occur due to malnutrition and almost 18 percent of all Kyrgyz children are malnourished. Malnutrition causes stunting, low birth weight and vitamin and mineral deficiencies that can have a life-long effect on one’s health and wellbeing.
  10. Education is also an important factor contributing to health and life expectancy. In Kyrgyzstan, education is mandatory for nine years between the ages of 7 and 15. UNICEF notes that many children drop out after grade nine when this mandatory education ends, as only 59 percent for boys and 56 percent for girls attend upper secondary school. Quality of education is another challenge for the nation, with more than 50 percent of children not meeting the basic level of achievement in reading, math and science.

These 10 facts about life expectancy in Kyrgyzstan shed light on health and living conditions in the nation. With new health initiatives being undertaken in the country, there is hope that life expectancy rates will continue to improve.

Navjot Buttar
Photo: UNICEF

10 Facts About Life Expectancy in The Gambia
The Gambia is a small West African country that people know for its diverse ecosystems around the Gambia River. It is the smallest country within mainland Africa and farming, fishing and tourism drive its economy. The Gambia has a life expectancy of 65 years which is relatively low when considering that the global average life expectancy is 72 years. The Gambia also faces problems associated with poverty that can have serious effects on population and life expectancy. Here are 10 facts about life expectancy in The Gambia.

10 Facts About Life Expectancy in The Gambia

  1. HIV/AIDS – Twenty-one thousand people are currently living with HIV or AIDS in The Gambia with only 30 percent seeking treatment. Since 2010, The Gambia has been working towards lowering the rate of transmission between mothers and children. With the establishment of the National AIDS Control Programme, HIV infections have decreased by 3 percent and AIDS-related deaths have decreased by 23 percent.
  2. Lack of Health Care Providers – The Gambia faces a lack of health care providers. According to a 2009 World Health Organization report, The Gambia had only 156 physicians. The World Health Organization recommends two doctors for every 10,000 people, whereas The Gambia only has one doctor for every 10,000. The International Organization for Migration, in partnership with the World Health Organization, is attempting to increase the amount of health care providers through its program, Migration for Development in Africa.
  3. Infant Mortality Rate – The infant mortality rate in The Gambia is at 58 deaths per 1,000 live births, severely affecting the life expectancy in The Gambia. Malaria is the cause for 4 percent of infant deaths under the age of 1, and 25 percent between the ages of 1 and 4. The National Malaria Control Programme launched in 2014 and prevents 75 percent of all malaria and severe malaria episodes.
  4. Maternal Mortality Rate – The maternal mortality rate in The Gambia is 706 deaths per 100,000 live births. The major cause behind maternal mortality is a lack of prompt response to emergencies combined with disorganized health care. Improving accessibility is necessary for preventing maternal deaths.
  5. Income – The average gross salary is $0.57 per hour with 75 percent of the labor force working in agriculture. Longterm challenges that the economy of The Gambia faces include an undiversified economy, limited access to resources and high population growth.
  6. Malnutrition – Approximately 11 percent of the country is chronically food insecure and 21 percent of children under 5 are malnourished which impacts the life expectancy in The Gambia. Thirty percent of the population do not have proper nourishment–a number that has increased over the past decade. The Gambia relies heavily on imports of food staples along with low agricultural production has made it easy to become food deficient. UNICEF has begun treating cases of malnutrition through preventative and curative services.
  7. Water – Only 32 percent of households have access to clean water with unprotected wells being more common in rural areas. With 4 percent of the rural population practicing open defecation, water, sanitation and hygiene-related diseases account for 20 percent of under-5 deaths. Water for Africa has begun to send aid to The Gambia in the form of building wells.
  8. Education – The Gambia sends its children to six years of primary school and three years of upper basic education, but there are still gaps in education. With aid from the United States and the World Bank, The Gambia launched its Education Sector Support Program to promote early childhood development and boost access to basic education. The project also provides for the building of 40 schools in remote areas.
  9. Malaria Endemic – Peak season for malaria is during the rainy season from June to October. The Catholic Relief Services (CRS) works to provide relief to malaria outbreaks in The Gambia with cases that have declined by 50 percent from 2011 to 2016. The CRS works by distributing bed nets and focusing its aid on children under 5 and pregnant women.
  10. Employment – Farming employs at least 70 percent of the population. Farmers are reliant on rain-fed agriculture. Most cannot afford improved seeds and fertilizers. Between 2011 and 2013, poverty, food shortages and malnutrition have increased due to crop failures that droughts caused.

Despite problems people associate with agriculture, income and health, life expectancy in The Gambia is rising while infant and maternal mortality rates are declining.

