Maternal and child mortality

Maternal mortality is such a rare term in Western countries that we often forgot that it even exists. It is remarkable, that worldwide, a woman dies every minute due to complications during pregnancy and childbirth , which makes more than 500 000 women per year (1). In developing countries, pregnancy and childbirth are actually the second leading causes of death among women of reproductive age after HIV and AIDS. (1). Factors associated more often with maternal mortality are usually preventable: severe bleeding, infections, hypertensive disorders (pre-eclampsia and eclampsia), unsafe abortion, and obstructed labour. (1) If health care system had enough facilities, most of these problems could be avoided. After childbirth mother can get fever, anaemia, fistula, incontinence, infertility or depression (1) and these factors increase the risk of other diseases and death. Adolescent pregnancies are a risk factor, too. Even the fact that there could be a trained midwife, nurse or doctor during childbirth available, could reduce the risk of maternal and new born baby deaths.

Maternal health also influences the health of a child, but there are also other threats for children, both environmental, social and many of these are connected with the conditions. Nearly 10 million children under the age of five die each year (2) and this is enormous amount of living years lost. The main reasons for the child mortality are pneumonia, diarrhoea, malaria, measles and HIV (2,3). In addition, malnutrition contributes to more than half of all child deaths (3). At first we shall concentrate on malnutrition, for approximately 20 million children under five year old worldwide are severely malnourished and malnutrition is connected with so many diseases. (3) Malnutrition may increase the risk of many diseases and lead to child death. In developing countries around three-quarters of malnourished children could be treated with "ready-to-use therapeutic foods" (3), which would be ideal food and also ideal for the conditions where hygienic level is not so good.

For many of these diseases causing child mortality the prevention and treatment could be even easy if the society had enough facilities and funding. For example, in pneumonia, antibiotics and oxygen treatment are essential (2,3) and still not available in many parts of the world. Diarrhoeal diseases are a leading cause of sickness in many developing countries and these could be prevented/treated with, for example, exclusive breastfeeding and use of oral rehydration salts (ORS).(3) For malaria, vaccinations are pretty uncommon in developing countries, but the use of insecticide nets and treatment with anti-malaria medication may be essential. (3) It is also surprising that even 90% of children with HIV are infected through mother-to-child transmission (3). This could also be prevented by certain manners and antiretroviral drugs. New born babies are most fragile: almost 40 per cent of all under-five deaths occur during the neonatal period, the first month of life, from a variety of complications. (3) Frequent check-ups after delivery and good hygienic condition could prevent or to help get faster treatment for inflammation diseases that are common in new born babies in developing countries.

Are there any similarities in reduction of child and maternal mortality? There certainly are. For example poverty increases the risk of both.(1, 3) Living in rural areas is a risk factor for both, respectively. (3) It is interesting to see that here we meet the familiar term, education, again. It is assumed that maternal education is a very important factor for child`s health, while an educated mother is more likely to know, for example, the benefits of breastfeeding, things concerning malnutrition and treatment of diarrhea and the importance of family planning.(4) In countries, where the maternal mortality rate is high, child mortality rate is also high so these deaths accumulate into same areas in the world. In addition, the same efforts could prevent both. Education, as already mentioned, better functioning health care systems, elimination of poverty, better hygienic conditions, clean drinking water, check-ups for a mother during pregnancy and for a child during early age, enough qualified health workers - the list is endless. There certainly are things that could be done to eliminate this huge problem in developing countries.

References:
1.WHO 2008. 10 Facts on maternal health.
2.WHO 2008. What are the key health dangers for children?
3.WHO 2008. 10 Facts on child health.
4.UNICEF 2008. Why are millions of children and women dying?