In many of the world’s poorest countries, ensuring that mothers stay alive and are healthy and that their children can survive and thrive are significant challenges. 287,000 mothers died in 2010 each from pregnancy-related causes and millions more suffered from complications related to pregnancy or childbirth, including haemorrhage, infection, hypertensive disorders and obstructed labour. Women living in developing countries are nearly 300 times more likely to die from complications during pregnancy and childbirth than women living in developed countries.
In 2012, 6.3 million children died before their fifth birthday. Despite some countries making improvements – and in some cases, dramatic gains – in child health in recent years, sub-Saharan Africa’s child mortality rate is still 15 times the average of high-income countries. Many of these deaths are from entirely preventable and treatable causes, such as pneumonia, diarrhoea, malnutrition and malaria. And because children who lose their mothers are five times more likely to die in infancy than those who do not, maternal health and child health challenges are deeply intertwined.
With proper care and treatment, nearly all of these deaths could be avoided. However, many health systems in low- and middle-income countries have a shortage of health-care workers, a lack of basic equipment, inadequate access to basic life-saving prevention and treatment tools, and poor infrastructure. Improving health systems is essential to saving the lives of mothers and children in the developing world.
Fortunately, simple, cost-effective solutions to improve maternal and child health already exist. Enabling women to plan and space births, treating infectious diseases and improving nutrition can help women stay healthy during pregnancy. Additionally, efforts to educate women – both in general and specifically during and immediately following their pregnancy – help ensure that mothers know how and when to seek health care services for themselves and their children.
Skilled care by a birth attendant during pregnancy and labour, emergency obstetric care, and immediate postnatal care all help reduce maternal mortality. These kinds of basic maternal health services before and after delivery could prevent 80% of maternal deaths, and have already helped cut the annual number of maternal deaths almost in half since 1990.
It is also possible to save many more children’s lives with low-cost interventions. Vaccinations against diseases like hepatitis B, Haemophilus influenzae type b (Hib), pertussis, measles, and yellow fever can save millions of lives each year. Vitamin A supplements, which cost $1 per child per year, could save over a quarter of a million young lives annually by reducing the risk and severity of diarrhoea and infections. Regular weighing of infants is a simple and cheap way to monitor the wellbeing of a child. Oral Rehydration Salts (ORS) and zinc supplements can also help treat diarrheal diseases.
Treatment to prevent mother-to-child transmission of HIV; anti-malarial bed nets, and the promotion of breastfeeding and proper nutrition can also guard against infectious diseases and ensure good health in the early stages of childhood.
The rapid drop in global child deaths in the last 20 years is one of the world’s most spectacular, and most hopeful, success stories. It shows what is possible with the right resources, programs and political will in place. But the story isn’t over yet. More needs to be done, especially in sub-Saharan Africa, to make sure this progress continues for children and mothers everywhere.