– Darci Flatley
Photo: Flickr

Microlife CRADLE VSA Saves MothersRoughly 800 women die every day as a result of obstetric hemorrhaging, sepsis and pregnancy-related hypertension. The majority of these deaths occur in low-income areas that do not have the necessary tools to check a mother’s blood pressure and heart rate during or after childbirth.

In response, Professor Andrew Shennan and the CRADLE research team at King’s College London developed the CRADLE Microlife Vital Signs Alert (CRADLE VSA). The device features a “traffic light” early warning system that uses the traditional red, yellow and green colored lights. The user-friendly system indicates when a patient has pre-eclampsia or sepsis, even if the user has not undergone formal training.

CRADLE VSA relies on Shock Index, “the most reliable predictor of serious maternal adverse outcome. Appropriate thresholds for shock index were therefore incorporated into the traffic light algorithm, together with universally understood hypertensive thresholds, to trigger the coloured lights.” Several research studies have investigated the benefits of CRADLE VSA devices.

2013

A CRADLE research team found that over 90 percent of health clinics in a rural district of Tanzania lacked blood pressure devices. Often, the ones they did have were broken. The team provided 19 CRADLE VSA devices, containing tally counters to monitor use, to these clinics.

The CRADLE researchers conducted preintervention and postintervention studies over 12 months in three rural hospitals in Tanzania, Zimbabwe and Zambia. During the three-month preintervention phase, pregnant women who went to the hospital at twenty weeks gestation or more had their blood pressure measured twice with the validated CRADLE prototype device. The three-month intervention phase resulted in twenty rural and semirural peripheral antenatal clinics receiving one to two CRADLE prototype devices. They also received training sessions, instructions and a guide to referring based on blood pressure readings.

The researchers analyzed readings from 1,241 women (694 from the preintervention phase and 547 from postintervention). They discovered a link between the use of the device in these rural clinics and improved antenatal surveillance of blood pressure. They found a decrease in the proportion of women who never had their blood pressure measured in pregnancy from 25.1 percent to 16.9 percent.

April 2016

Researchers held a 20-month trial to determine the device’s efficiency. Over this time, new healthcare sites received the CRADLE VSA device every two months until 10 sites had the device. The goal of the trial was to determine the device’s ability to detect obstetric hemorrhaging, sepsis and hypertension and help providers reduce the number of deaths occurring during childbirth. In June 2016, researchers implemented the device in 10 low-income countries including Uganda, Sierra Leone, Ethiopia and Haiti.

June 2018

Studies showed that clinics in twelve countries across Africa, Asia and the Caribbean were using over 6,700 CRADLE VSA devices. A cluster randomized controlled trial in Mozambique, India and Pakistan used a prototype of the device in the intervention phase of pre-eclampsia. The trial enrolled a total of 75,532 pregnant women.

The CRADLE VSA saves lives by foreseeing the early diagnosis of pre-eclampsia. For many women, these health risks may have otherwise gone unnoticed. This innovation is contributing to the prevention of maternal deaths. This could help the world meet the United Nations Sustainable Development Goal 3, “to reduce the global maternal mortality ratio to less than 70,000 per 100,000 live births by 2030.”

– Sareen Mekhitarian
Photo: Upsplash

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

How Poverty Affects PregnancyWomen living in poor rural communities have a higher risk of maternal mortality. An astounding 99 percent of maternal deaths take place in developing countries. More than half of these victims lived in sub-Saharan Africa and one-third lived in South Asia.

The number one cause of death for adolescent females in developing countries is complication in reproduction. The risk of death is higher in girls of the age 15 years and younger. Their country’s health systems often fail to provide adequate health services to survive pregnancy and childbirth.

An estimated 75 percent of maternal deaths are caused by:

  • High blood pressure: during pregnancy preeclampsia should be detected and can be remedied with magnesium sulfate.
  • Infections: when recognized in a timely manner, they can be treated, and good hygiene following childbirth can prevent it.
  • Excessive bleeding after childbirth can kill a healthy woman in a matter of hours. To reduce this risk, oxytocin is injected immediately after birth.
  • Diseases such as malaria and AIDS (during pregnancy) account for all other maternal deaths.

Poor Health Systems

In developed countries, it is typical for women to have at least four prenatal care visits. Postpartum care is also recommended and received by high-income countries. Unfortunately for millions of poor mothers, there is no access to skilled providers to help them.

The lack of access to health workers can be due to lack of information or an issue of distance. At times, cultural practices prevent women from getting the care they need, and most often the nearest health facility is in another community.

The World Health Organization is contributing to the Global Strategy to improve health for women and children. Their goal is to ensure access to a better health system with effective treatments, trained health workers, and health coverage programs. Without access to quality health care during these critical times of development, this is another way in how poverty affects pregnancy.

