Fewer maternal and child deaths
“A commitment that doesn’t translate into concrete programs and services is only an empty promise,” said Ann Starrs, president of Family Care International and an author of the report. “By objectively measuring progress and identifying gaps, Countdown to 2015 is a critical tool to help civil society advocates make sure that their governments deliver on the commitments they’ve made to women and children.”
The release of the Countdown 2012 Report coincides with a two-day forum to chart a course toward the end of preventable child deaths, taking place June 14-15 in Washington, DC. The governments of the United States, India, and Ethiopia, in collaboration with UNICEF, will convene this Child Survival Call to Action. US Secretary of State Hillary Clinton will attend.
Following in July, the UK government and the Bill & Melinda Gates Foundation will hold a summit to emphasize the need for greater attention to family planning.
“Maternal deaths are both caused by poverty and are a cause of it. The costs of childbirth can quickly exhaust a family’s income, bringing with it even more financial hardship,” says Tamar Manuelyan Atinc, Vice President for Human Development at the World Bank. “Given the weak state of health systems in many countries, we must work closely with governments, aid donors and agencies, and other partners to strengthen these systems so that women gain significantly better access to quality family planning and other reproductive health services, skilled midwives at their births, emergency obstetric care, and postnatal care for mothers and newborns.”
The report that covers the period from 1990 to 2008 also highlights the following.
- Ten out of 87 countries with maternal mortality ratios equal to or over 100 in 1990, are on track with an annual decline of 5.5% between 1990 and 2008. At the other extreme, 30 made insufficient or no progress since 1990.
- The study shows progress in sub-Saharan Africa where maternal mortality decreased by 26%.
- In Asia, the number of maternal deaths is estimated to have dropped from 315 000 to 139 000 between 1990 and 2008, a 52% decrease.
- 99% of all maternal deaths in 2008 occurred in developing regions, with sub-Saharan Africa and South Asia accounting for 57% and 30% of all deaths respectively.
“We still need to do more to strengthen national data collection systems,” says Dr Chan. “It is vital to support the development of complete and accurate civil registration systems that include births, deaths and causes of death. Every maternal death needs to be counted,” she adds.
In September, the United Nations Secretary-General, Ban Ki-moon, will issue an update on the impact of his Every Woman Every Child effort.
Key findings of the new report
Country-by-country data gathered and analyzed for the 2012 report highlight the progress and show where greater efforts are needed in 75 high-burden countries:
On reducing maternal deaths: Annual maternal deaths are down by 47 percent over the past two decades. Nine Countdown countries are on track to meet their 2015 MDG 5 goal by reducing the maternal mortality rate by 75 percent. But more than a third of the 75 Countdown countries have made little, if any progress.
On reducing deaths of children under age 5: Twenty-three Countdown countries are expected to achieve MDG 4. But 13 countries have made no progress in reducing child deaths.
Forty percent of child deaths occur during the first month of life and most of these deaths are preventable through better nutrition and access to health services before, during and immediately after childbirth.
Complications due to preterm birth are the leading cause of newborn deaths and the second leading cause of death in children under 5.
More than 10 percent of all babies are born too soon. Preterm births are rising, instead of declining.
Inadequate nutrition is a crisis in most Countdown countries, contributing to more than one-third of child deaths under 5 and one-fifth of maternal deaths.
In most of these countries, more than one-third of the children are stunted, a condition especially common among the poorest populations where children are small because of a lack of good nutrition.
Short maternal stature, often a result of stunting in childhood, and micronutrient deficiencies place pregnant women at greater risk for complications and low birth weight babies.
Forty Countdown countries allocate less than 10 percent of total government spending to health.
Fifty-three of the 75 Countdown countries face a severe shortage of health workers. Countries including Ghana, Malawi, the Lao People’s Democratic Republic and Tanzania have implemented innovative policies to hire, retain and motivate skilled health workers.