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. Since 1990, the number of child deaths globally has been cut in half and maternal mortality worldwide dropped by about 44%.
Yet in many of the world’s poorest countries, ensuring that mothers stay alive and healthy and that their children can survive and thrive still represents a significant challenge. In 2015, 303,000 mothers died from pregnancy-related causes and millions more suffered from complications related to pregnancy or childbirth, including hemorrhage, infection, hypertensive disorders and obstructed labour.
Women in the poorest countries are most at risk of dying from pregnancy and childbirth. A woman’s lifetime risk of maternal death is 1 in 180 in developing countries compared to 1 in 4900 in developed countries. In countries designated as fragile states, the risk is 1 in 54.
Because children who lose their mothers are ten times more likely to die in infancy than those who do not, maternal health is deeply intertwined with child health, which also remains a significant global challenge. By 2016, 5.6million children died before their fifth birthday. If current trends continue, 60 million children under the age of 5 will die between 2017 and 2030 – over half of whom will be newborns.
More than any other region, sub-Saharan Africa is home to the highest number of child deaths – just under 3 million in 2016. Despite some countries making improvements – and in some cases, dramatic gains – in child health in recent years, 1 in 13 children in sub-Saharan Africa will die before his or her fifth birthday, compared to 1 in 189 in high-income countries. Many of these deaths are from entirely preventable and treatable causes, such as pneumonia, diarrhoea, malnutrition and malaria.
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.
Simple, cost-effective solutions to improve maternal and child health 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 up to 80% of maternal deaths.
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. Since 2000, Gavi, the vaccine alliance, has supported the immunisation of 580 million children and has helped save 9 million young lives. An increase in measles vaccination alone resulted in an 84% drop in measles deaths between 2000 and 2016 worldwide. Other interventions like Vitamin A supplements, which cost as low as $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.
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.
Thanks to strong financing, programs, and political will over the last fifteen years, we know we can end maternal and child deaths from preventable causes. But we have a long way to go before achieving the Sustainable Development Goals (SDG) targets to substantially reduce global maternal mortality, neonatal mortality, and under-5 mortality.
ONE’s Policy Position
ONE advocates for sustained financing for maternal and child health through proven and effective programs. ONE calls on governments to increase their domestic financing for health and ensure there are systems in place to support maternal and child health from the clinic level to the community level, including a strong healthcare workforce. ONE calls on donor countries to provide strong support for through official development assistance (ODA) channeled through effective bilateral programs and international organizations like Gavi, the Vaccine Alliance.