Food Insecurity Impacts Female Health

Food insecurity is another way in which poverty affects pregnancy. Creating a new life requires a lot of energy from a woman’s body. This is why women facing food insecurity are at risk of health problems. A poor diet can cause:

  • gestational diabetes
  • iron deficiency (the mother becomes anemic)
  • low birth weight.

If women do not intake the appropriate amount of nutrients, the baby will take the vitamins and minerals from their mother’s body. This weakens a woman’s immune system which is needed to fight off disease and infection.

The Importance of Nutrition for Child Development

A healthy diet when creating a new life is consuming 1,800 calories a day in the first trimester, 2,200 in the second trimester and 2,400 in the third trimester. Essential nutrients include:

  • calcium for healthy growth
  • iron for a baby’s blood supply and
  • folic acid, which reduces the risk of spina bifida and anencephaly (a brain defect).

Without proper nourishment, a child will suffer from chronic malnutrition. This leads to impaired brain development, a weakened immune system and shorter stature. This could mean that some children will be unable to complete schooling. This is yet another factor in how poverty affects pregnancy.

The USAID study shows that girls with stunted growth have their firstborn at approximately four years younger than non-stunted girls. Additionally, these girls who are not fully developed to give birth to a child contribute to the maternal death rate.

It does not stop there. UNICEF estimates the under-performance of these victims will cost their generation’s global economy $125 billion. The five countries where nearly half the population of children under age five are chronically malnourished include Madagascar, Papua New Guinea, Eritrea, Burundi and Timor-Leste.

Overall, without access to a proper health system or proper nutrition, studies indicate the negative ways in how poverty can affect pregnancy. The health of a pregnant woman is vital for childbirth. Prenatal malnutrition stunts the development of children’s bodies and minds. Children can find themselves with learning challenges. This sets generations back from reaching their full potential to advance their communities, fueling the cycle of poverty.

-Crystal Tabares
Photo: Flickr

Life Expectancy in Laos

The both ethnically and linguistically diverse country of Laos is a landlocked, independent republic in Southeast Asia. It is home to about 7 million people, representing just 0.9 percent of the world’s total population. The average life expectancy in Laos is currently 65.8, but the number has gone up in recent years. The information below will provide 10 facts about life expectancy in Laos and what action is being taken to improve it.

Top 10 Facts About Life Expectancy in Laos

  1. Currently, the life expectancy of the total population in Laos is 65 years. Men in Laos have a lower life expectancy than the average rate at 62.9 years, and women’s life expectancy is approximately 67 years.
  2. The maternal death rate in Laos is one of the highest in the Western Pacific Region. According to the Laos Maternal Death Review, 54 percent of maternal deaths were caused by complications from postpartum hemorrhage. In 1990, 905 women per 100,000 live births had died. Given this statistic, the primary focus of the ministry and WHO has been developing a voucher program that ensures free delivery of pre and postnatal care for women.
  3. In conjunction with WHO, the ministry is providing free health services to women and children in 83 districts in 13 provinces. As of 2015, the mortality rate has dropped to 197 deaths for every 100,000 live births. This drop can also be largely attributed to the work being done by the UNFPA, which is providing counseling on family planning and training midwives to match international standards.
  4. Assisted childbirth was almost unheard of in 2007, and death during childbirth was considered common if not likely. Since 1995, the Ministry of Health has begun to recognize the importance of having trained and skilled professionals present during birth and is working to decrease the number of home births in the country. As of 2015, the maternal mortality rate had decreased 75 percent. Only eight other countries had been able to accomplish that goal.
  5. As of 2017, heart disease and stroke accounted for 22 percent of deaths in Laos. Since 2007, the number of deaths from stroke has risen 5.6 percent, and deaths from heart disease have risen 3.3 percent. Most cardiovascular and respiratory problems stem from smoking and high rates of air pollution.
  6. In March of 2019, the Pollution Control Department reported that there had been a large number of wildfires in Laos and neighboring countries. Forest fires in Thailand had caused air pollution levels to become hazardous. Currently, air pollution levels are more than 20 times the safety limit. Residents have been advised to wear safety masks to prevent smoke inhalation, and officials are working to bring down toxicity levels by spraying water into the polluted air.
  7. Malnutrition has also been a persistent problem in Laos and can lead to cognitive difficulties, delayed development and high mortality rate. In 2015, 17 percent of the population was considered malnourished. Additionally, 45 percent of deaths of children under five are linked to undernutrition. Food security, diet diversity and water and sanitation all contribute extensively to the malnutrition issues. Fortunately, UNICEF has been able to advocate for nutritional programs and interventions with the hope of lowering the mortality rate.
  8. In September of 2018, Ministries of Planning and Investment, Agriculture, Public Works, Transport and Health teamed up with the World Bank to tackle the malnutrition problem in Laos. These organizations have developed a program that is focused on the critical development that occurs in the first 1,000 days of a child’s life. The ministries and World Bank intend to establish welfare programs, diversify food production and improve hygiene and sanitation by ensuring clean water is accessible in rural sectors of Laos.
  9. Drinking water in Laos is often contaminated with dangerous chemicals and waste, particularly in rural areas and schools. Only 66 percent of the nearly 9,000 primary schools in Laos have functional water supply systems and latrine facilities, causing widespread health complications. UNICEF has been working with the Ministry of Education and Sports to implement a program called WASH, which improves water, sanitation and hygiene in conjunction with one another. Through the program, UNICEF is implementing effective hygiene practices, providing access to safe water and ending the practice of open defecation in rural communities.
  10. Government health expenditures have gone up more than 2 percent in the last four years in an effort to provide universal health coverage by 2025. The nation continues to work towards protection from infectious disease, and while the progress has been slow, with continued government funding health coverage is likely to expand.

