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The “Three Delays” at the Root of Maternal Mortality

Maternal_Mortality
The World Health Organization (WHO) estimates 303,000 women will die of maternal causes by the end of 2015. While this figure has been reduced by approximately 44 percent in the past 25 years, improvements to maternal mortality rates still need to be made. Almost 99 percent of maternal deaths occur in developing regions, two-thirds of which are concentrated in sub-Saharan Africa.

In 1994, Sereen Thaddeus of the United States Agency for International Development (USAID) and Deborah Maine, Professor Emerita at the Columbia University Mailman School of Public Health, linked causes of maternal mortality to “three delays:” delay in seeking care, delay in arrival at a health facility, and delay in the provision of adequate care.

Today, these three delays still make up a framework that helps in understanding what causes maternal deaths.

1. Delay in Seeking Care

Around 28 percent of maternal deaths stem from pre-existing conditions like anemia and malaria, according to WHO. Women, however, may put off seeking prepartum care because of the inadequacy of available health facilities.

The question of agency plays another role in this delay. According to Kingsley Ighobor, in some countries such as Mali, Burkina Faso and Nigeria, many women do not make the decisions over their health. This responsibility is instead left to spouses or other relatives.

2. Delay in Arrival at a Health Facility

Those living in rural areas face the major obstacle of distance from healthcare facilities. In developing nations, Thaddeus and Maine pointed out how weak infrastructure often means poor roads and slow transportation methods which can delay a woman’s arrival at a health facility.

Socioeconomic divisions within countries often mean unequal access to health facilities. WHO reports “delivery care… is strongly associated with their income, whether they live in a rural or urban area, and their level of education”.

3. Delay in the Provision of Adequate Care

Postpartum hemorrhage accounts for 27 percent of maternal deaths while obstructed labor constitutes eight percent.

Especially in developing nations, a shortage of staff, insufficient training, little to no antibiotic availability and more means health facilities are often ill-equipped to respond to a mother’s needs during and after her pregnancy.

Inadequate sanitation can also be detrimental to mothers. Maternal deaths as a result of infection rank at 15 percent.

Solutions moving forward

Goal Three, Target 3.1 of the 2015 Sustainable Development Goals seeks to “reduce the global maternal mortality rate to less than 70 per 100,000 live births by 2030.”

Achieving this goal may call for tackling the three delays that play a central role in the causes of maternal mortality.

“One of the easiest ways to continue to reduce the rate of maternal mortalities is to improve access to reproductive health”, Dana Dovey of Medical Daily said.

Educating women and relatives on reproductive health along with strengthening the infrastructure of health facilities is necessary to ensure mothers have the help they need for safe pregnancies.

– Jocelyn Lim

Sources: Medical Daily, Kingsley Ighobor, Nawal M. Nour, Sereen Thaddeus and Deborah Maine, United Nations, World Health Organization (WHO), WHO report on health from MDGs to SGDs, WHO: Trends in maternal mortality, 1990-2015
Picture: Google Images

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MDGs: What They Achieved After 15 Years

MDGsAt the Millennium Summit in 2000, history was made when a record number of world leaders gathered to adopt the U.N. Millennium Declaration, committing nations to cutting extreme poverty in half through the Millennium Development Goals (MDGs) by 2015 and eradicate poverty through the Sustainable Development Goals (SDGs) by 2030.

Through the agreement, the MDGs target different dimensions of poverty including hunger, disease, insufficient shelter, gender inequality, global education and environmental sustainability.

With an expiration date of December 2015, the achievements made through the MDGs provide evidence that poverty can be eliminated worldwide by 2030.

MDG 1: Cut Extreme Hunger and Poverty in Half

Since 1990, the amount of people living on less than $1.25 per day decreased from 1.9 billion to 836 million in 2015. While extreme poverty was cut in half, extreme hunger narrowly missed the mark, dropping from 23.3 percent to 12.9 percent.

MDG 2: Achieve Universal Primary Education

Primary School Enrollment has seen a slight rise, increasing from 83 percent in 2000 to 91 percent in 2015.

MDG 3: Eliminate Gender Disparity in Education and Empower Women

Since 1990, approximately two-thirds of developing countries have achieved gender unity. In Southern Asia, the primary school enrollment ratio favors girls over boys in 2015.

MDG 4: Reduce Child Mortality by Two-Thirds

The child mortality rate decreased from 12.7 million in 1990 to 6 million in 2015. In addition, the measles vaccine compared to 2000 covered almost 10 percent more children worldwide.

MDG 5: Reduce the Maternal Morality Rate by 75 Percent

Compared to 1990, the maternal mortality rate has been cut in half, narrowly missing the 75 percent benchmark.

MDG 6: Combat HIV/AIDS, Malaria and Other Diseases

Since 2000, the number of new HIV infections decreased by 40 percent, dropping from 3.5 million to 2.1 million in 2013.

MDG 7: Increase Environmental Sustainability

In 2010, the goal to increase access to clean water was achieved five years early. Since 1990, 2.6 billion people have gained access to improved drinking water.

MDG 8: Develop an Open Partnership for Development

Overseas development assistance from developed nations to developing countries increased 66 percent. With the expansion of technology, Internet infiltration increased significantly from 6 percent in 2000 to 43 percent in 2015.

– Alexandra Korman

Sources: The Guardian
Photo: NaijaLog