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2015 MDGs Review / Post 2015 SDGs Preview Scorecard On Maternal Death – Africa’s Health Inequity Against WomenDespite Relative Progress – African Governments Still Failing Women
Citizens As Health Ministers Hold Last Conference Of MDGs Era – 16/17 April 2015, In EthiopiaHighlights*Maternal Mortality Ratio In Africa
  • As The MDGs Draw To An End & New Post 2015 Sustainable Development Goals (SDGs) Beckon – 38 Out Of 55 African Countries Still Have High Maternal Mortality Ratio (MMR) Of Over 300 Maternal Deaths Per 100,000 Live Births.
  • 16 African Countries Have Very High Maternal Mortality Ratio (MMR) Of Over 500 Maternal Deaths Per 100,000 Live Births – Global Highest.
  • Sierra Leone Has Worlds Highest Maternal Mortality Ratio (MMR) – Of 1,100 Deaths Per 100,000 Live Births.
  • Followed By 15 Other African Countries With Very High MMR Of Over 500: Chad (980); Central African Republic (880); Somalia (850); Burundi (740); Democratic Republic of the Congo (730); South Sudan (730); Côte d’Ivoire (720); Guinea (650); Liberia (640); Niger (630); Cameroon (590); Guinea-Bissau (560); Nigeria (560); Mali (550); And Malawi (510).

 

*Lifetime Risk Of Maternal Death – Also Remains Highest In Africa

  • Highest Lifetime Risk Of Maternal Death Is In Chad – 1 in 15;
  • Followed By 9 Other Countries With High 1 In 18 to 1 In 30 Risk Of Maternal Death: Somalia 1 in 18; Niger 1 in 20; Sierra Leone 1 in 21; Burundi 1 in 22; DR Congo 1 in 23; Mali 1 in 26; Central African Republic 1 in 27; South Sudan 1 in 28; Cote d’Ivore 1 in 29;

Multisectoral & Social Factors: Links Between Maternal Mortality Ratio, Risk Of Maternal Death – & Underage/Child/Forced ‘Marriage’

  • 13 Of The Countries With Highest Maternal Mortality Ratio – Are Also – 13 of Joint Top 15 Countries With Highest Percentages Of Underage/Child/Forced ‘Marriage’  – i.e. Where 36% – 76% Girls Under 18 Years Of Age Impregnated Through Underage/Child/Forced ‘Marriage’
  • 13 Of Highest Maternal Death Risk Countries – Are Also – 13 Of Top Joint 15 Countries With Highest Percentages Of Underage/Child/Forced ‘Marriage’  – i.e. Where 36% – 76% Girls Under 18 Years Of Age Impregnated Through Underage/Child/Forced ‘Marriage’
  • (In Alphabetical Order) The 13 Countries Are Cameroon, Central African Rep, Chad, D.R. Congo, Guinea, Liberia, Malawi, Mali, Niger, Nigeria, Sierra Leone,Somalia, South Sudan.

*Based on latest comparable figures from 2013

Overall, Main Causes Of Maternal Death Are:
  • Haemorrhage (Uncontrolled Bleeding); Sepsis (Infection); Hypertensive Disorders; Unsafe Abortion; Prolonged Or Obstructed Labour (i.e. Lack Of Access To Adequate Care; Poor Health Systems; Lack Of Skilled Personnel)
  • Health & Medical Conditions Including Anaemia; Nutritional Status; Malaria; Hepatitis; Heart Disease; HIV/AIDS – All Increase Risk of Maternal Death (But Are Preventable, Treatable Or Manageable)
  • Multiple Pregnancies Spaced Too Closely Together/ Absence Of Family Planning; High Adolescent Fertility & High Total Fertility Rates; Female Genital Mutilation/Cutting.
  • Social Factors Such As: Inequity; Poverty; Women’s Low Status, & Negative Attitudes Towards Women’s Health & Rights; Lack Of Education & Empowerment.
  • Significantly – Underlying Causes Of Maternal Mortality Includes Underage/Adolescent Pregnancies – Mostly From Underage/Child/Forced “Marriage’ – Girls Under 18 Are More At Risk Than Older Women.
  • Risk Of Maternal Mortality Is Highest For Girl Children / Adolescent Girls Under 15 Years Old. Complications In Pregnancy & Childbirth Are Leading Cause Of Death Among Adolescent Girls In Developing Countries.
Support Africa Campaign To End Underage/Child/Forced ‘Marriage’ on Twitter- @End2ChildAbuse

Top Joint 15 – Maternal Mortality Ratio & Maternal Death Risk

Also Available For Online & Social Media – See Full Scorecard & Data 
maternal death list pic 1maternal death list pic 2

For context only 2 countries outside African region have high MMR: Afghanistan (400) & Haiti (380). 

 

Impact Of Adolescent / Girl Child Pregnancy On Maternal Mortality.