Many of Laos’ SDG’s are still far from being accomplished, but the 2018 country profile from the WHO suggests that improvements have been made that will eventually lead to an overall increase in life expectancy. These 10 facts about life expectancy in Laos provide insight into what steps toward improvements have already been made and what still needs to be accomplished. The hope is that Laos will continue to increase its overall life expectancy, reaching an average age of 70 by the year 2030.

Anna Lagattuta

Photo: Everystock

Maternal Mortality in Africa

Upon learning they are pregnant, most women do not immediately wonder if it’s a fatal diagnosis. However, that is the stark reality for many women in developing countries, particularly in sub-Saharan Africa. Maternal mortality in Africa is a pervasive and devastating issue. Far hospitals, scarce doctors and poor healthcare systems all contribute to maternal mortality. Most maternal deaths are preventable and caused by complications treatable in developed nations. It is important to recognize the causes of maternal death and solutions already in place to further reduce maternal mortality in Africa.

Causes of Maternal Mortality

The most common causes of maternal mortality are severe bleeding, infections, high blood pressure during pregnancy, delivery complications and unsafe abortions. In most cases, these are treatable with access to trained medical staff and proper medication. Access to maternal health care varies around the world. “A 5-year-old girl living in sub-Saharan Africa faces a 1 in 40 risk of dying during pregnancy and childbirth during her lifetime. A girl of the same age living in Europe has a lifetime risk of 1 in 3,300,” according to Dr. Greeta Rao Gupta, deputy executive director of UNICEF. Factors such as “poverty, distance, lack of information, inadequate services, [and] cultural practices” prevent women from having access to the proper medical services they need.

Additionally, warfare in developing countries causes the breakdown of healthcare systems. This further prevents women from accessing life-saving medical care. For example, when the 11-year civil war in Sierra Leone ended in 2002, it left less than 300 trained doctors and three obstetricians to treat the country’s 6 million people.

Solutions to Reduce Maternal Mortality

Many NGOs work throughout the region to combat maternal mortality in Africa. In fact, the United Nations initiated the Global Strategy for Women’s, Children’s and Adolescents’ Health, 2016-2030. Their goal is to “reduce the global maternal mortality ratio to less than 70 per 100,000 live births” by 2030.

According to a study by the World Health Organization, there needs to be better documentation of maternal mortality in Africa to create more effective policy solutions. Currently, less than 40 percent of countries have a registration system documenting the causes of maternal mortality. Hence, this lack of information makes it difficult for the U.N. and NGOs to create effective solutions.

An unexpected yet effective way maternal mortality in Africa has been combated is through photography. Pulitzer-prize winning war correspondent Lynsey Addario took her camera to the region to document maternal mortality. Addario documented the experiences of many women, including 18-year-old Mamma Sessay in Sierra Leone. Sessay traveled for hours by canoe and ambulance while in excruciating labor to reach her nearest hospital. Addario stayed with Sessay for the entire experience, from the birth of her child to her subsequent hemorrhage and death. Addario even traveled with Sessay’s family back to their village to document Sessay’s funeral and her family’s grief.

Ultimately, TIME published Addario’s photographs. And as a result, Merck launched Merck for Mothers, giving $500 million to reduce maternal mortality rates worldwide. Addario stated, “I just couldn’t believe how unnecessary her death seemed, and it inspired me to continue documenting maternal health and death to try to turn these statistics around.”

The Bottom Line

The international community must continue to address maternal mortality, a preventable tragedy. No woman should have to fear for her own life or the life of her unborn child upon discovering she is pregnant. Through documentation, reporting and care, the international community can fight to reduce maternal mortality in Africa.

Alina Patrick
Photo: Flickr