Maternal and Child Health in sub-Saharan Africa

More children and mothers in sub-Saharan Africa are being saved each year thanks to expanded access to basic health care and simple tools like immunizations, bed nets and vitamin A supplements.

FAST FACTS:

• Senegal reduced its under-five mortality rate by 22% between 1990 and 2006 and now also has West Africa's lowest rates of malnutrition.
• Measles deaths in Africa fell by 89% between 2000 and 2007 after a massive vaccination program carried out by a partnership among African governments, UNICEF, the American Red Cross and the World Health Organization.
• Malaria incidence in children living in Equatorial Guinea decreased by 49% between 2003 and 2008.

Several sub-Saharan African countries make progress in child survival

Despite continuing high child mortality in sub-Saharan Africa, there has been significant progress in some countries thanks to increased immunization coverage, vitamin A supplementation, bed net distribution, and increased access to clean water. Eritrea's under-five mortality rate declined by 52% between 1990 and 2007. In Malawi, Mozambique, Niger and Ethiopia child mortality rates have declined by more than 40% across the same period. Child mortality in Tanzania dropped by 24% between 2000 and 2004 thanks to scaled up investment in the public health system and the delivery of key child-survival interventions such as insecticide treated nets, vitamin A supplementation, immunization and exclusive breast feeding.

Rwanda: Health insurance program and increased funding boost access to skilled birth attendance

The Rwandan government, in collaboration with donor partners, has implemented a health insurance program ("Mutuelles de Santé) which is run by community representatives and local health providers. Mutuelles, which cover about 85% of the Rwandan population, reduce financial barriers to access by subsidizing health insurance premiums: mutuelle members pay an annual premium of about $2. Female members can deliver at no cost if they have completed four antenatal visits, and pay about 10% of the usual cost for maternity care. As a result of increased participation in mutuelles, as well as increased funding for maternal health, skilled birth attendance in Rwanda increased from 31% in 2000 to 49.5% in 2006.

Central African Republic: Government collaboration to immunize mothers

In the Central African Republic, the Ministry of Health, the WHO, the United Nations Population Fund and UNICEF collaborated to create the Mother and Child Survival Campaign to decrease the high rate of maternal and infant mortality. In January 2008, the campaign immunized over 700,000 women of reproductive age against tetanus and plans were in place to immunize 1.5 million women across the country in March 2008. Other countries such as Kenya, Sudan and the Democratic Republic of the Congo are implementing vaccination programs against tetanus and other preventable diseases, and are likely to decrease the overwhelming number of maternal deaths across sub-Saharan Africa.

Mali: Implementation of maternal care program increases access to antenatal care

The Accelerated Child Survival and Development (ACSD), which was implemented in Mali with the help of UNICEF, successfully increased access to healthcare for women in rural areas who are at a greater risk of dying during or suffering complications from childbirth. Since 2001, outreach done through the Accelerated Child Survival and Development (ACSD) strategy has reduced inequalities in access to antenatal care between poor and wealthy women, and doubled the percentage of women who receive three or more antenatal care visits.