(In Alphabetical Order) 13 Countries With High Maternal Mortality Ratio & Risk Of Maternal Death –

Where 36% – 76% Of Girls Under 18 Years Of Age Impregnated Through Underage/Child/Forced ‘Marriage’: Cameroon, Central African Rep, Chad, D.R. Congo, Guinea, Liberia, Malawi, Mali, Niger, Nigeria, Sierra Leone,Somalia, South Sudan.

Important Notes – Including Global, Regional & National Trends
See Scorecard & Factsheet For More Info
  • In high-income countries
    – virtually all women have at least 4 antenatal care visits, are attended by a skilled health worker during childbirth and receive postpartum care.
  • In low-income countries
    – just over a third of all pregnant women have the recommended 4 antenatal care visits.
  • Maternal mortality is higher
    – in women living in rural areas and among poorer communities.
  • Almost all maternal deaths (99%) occur in developing countries
    – More than half of these deaths occur in sub-Saharan Africa and almost one third occur in South Asia.
  • Developed & Developing Country MMR:
    The maternal mortality ratio in developing countries in 2013 is 230 per 100,000 live births versus 16 per 100,000 live births in developed countries.
  • Maternal health and newborn health are closely linked –
    Almost 3 million newborn babies die every year, and an additional 2.6 million babies are stillborn.
  • Some key factors preventing women from receiving or seeking care during pregnancy and childbirth are:
–        Cost of accessing healthcare/Poverty
–        Distance to healthcare facilities
–        Lack of information on reproductive,
          maternal health
–        Inadequate services in communities
–        Negative cultural practices – including
         restrictions of women’s right to movement
         and healthcare
Maternal Mortality By Percentages & Absolute Numbers
  • Globally
    – there were an estimated 289,000 maternal deaths in 2013, a decline of 45% from 1990.
  • Sub-Saharan Africa region alone
    – accounted for 62% (179,000) of global deaths followed by Southern Asia at 24%.
  • At the country level
    – the two countries accounting for one third of all global maternal deaths are India at 17% (50,000) and Nigeria at 14% (40,000).
Lowest & Highest Maternal Mortality Ratio (Deaths Per 100,000 Live Births)
  • 6 African countries had low MMR for the period of less than 100:
    Algeria (89); Mauritius (73); Cabo Verde (53); Tunisia (46); Egypt (45); and Libya (15) – i.e. maternal deaths per 100 000 live births respectively.
  • The ten African countries with lowest MMR
    – maternal deaths per 100 000 live births are: Botswana (170); South Africa (140); Namibia (130); Morocco (120) Algeria (89); Mauritius (73); Cabo Verde (53); Tunisia (46); Egypt (45); and Libya (15).
  • By sub-regions:
    North & Southern Africa have the countries with lowest MMR
  • By sub-regions:
    West & Central Africa have the countries with highest MMR
Lowest & Highest Life Time Risk Of Maternal Death.
  • The 10 countries with lowest Life Time Maternal Death Risk in Africa for the period are:
    Libya 1 in 2,700; Tunisia 1 in 1,000; Mauritius 1 in 900; Cabo Verde 1 in 740; Egypt 1 in 710; Algeria 1 in 380; South Africa 1 in 300; Morocco 1 in 300; Namibia 1 in 230; and Botswana 1 in 200.
  • Developed & Developing Country Life Time Risk:
    The estimated lifetime risk for maternal mortality in developing regions is 1 in 3700 in comparison to developed regions where the lifetime risk is 1 in 160.
  • By sub-regions: West & Central Africa have the countries with highest Maternal Death Risk
    – influenced strongly by adolescent pregnancies resulting from underage/child/forced ‘marriage’
  • By sub-regions: North & Southern Africa have the countries with lowest Maternal Death Risk
    – taking into account that Southern Africa would have made more progress if not for HIV/AID related maternal deaths.
Births Attended By Skilled Health Personnel
  • Only in two African countries were 100% of births – attended by skilled personnel over 2006 – 2013 – Libya & Mauritius. 
  • In five other countries Botswana, Cabo Verde, Seychelles, Algeria, and Congo 90% to 99% of births were attended by skilled personnel over 2006 – 2013
  • Overall over 50% of births were attended by skilled personnel in 35 African countries.
  • The countries in which less than 50% of births were attended by skilled personnel are:
    Angola 49%; Tanzania 49%; Zambia 47%; Guinea 45%; Kenya 44%; Madagascar 44%; Togo 44%; Guinea Bissau 43%; Central African Republic 40%; Nigeria 38%; Niger 29%; Sudan 20%; Mozambique 19%; Chad 17%; South Sudan 17%; Ethiopia 10%; Somalia 9%.
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Factsheet & Scorecard Research, Analysis, & Design By Africa Health, Human & Social Development Information Service (Afri-Dev. Info); & Afri-Dev Parliamentary Support Network; With Africa Coalition On Maternal Newborn & Child Health . © 2015. Kindly Acknowledge / Cite As Used.